Lasik after 3 years.

[Roger]

I did my lasik 3 years ago. I guess my problems are not unique but will post anyway to see if anyone has any feedback. I was -0.7 both eyes before operation and the machine was Carl Zeiss MEL 80. My pupil size is around 7.5mm. After surgery, on eye chart, my right eye is 20/20. Left eye has slight astigmatism and maybe -0.025 left behind. My recovery took up to six months, during the early days, there was a thick midst

As of now, basically, I see everything like through a plastic shield, it's like the eyes are covered by vaseline or something. The vision is kind of foggy and lacks details. Peripheral vision is worse than central vision. Even mildly dim light setting is horrible. I guess some may call it glare and double vision. I just can't see anything sharp and it's like I am always guessing my way around rather than seeing my way around. Halo is a given but that's tolerable.

Also, dry eyes. I put on preservatives free eye drops but it doesn't seem to help the dry feeling or the vision clarity.

I consulted another eye doctor and he said this could be high order aberration and having another surgery is the only option, which I am very hesistant.

I only read more about the different equipments now and do wonder if MEL 80 was not as advanced and some other machines capable of wavefront customized lasik like Zyoptix will be better.

I also read that Mel 80 is capable of "optimized wavefront". How does this really compare to customized wavefront and is there any way I can tell if the doctor used the optimized technology but not the standard conventional lasik? I did get a printed report of the surgery but not knew if it's something the report will say specifically.

Many thanks for your advice.

[LasikExpert]

IAs of now, basically, I see everything like through a plastic shield, it's like the eyes are covered by vaseline or something. The vision is kind of foggy and lacks details. Peripheral vision is worse than central vision. Even mildly dim light setting is horrible. I guess some may call it glare and double vision. I just can't see anything sharp and it's like I am always guessing my way around rather than seeing my way around. Halo is a given but that's tolerable.

Do your symptoms dissipate with corrective lenses? Do they dissipate in bright light? Have you tried rigid gas permeable (RGP) contact lenses?

Also, dry eyes. I put on preservatives free eye drops but it doesn't seem to help the dry feeling or the vision clarity.

Please see our articles on Lasik and dry eyes and Lasik dry eye treatment.

I consulted another eye doctor and he said this could be high order aberration and having another surgery is the only option, which I am very hesistant.

It's good that you received a second opinion. What did the second doctor say about the dry eyes? If you read our article on Lasik and halos/starbursts you may understand why enhancement surgery may be the only method to resolve the underlying problem.

I only read more about the different equipments now and do wonder if MEL 80 was not as advanced and some other machines capable of wavefront customized lasik like Zyoptix will be better.

The MEL 80 was probably an appropriate laser because of its ability to treat a large area.

I also read that Mel 80 is capable of "optimized wavefront". How does this really compare to customized wavefront and is there any way I can tell if the doctor used the optimized technology but not the standard conventional lasik?

Customized wavefront-guided Lasik is when a wavefront analysis of the patient's eye is taken and the treatment plan is based upon that data. Wavefront-optimized is when the manufacturer uses wavefront data to optimize the ablation pattern universally. The laser manufacturers make a lot of claims why their particular platform is better, but several studies indicate that wavefront-optimized is nearly equal to custom-wavefront in Lasik results.

An advantage of the wavefront-optimized is that it is able to treat a larger area than custom-wavefront.

[Roger]

Glenn,

Not sure what's RGP. I will search more into that. Since I have only little degree of astigmatism and short-sightedness left in the left eye, not sure the normal corrective lens will help.

The second doc didn't say anything on the particular reasons of the dry eyes.

The blur is better under bright sun light. But even if it's very bright, things still look slightly out of details.

If I am to do an enhancement, what should I look out for then? What technology is needed?

Thanks a lot.

Roger

[Anyman]

At the 3 year mark you quite possibly have passed whatever statute of limitations exists in your area. If you were the victim of malpractice then you may have already lost your ability to take legal action, assuming errors were committed. Were you duped into not taking any action by endless promises of "it'll get better", only to find to the contrary?

Were I in your shoes at this point I doubt I'd be so calm. Have you found out exactly why this is happening to you? What remedies do you have both to repair your vision & ensure others aren't similarly afflicted?

You need answers and you need some darned good ones. You deserve no less.

[LasikExpert]

Not sure what's RGP.

RGP is a rigid gas-permeable contact lens. RGPs can provide superior vision correction to glasses or conventional soft contacts because they are able to mildly reshape the cornea, thereby reducing imperfections that can lead to poor vision quality.

Since I have only little degree of astigmatism and short-sightedness left in the left eye, not sure the normal corrective lens will help.

You may be surprised. Even a small amout of astigmatism or myopia (nearsighted, shortsighted) vision can cause halos, starbursts, glare, and similar vision limitations.

The second doc didn't say anything on the particular reasons of the dry eyes.

This is an area that needs resolution. Perhaps you should contact the doctors' offices and ask if they could look at your charts and recommend treatment for your ongoing dry eye issues. Restasis or punctal plugs may be appropriate, as well as other remedys mentioned at our Lasik dry eye treatment article.

The blur is better under bright sun light. But even if it's very bright, things still look slightly out of details.

This is consistent with a small amount of astigmatism and myopia.

If I am to do an enhancement, what should I look out for then? What technology is needed?

Enhancement surgery is virtually the same as initial surgery except a new Lasik flap will not be needed (lift existing flap) and the doctor knows better how your eye responds to laser treatment. You need to evaluate enhancement surgery just as you would initial surgery.

