Corneal Ectasia...

Post your questions and start your research in this forum if more than three months ago you had any type of surgery to reduce the need for glasses and contacts.

Corneal Ectasia...

Postby saram_ » Tue Mar 30, 2010 12:20 pm

I had my Lasik done a few years back in Seoul, Korea in 2006. Things were going really great for a long time BUT as of now I have a worrying complication... After noticing that my eyesight was deteriorating especially in one eye I went for a check. The clinic then told me about this kind of condition that I have since known to be Corneal Actasia from my own research. This is quite a serious complication and I hope my eyes will be ok but its very worrying..

Basically the cornea became too thin after the surgery and now there is too much pressure coming from behind.

I was told back then to visit again in 2 months time (which is very soon). Ahh..so since then Ive been searching wide and far. The first thing I noticed was that this is one of the most feared complications of LASIK (not LASEK). It can potentially lead to a corneal transplant in its worst case..
Ahh, anyway this was the first i had ever heard of this and leaves me worried and disappointed at the same time..

I have since uncovered more promising news and now I see that the condition can be controlled with Corneal Cross linking with Riboflavin..( all going well..)

My eyesight was - 1.3 or something before Lasik and I was told I was the ideal candidate for LASIK..Even after a year or more after surgery everything looked to be going great.. My eyesight was perfect after the surgery and I recommended to everybody.

I think this problem will affect a lot of people and its definitely something to consider about.. Seems the LASEK might be better after all.. I cannot redo the surgery and also my eyes have deteriorated..

I will know more in a few weeks when I go back.....

I still don't regret doing the surgery and the clinic said that with all the advances in eye care etc...the prob can be overcome.. FINGERS CROSSED!

Can you please offer some insight on what to expect?

Thank you..

Saram
saram_
 
Posts: 5
Joined: Mon Mar 29, 2010 3:45 pm

Re: Corneal Ectasia...

Postby PRKorIntacs » Tue Mar 30, 2010 9:29 pm

Did you mean -13? What's your prescription now? You may want to consider intacs to stabalize your ectasia and correct your residual prescription.
I am looking into PRK instead of lasik for this and many other reasons. From what I read, PRK has less risks. The only downside is a long healing period.
PRKorIntacs
 
Posts: 90
Joined: Thu Feb 25, 2010 5:43 am

Re: Corneal Ectasia...

Postby saram_ » Wed Mar 31, 2010 11:13 am

Actually I don't have a prescription at this time. My eyesight is not very poor right now.. It is certainly a lot better still than before the surgery.. I'm just hoping it doesn't deteriorate more.. I do some some small black things from time to time though...ahh

As i said I only found out about this two months ago.. I am going back to the clinic in the next week or so and they will tell me the best course for me based on my progress in 2 months or so..
I could probably do with a pair of spectacles but I will wait it out..

I am up for whatever, -intacs, cross linking etc..

Hmm.. -1.3 were the calculations they used at the clinic.. I am not sure what that is in other measurements.. I was short sighted with astigatism..but my eyesight was never really terrible.. 2.0 is perfect.... After the surgery and for quite a long time my eyesight was 2.0 or better..

A concern for me is that...I have never worn (couldn't, despite some efforts) to wear contact lens.. The whole putting in and out etc would be too much for me I think.. I am very squemish about my eyes. Anyway- i will prob do whatever to get my sight treated.. :(

Cheers,

Saram
saram_
 
Posts: 5
Joined: Mon Mar 29, 2010 3:45 pm

Re: Corneal Ectasia...

Postby LasikExpert » Wed Mar 31, 2010 4:22 pm

I find it very difficult to believe that your self-diagnosis of corneal ectasia is accurate. A refractive error of 1.30 diopters would require a very minimal amount of tissue removal. A normal healthy cornea will remain stable so long as at least 250 microns of tissue remains untouched (more is always better). You would have required a very, very thin cornea for conventional Lasik to pass beyond this point.

Did your doctor diagnose ectasia upon examination? What is your current prescription.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
Site Admin
 
Posts: 3309
Joined: Fri May 12, 2006 6:43 am
Location: California

Re: Corneal Ectasia...

Postby saram_ » Thu Apr 01, 2010 12:27 pm

I wasn't told I had Corneal Ectasia BUT... this was how they explained it..

There are a few reasons why peoples eyes may deteriorate after LASIK.. 1. most common way is due to growth again...and re-doing the surgery again is the treatment...No big prob..
2. There is too much pressure placed on the front part of they eye (cornea) from the back. They said this is what happened with me. The cornea is too thin now..

They said it was very rare, 1 in 2000 or something.. I asked the nurse there if she ever came across this before and she said just once. I asked what was the outcome and she said they prescribed hard contact lens for the patient..

As I said..I am due to go back to visit again soon to check my progress over 2 months.... I will be diagnosed then or whatever..

I don't have a prescription now.. My right eye is a lot worse than my left eye. My left eye is compensating now. At this moment my eyesight is not too bad...

Now everything the clinic told me and from my own research into stuff...the conclusion I came up with was Corneal Ectasia-- (even the fact that one eye is affected first is another hint..)

If it is still too difficult to understand that i have Corneal Ectasia...then please tell me what it is I have...

If yes...it seems like this is ectasia...then please put my mind at ease and let me know where I stand...

Thank You
saram_
 
Posts: 5
Joined: Mon Mar 29, 2010 3:45 pm

Re: Corneal Ectasia...

Postby LasikExpert » Thu Apr 01, 2010 4:13 pm

The doctor's diagnosis of forward vaulting of the cornea because it was made too thin by the surgery is corneal ectasia.

