Wrong Procedure -- Can it be corrected?

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.

Wrong Procedure -- Can it be corrected?

Postby 4angelz » Thu Apr 15, 2010 8:04 pm

In January, 2008, I had LASIK correction ---- but with the wrong measurements programmed!

the correct prescription was:
OS: -4.5 -1.5 x175; I received -7.75 -1.25 x170
OD: -5.00 -2.25 x180; I received: -5.75 -1.5 x10

For some unknown reason, my consensus prescription was not used ---- and I ended up with the wrong correction! I was told that is was just a mix-up and to come back in 3 months for an enhancement. I was not comfortable with that, so I went to another specialist for a second opinion. The second doctor examined my eyes at length for over 6 months. His finding: there was not significant corneal tissue left to do an "enhancement".....especially due to the fact that I was supposed to have monovision correction. My corneas are now measuring at approximately 425 microns. There is a larger cup to disk ratio in my right eye. Two different doctors; two different answers.


I need to know if there is an answer.....Can an enhancement to achieve the original prescription be safely performed?
4angelz
 
Posts: 2
Joined: Thu Apr 15, 2010 4:48 am

Re: Wrong Procedure -- Can it be corrected?

Postby LasikExpert » Thu Apr 15, 2010 9:32 pm

There are many factors to consider, however enhancement surgery may be possible.

A healthy cornea will remain stable as long as at least 250 microns of tissue remains untouched - more untouched tissue is always better. The second opinion surgeon measured 425 microns. I will assume that this is the thinnest measurement across the cornea and that it includes the Lasik flap. It is also likely the measurement is at the center of the cornea, which is naturally thinner than the periphery. A Lasik flap is commonly about 110-150 microns thick. Subtracting a 150 micron flap from the 425 micron total remaining corneal thickness leaves about 275 microns untouched. This is close to the 250 margin, but this is not the whole story.

Your original surgery was for myopia (nearsighted, shortsighted) correction. This removes tissue in the center of the cornea (clear front of the eye). You have been overcorrected into hyperopia (farsighted, longsighted) vision. Surgery to correct hyperopia removes tissue in a ring from the outer edges of the cornea. It is possible that there is enough untouched corneal tissue at the outer edges that enhancement can be safe, but a careful mapping of the cornea and analysis of the intended tissue removal compared to the current thickness is necessary.

It is possible that rather than lifting the Lasik flap and removing tissue underneath, the tissue can be removed from the flap itself. This is called PRK on the Lasik Flap. The current untouched corneal bed would remain the same.

Following you for six months was wise as regression back toward the correct refractive error was likely during the healing stages. Do you know your current eyeglass 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: Wrong Procedure -- Can it be corrected?

Postby 4angelz » Fri Apr 16, 2010 4:11 am

Thanks for the quick response! It sound like this will obviously extend beyond a simple enhancement....Your stated "a careful mapping of the cornea and analysis of the intended tissue removal compared to the current thickness is necessary" Is there a specific test for this? I do not want to take any risks!

My current prescription is:
Right: +1.00 -1.75 x145 (ADD 2.25)
Left: +1.75 -1.50 x31 (ADD 2.25)

I'm not sure what it all means.....I'm in bi-focals........My prescription has gone through a number of changes over the past 2 years. My optometrist said that my corneas were quite malleable. I tried 4 different pairs of soft contacts, but they didn't fit well. Then I was put into reverse geometry lens. I had the best vision with the RG, but when I removed them for 2 weeks, my prescription changed enough so that vision was distorted with the lens. Also, I understand that reverse geometry lens do not let oxygen into the eye and can compress the cornea.....I also have a moderate to severe oblique astigmatism.

At this point, I'm thinking that the safest route would be to keep the glasses.....I'm starting to develop cataracts ----- (thinking until the cataracts are more mature) then have cataract surgery next year???

Thanks so much for your help.....
:)
4angelz
 
Posts: 2
Joined: Thu Apr 15, 2010 4:48 am

Don't get enhancements.

Postby PRKorIntacs » Fri Apr 16, 2010 7:49 am

Wow this is scary. I am looking to get PRK and it would be terrible if he did the wrong programming and severely overcorrected me. That's malpractice. Ill have to be sure he programmed it right and perhaps check the programming myself. Im also thinking of buying a "guarantee". It is also terrible to get cataracts so soon after lasik. Did you have any signs of cataracts before lasik? What's your age? I read average age for cataracts is 65. It would be malpractice then. Your surgeon definately should refund you the full cost of lasik since you didn't benefit at all from it. Don't get any enhancements, they won't help and would be pointless as you said. When you get your cataract surgery, hopefully they don't miscalculate the IOL. You may want to ask for -1.5 or so that way, you are less likley to end up hyperopic. I am asking for -1, maybe -1.5 with PRK in order to reduce the risk of being hyperopic and to stay out of bifocals.
PRKorIntacs
 
Posts: 90
Joined: Thu Feb 25, 2010 5:43 am

Re: Wrong Procedure -- Can it be corrected?

Postby LasikExpert » Fri Apr 16, 2010 9:26 am

4angelz wrote:Is there a specific test for this? I do not want to take any risks!


Corneal topography with thickness is quite common for Lasik doctors. You probably have several in your medical chart already. All current versions of the popular lasers will provide an estimated ablation depth map that can be compared to the thickness map.

4angelz wrote:My current prescription is:
Right: +1.00 -1.75 x145 (ADD 2.25)
Left: +1.75 -1.50 x31 (ADD 2.25)


You are moderately hyperopic with significant astigmatism and are presbyopic (that is the bifocal). Hyperopia and presbyopia can present as poor vision quality at all distances.

4angelz wrote:My optometrist said that my corneas were quite malleable.


This is another good reason to have followed your actual recovery for six months. You may want to suggest your doctor consider if CLAPIKS is an appropriate treatment for your situation.

4angelz wrote:At this point, I'm thinking that the safest route would be to keep the glasses.....I'm starting to develop cataracts ----- (thinking until the cataracts are more mature) then have cataract surgery next year???


This may be a good idea. Cataract surgery (see Refractive Lens Exchange (RLE)) would resolve the hyperopia, but not the astigmatism so well. A combination of cataract surgery for hyperopia and Lasik enhancement for astigmatism may be appropriate, or cataract surgery with a toric intraocular lens (IOL). All things to discuss with your surgeon.
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


Return to Had It A While Ago

Who is online

Users browsing this forum: No registered users and 2 guests