5 Months Post Lasik

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.

5 Months Post Lasik

Postby DryEye » Tue Nov 14, 2006 2:13 pm

I am 5 months post lasik and still have to use artificial tears to see clearly?
I never had to use so many tears while in my soft contacts.
I did develop microstriae after Lasik, but that has been getting better with time. I still see ghosts with green lights, but not all the time.
Do you think the ghosting & crispness of vision resolves (eye dryness) itself with time, so that I can basically just wake up and see like I do when I use artificial tears in my eyes or should I be talking enhancement and/or contact lens wear! Is it possible that the issues I speak about get better even after 6 months (The 6 month to 1 year period of time) Maybe then see what options exist?
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Postby LasikExpert » Wed Nov 15, 2006 7:16 am

Microstriae is a problem that commonly resolves on its own, but it takes months, not weeks. Long term Lasik induced dry eye is a known complication, however continued resolution may occur even beyond the 5-6 month postop mark.
Last edited by LasikExpert on Sun Nov 19, 2006 1:09 am, edited 1 time in total.
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5 1/2 Month Post Op

Postby DryEye » Sat Nov 18, 2006 11:13 pm

Went in to see regular eye doctor. Did Orbscan and says it shows a slight residual astigmatism? He says I see 20/20 and that if I wanted I could get a pair of glasses for the astigmatism to be used as I see fit? When he did the 4 opter machine it looks crisper when he notched it up once or twice.
I see my corneal specialist in January and will wait to hear what he has to say since he has been right on since I was sent to him by the individual who did my lasik.
I feel I was slightly undercorrected by the custom procedure - My contacts were -3.25 and -3. I remember the machine doing -2.59 and -2.65? Why does it do this? I didn't have stoplight issues with my contacts and my vision was more consistent.
The corneal speicialist back in october said he thought the stoplights would get better. In January I will be 7 months post op.
I don't always have the ghost/almost double green lights (maybe 10% of time without) and can see how some people get the WOW with Lasik, but I think that i was underdone by just enough to not be happy and to top it off I had microstriae and dry eyes from all this. Not a fun 5 1/2 months at all.
So, do you think it could get better from here and get me that total lasik WOW package? Should enhancement come into play (not happy)? Is it better to wait a full year, consider some other permanent alteration that doesn't suck your eyeball up, occasional glasses wear and will the cornea (vision wise) get worse overtime anyway where I will definetely need and enhancement and/or contacts?
If so, can contacts (soft) be worn without damaging a post lasik cornea?
Hindsight is 20/20, but so far all of this has been difficult and my biggest concern is my eye health. Crazy because you read and hear about so many people getting lasik done and so many experienced doctors not having concern over the procedure.
By the way I am lucky to have been sent to my corneal specialist at a major hospital/university. Just from seeing him the past few months vs the others I have been able to see a true pro. Wish I knew him before I did this.
Thanks for the advice & the site!
Last edited by DryEye on Sun Nov 19, 2006 5:29 pm, edited 1 time in total.
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Re: 5 1/2 Month Post Op

Postby LasikExpert » Sun Nov 19, 2006 6:51 pm

DryEye wrote:I feel I was slightly undercorrected by the custom procedure - My contacts were -3.25 and -3. I remember the machine doing -2.59 and -2.65? Why does it do this?


It is not unusual for contact prescriptions to be slightly different than the programmed laser correction. There is variability in treatment that can be caused by internal and external factors. If the relative humidity was below normal, the laser would have more energy at the cornea because it would have passed through less water in the air. If the atmospheric pressure was lower than normal the laser would have more energy at the cornea because it would have passed through less air. Each laser is unique and has its own "personality". The surgeon may have learned after reviewing previous outcomes that programming a slight undercorrection is more likely to provide the desired outcome. Additionally, correction of refractive error within the cornea with a laser has slightly different optics than correcting refractive error on the cornea with contacts.

DryEye wrote:I didn't have stoplight issues with my contacts and my vision was more consistent.