[Roger]

Enhancement surgery is virtually the same as initial surgery except a new Lasik flap will not be needed (lift existing flap) and the doctor knows better how your eye responds to laser treatment. You need to evaluate enhancement surgery just as you would initial surgery

Glenn,

Please let me ask some more questions. The lasik caused the HOA/glare and I am not quite clear how another lasik can improve the HOA/glare. I mean, if the technology is good enough to measure, predict and treat HOA/glare, should it not be avoided in the first lasik? If I do a surgery again and they just go through the same procedure and step, with the same or other equipment, how can it make any difference?

While lasik always involves risk and some articles say lasik always induce HOA/glare, I hope to get better understanding of the process and what to be expected.

Many thanks.

Roger

[LasikExpert]

It appears that your vision problems relate to undercorrecton and residual astigmatism. Once these two are resolved, your vision quality should improve.

Although Lasik knowledge and technology are quite advanced, it is impossible to predict with absolute certainty what an individual's corneas are going to do. This is why even appropriate treatment plans do not provided the desired result 100% of the time. An advantage of enhancement surgery is that the desired changes are usually quite small, so the trauma of surgery is less severe, and the doctor better knows how your individual corenas react to surgery.

[Roger]

It appears that your vision problems relate to undercorrecton and residual astigmatism. Once these two are resolved, your vision quality should improve.

Although Lasik knowledge and technology are quite advanced, it is impossible to predict with absolute certainty what an individual's corneas are going to do. This is why even appropriate treatment plans do not provided the desired result 100% of the time. An advantage of enhancement surgery is that the desired changes are usually quite small, so the trauma of surgery is less severe, and the doctor better knows how your individual corenas react to surgery.

Many thanks.

[Roger]

If anyone out there in the forum has experienced poor night vision, please kindly share if you have considered an enhancement or the experience of having one.

Many thanks.

[LasikExpert]

Roger,

Many many people have had night vision problems resolved by simply resolving the residual refractive error. You can experience the probable result of enhancement surgery on night vision by wearing glasses that fully correct your residual refractive error.

For other's results, search our website for keyword "enhancement".

[Anyman]

Lasikexpert- I note your post on how enhancements can help night vision.

Are some issues more or less likely to be resolved with a 2nd procedure? In other words, are some issues more suited to enhancement than others? For example, are starbursts commonly resolved with enhancements and glare less so?

Thanks in advance

[LasikExpert]

Enhancement surgery can resolve residual or induced refractive error including astigmatism, may expand the treatment zone, and may make more regular an irregular cornea. If glasses improve vision and reduce starbursts, then enhancement surgery is likely appropriate. If contact lenses improve vision more than glasses, then enhancment surgery may be appropriate. Your surgeon should be able to advise you of what symptoms are likely to be improved with enhancement surgery.

[Roger]

Enhancement surgery can resolve residual or induced refractive error including astigmatism, may expand the treatment zone, and may make more regular an irregular cornea. If glasses improve vision and reduce starbursts, then enhancement surgery is likely appropriate. If contact lenses improve vision more than glasses, then enhancment surgery may be appropriate. Your surgeon should be able to advise you of what symptoms are likely to be improved with enhancement surgery.

Glenn,

I did search the forum and hope you can help with more questions.

Does that mean I should try glasses and contact lens first? My measurement is only very slight short-sightedness and astigmatism on left eye, what can I wear for the right eye?

In order to treat HOA, what machines should be used for measuring and surgery? I am trying to find the clinic with the right technology and try not to get biased diagnosis from doctors because of their equipment availability.

Thanks.

Roger

[LasikExpert]

Does that mean I should try glasses and contact lens first?

When your doctor does a refraction (which is better, one or two?) the doctor is putting lenses in front of you that resolve the refractive error as much as lenses are able. Whatever the lenses resolve, it is conceivable that enhancement surgery would resolve the same. Simply put, if your vision problems are resolved with glasses, then they may be resolved with enhancement surgery. By wearing glasses you can get a real-world view of what vision would be like after enhancement surgery. This can be an excellent "try before you buy" test.

Depending upon the exact nature of the vision problem it may be possible for enhancement surgery to provide even better vision than what you see with glasses, but that is less predictible. If you are happy with vision with glasses, then you are likely to be happy after enhancement surgery. If you are unhappy with vision with glasses, then you may be happy after enhancement surgery. This is where advice of a good surgeon is helpful.

My measurement is only very slight short-sightedness and astigmatism on left eye, what can I wear for the right eye?

Yes. If the left eye does not need correction, then the lens in the left side of the glasses will be blank.

In order to treat HOA, what machines should be used for measuring and surgery? I am trying to find the clinic with the right technology and try not to get biased diagnosis from doctors because of their equipment availability.

Ask if the available laser uses custom wavefront-guided technology, as opposed to wavefront-optimized or conventional technology. Wavefront-guided would likely provide the best available result if the issues are able to be resolved with wavefront technology. You should not choose your doctor's tools for you. The doctor should know the limits of his/her tools and techniques and select what is best for your unique circumstances, but you are wise to select a doctor who has wavefront-guided technology available.

[Roger]

Glenn,

Thanks for the information. I have to say the vision doesn't improve much when the doctor gave me the lens test....Not sure what to expect...

I think Zyoptix is the only wavefront guided technology, is that right? The others like Allegretto and MEL 80 are only wavefront-optimized.

Thanks again. I am so desparate.

Roger