There are a few probable reasons for the result. If the Lasik flap was cut too deep into the corneal tissue. This is indeed very rare these days. Also, many doctor make an intraoperative measurement of the residual corneal bed underneath the flap to affirm that the projected and actual flap thickness/incision depth are the same. To be honest, that probably would not have made much difference in your case. With your very low refractive error, only about 18 microns of tissue would have been removed by the laser. Even if the laser treatment had been aborted, once the flap was that deep the structure of the cornea was compromised.

Another reason is that you may have had undiagnosed (undiagnosable?) corneal disease, such as keratoconus, that had already weakened the cornea. Even if the Lasik flap was the correct depth, the cornea couldn't withstand the disruption due to the disease.

It is also possible that the intraocular pressure (IOP) within the eye has raised dramatically and is pushing forward the cornea, however your doctor would have undoubtedly performed this test and you do not report that finding.

The most rare is that the cornea is healthy, the flap was the proper depth, everything was performed textbook perfect, but your cornea reacted in a way that could not be predicted.

The rigid gas permeable contact lens would likely be the response of choice. It is least invasive and acts like a splint to support the cornea and correct any refractive error. IOP reducing medication may help too. A combination of the two may be in your future. A full corneal transplant is possible, but from your symptoms does not sound like a likely recommendation. What treatment is best will depend upon where you are in a couple of months.

Please keep us posted on your progress.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
Site Admin
 
Posts: 3309
Joined: Fri May 12, 2006 6:43 am
Location: California

Re: Corneal Ectasia...

Postby saram_ » Mon Apr 05, 2010 1:38 pm

Ok..well thanks for the info. With regards the contact lens.. Do you you think i will just need one in my poorer right eye or two for both eyes..
Is my left eye going to deteriorate too..

Erm.. as a guy who really dislikes the idea of wearing contacts (tried once and never again) is there any other treatments that you would think could be good or possible too? I realise as you say though those treatments may be more invasive but I can see myself having a REALLY difficult time with contacts..

They did give me some eye drop medication for my eyes..as well and also mentioned contact lens so it seems ye have the same general idea..

I will go back this week at some stage. It's been over two months since my last visit now..

Would the idea of intacs be completely off limits you think.. or Crosslinking with riboflavin which I see has shown lots of promise?


Anyway, I will report back with my latest news..

I just hope I will be ok and as the clinic said with the all the developments in eye care etc...there are lots of treatments for everything..
I am trying to remain as positive as possible.. :}


Dec
saram_
 
Posts: 5
Joined: Mon Mar 29, 2010 3:45 pm

Re: Corneal Ectasia...

Postby LasikExpert » Mon Apr 05, 2010 4:42 pm

saram_ wrote:Ok..well thanks for the info. With regards the contact lens.. Do you you think i will just need one in my poorer right eye or two for both eyes..
Is my left eye going to deteriorate too..


This depends totally upon the underlying reason for the forward vaulting of your cornea. If it is disease, progression of the disease may affect the other eye. For now, only the one eye may need a contact lens.

saram_ wrote:Erm.. as a guy who really dislikes the idea of wearing contacts (tried once and never again) is there any other treatments that you would think could be good or possible too?


Yes. If the cornea stabilizes, then spectacles can correct the refractive error. If the cornea does not stabilize, then Intacs and/or corneal crosslinking may be an appropriate treatment. If the cornea stabilizes fully, then PRK on the Lasik flap may be considered.

saram_ wrote:I am trying to remain as positive as possible.. :}


Despite your current concerns, there seem to be many options and the actual underlying problem is not yet determined. It seems being positive is reasonable.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
Site Admin
 
Posts: 3309
Joined: Fri May 12, 2006 6:43 am
Location: California

Re: Corneal Ectasia...

Postby saram_ » Wed Apr 07, 2010 12:40 pm

Ok so here is the latest..

I was back at the clinic this evening...

It has been over two months since my last visit. My eyes have appeared to have stabilised. I was really happy to hear this..


The clinic told me there are treatments that I can do but its better for me to wait a while as these techniques are relatively new- crosslinking and also placing a kind of ring on the affected area.

They said that one hard contact lens on my right eye could help my vision but would make no difference with the treatment of my ectasia. I explained to them about the difficulties i had with contacts before and they understood well.
I do have astigatism on my right eye and thus....spectacles are not a great option as one of my eyes is almost perfect anyway..

So, I will bide my time.. and check again in about 6 months or less and then take it from there.

I have some more eye drops to put in..BUT after this pack I don't need to use anymore..

I am very relieved now and I can safely (almost) say again that I am still delighted I choose LASIK surgery..
saram_
 
Posts: 5
Joined: Mon Mar 29, 2010 3:45 pm

Re: Corneal Ectasia...

Postby browneyedgirl70 » Wed Apr 07, 2010 4:46 pm

Thank you for the update, and I am glad things are going better. If anything changes please update us again!
browneyedgirl70
 
Posts: 21
Joined: Thu Mar 11, 2010 10:04 pm

Re: Corneal Ectasia...

Postby PRKorIntacs » Thu Apr 08, 2010 12:21 am

Im glad to hear your ectasia is under control. What's your prescription in each eye? Are you a candidate for intacs in one or both eyes?
PRKorIntacs
 
Posts: 90
Joined: Thu Feb 25, 2010 5:43 am


Return to Had It A While Ago

Who is online

Users browsing this forum: No registered users and 1 guest

cron