Consistentancy with contacts may be because the contact acted as an additional support for the cornea, providing stability.

Only you know how disruptive ghosting on a green stoplight 10% of the time is to your lifestyle, but ask yourself this: If I was told before surgery I would not need glasses but I might have ghosting of green traffic lights 10% of the time, would I have had surgery?

Some people may consider green traffic light ghosting 10% of the time a worthwhile trade-off to no longer need glasses or contacts.

DryEye wrote:So, do you think it could get better...


It is quite possible. Microstriae resolves itself, but over months, not weeks. The brain figures out how to ignore information it does not want. This is why you don't see the blind spot where the optic nerve enters the eye. Your brain has learned to just ignore it. Needing artificial tears may be due to refractive surgery related dry eye, underlying natural dry eyes, or because you are now taking better care of your eyes than you did before surgery.

DryEye wrote:Should enhancement come into play (not happy)?


If your only refractive error problem is green traffic light ghosting 10% of the time, absolutely not.

DryEye wrote:...can contacts (soft) be worn without damaging a post lasik cornea?


In almost all cases, the changes from Lasik do not limit the use of contact lenses.
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Postby DryEye » Sun Nov 19, 2006 7:17 pm

Actually, the ghosting is more like 80-90% of the time on stoplights. The 10% I mentioned was without seeing a ghost. I do think that the slight undercorrection is the difference here, but also that it may actually get there over the next couple of months. I say that because when I wake up they tend to see better and as the day goes on they feel more tired and dry like? Who knows? I just wish I got what everyone else got initially, but I'll take it for sure if it takes me a few more months!
Does that sound reasonable - that it may take a little more time and that the little difference in correction may work itself out into my favor?
Someone also told me to take Vitamin B-12 - it helps with the corneal nerve regrowth and that that may be the little factor here.
Thanks!
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Postby LasikExpert » Sun Nov 19, 2006 7:46 pm

Sorry, I had the percentages backward.

If the problem is refractive error, the use of a contact lens may resolve the problem.

The Vegatarian Society has an interesting article on Vitamin B12.
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Postby DryEye » Mon Nov 20, 2006 3:46 am

Today I seemed to have less of the stoplight issue, but I do think I am slightly off for now at least. Things have gotten better since June for sure, so I am wondering if I may need just a little more time with healing since there was microstriae involved?
I picked Custom instead of conventional because I thought that custom would get me as close to my contact lens prescription (a better result) over custom. Shouldn't that be the case or is it better to have gone with a more known surgeon who would've done non-custom? Maybe he decides to do more non-custom because he has seen that custom doesn't get people the at the money result?
Hopefully, your answer here helps others who are or will be in a similar scenario?
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Postby LasikExpert » Mon Nov 20, 2006 4:07 am

It appears that what is at issue for you is single image ghosting with a particular light wavelength (green). It does not seem that this is predictable or related to a particular technique or technology.

About the only way to be absolutely sure to avoid microstriae is to have a surface ablation technique like PRK, LASEK, or Epi-Lasik, all of which do not use a flap of stromal tissue so striae would be impossible.
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Postby DryEye » Mon Nov 20, 2006 4:17 am

So, if it ever one day does come down to an enhancement (for that extra .50 crispness and slight astigmatism - that is if it doesn;t still clear up in time) knowing that I had microstriae would it be best to do PRK or lasik again?
If it were lasik would it for sure make the microstriae return and would I have the same recovery time that I have been having with this go around?
I hope all these detailed questions helps everyone and gets you more visitors and users, so that they can also post and we all keep learning!
Thanks Again
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Postby DryEye » Mon Nov 20, 2006 4:21 am

Also, if I get a pair of glasses or one week disposable contacts and get the result I am looking for then it is probably all refractive difference that may or may not clear up with a little more time and would it be possible to get it just right with an enhancement - To thread the needle so to speak, which I think i would then go with the corneal specialist who has been seeing me even if it means shelling out more money!!!!!!!!!!
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Postby DryEye » Mon Nov 20, 2006 8:30 pm

If an enhancement is needed/wanted at some point what would be the best laser and or other surgical method(s)? Is there anything out there on the horizon that may get these small details polished up without overcorrection and or other risks? My vision was stable for 3 years or so, so do you think it will stay that way or regress more overtime? If I were to do it I would want it to be only one more time unless there is some great new technology out there that makes the procedure easier and safer.
Thanks!
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Postby LasikExpert » Tue Nov 21, 2006 7:13 am

I cannot imagine anyone would provide enhancement surgery for the issues you have presented. There is no real refractive error, therefor nothing to correct.
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Postby DryEye » Wed Nov 22, 2006 5:47 pm

So, I went in last night to discuss what my vison is currently.
Before I did lasik I was (L) -3.50 -1.25 1.80 (R) -3 -1.25 1.70
After lasik (almost 6 months) I think I am (L) -25 -50 30 (R) -50 -75 15
I went to my eye doctor who I have gone to my while life. He mentioned that if I wanted I can get this light powered prescription for glassses and use them as need be. He also said that an enhancement wouldn't be recommended and that it would be difficult for a laser to get the small amount of residual astigmatism, etc. Also, soft contacts like I had wouldn't do the trick, perhaps a hybrid RGP or something. They are expensive, but right now not necessary. Hopefully, it won't come to that one day.
It took a few days for that to sink in considering I thought about having lasik done for 7 years and know a lot of people who did it and loved it from the next day. I unfortunately didn't get that package with the microstriae, something getting into my eye a few days after the procedure, dry eyes (tons of artificial tears) and the almost there prescription. Looking back on all this if I could've known what I know now I am not sure if I would've done it. I know with my contacts I didn't have the slight astigmatism or all this artificial tears usage. Hopefully things will settle from here on out & I think I will be happy in the long term.
One last thing I have noticed since last month when I wake up in the morning- I notice on the lower portion of my vision and some of the peripheral vision wavy or strobing like vision. It is not immediately upon waking, but usually after I get up and walk around. It is noticeable in the dark & with the lights on (ableit a little less with the lights on) Hard to describe. I had my retinas looked at & don't have any ocular diseases? It clears up after 30 seconds to a minute or so I think. I never noticed it before? Have you ever heard of this? I pray it is nothing serious and that it clears up on its own, so I can just move on from this. Is it something related to the pupils or the newly shaped corneas? Do you think the procedure did some damage in some way?
Thanks for the site & hopefully it continues to gather post lasik information for everyone to learn from.
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Postby LasikExpert » Wed Nov 22, 2006 6:37 pm

Follow this link to a web page about Optical Illusions. These sort of events occur in everyday life. Sometimes we notice. Sometimes we don’t. But after having eye surgery we become hyper-aware of anything to do with our eyes.

I don’t know how much, if any, of what you experience is a phenomena that existed before but was either not noticed (due to the brain’s relevance exclusion functions) or was not able to be noticed because corrective lenses did not provide the same quality of vision you have now. It just might be that the tiny imperfections you notice now were not noticeable before because your vision quality is now better.
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Postby DryEye » Sat Nov 25, 2006 5:55 pm

Interesting site, but this is something that is defintely happening and didn't happen when i wore contacts and i think just started happening in October (I had lasik in June)?
Do you think it is dry eye related, pupil related, circulatory in nature (don't have those problems), new wake up thing, etc.?
Do you think it is anything serious? I have asked a couple of my doctors, but they don't seem concerned since it only a morning thing.
Frankly, going through all this ending up slightly undercorrected is one thing, but to have this going on is beginning to worry me.
Have you ever heard of this in your research? Why would it only be on the edges of one's vision? That makes me think it may have to do with tears or pupil related, although I see it slightly less with the light on.
I did read something close to it on another board about it possibly being tears in the a.m., but it doesn't happen immediately upon awakening ususally after I get up. I do not believe it happens during the day and certainly hope it doesn't.
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