Overcorrection?

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Overcorrection?

Postby megeed » Thu Sep 21, 2006 2:57 am

Hello,

I had lasik done 6 days ago and my eyesight is not doing so well. I am 32 years old. Prior to the surgery, I was -6.8 on the right eye and -6.0 on the left without astigmatism. After the lasik, I am +2.25 -.25x142 in the right eye and +.5 -.75x175 in the left eye. The day after the surgery, the nurse said I saw 20/30 in the right eye and 20/40 with the left eye. I think that it is actually worse because I printed out an eye chart and I can barely read the 20/40 line with both eyes. My eyesight near and far is pretty blurry, and fluctuations during quite a bit. I guess the questions I have are.
1) Why would the doctor over correct me so much in one eye?
2) How much of a regression and healing should be expected over the first month? Will the +2.25 correction get closer to zero? if so by how much?
3) I did not have astigmatism before, now I do. Is this going to go away as my eyes heal?
4) The docter didn't say, but he intended these results for better long term results. Do you think he was targeting monovision and/or avoiding reading glasses in the future?

Thank you.
megeed
 
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Re: Overcorrection?

Postby LasikExpert » Thu Sep 21, 2006 3:57 am

megeed wrote:1) Why would the doctor over correct me so much in one eye?


I am certain that this was not planned or desired.

megeed wrote:2) How much of a regression and healing should be expected over the first month? Will the +2.25 correction get closer to zero? if so by how much?


Considering the amount of correction you have received, it is very reasonable to expect regression in the 0.50 to 1.00 diopter range. It seems likely that you will have induced hyperopia (farsighted, longsighted) vision after regression.

megeed wrote:3) I did not have astigmatism before, now I do. Is this going to go away as my eyes heal?


The astigmatism may have been induced by surgery, caused by edema (swelling), or caused/exacerbated by Lasik induced temporary dry eyes. Edema and dry eyes are likely to resolve with healing. It is way too early to know what will be the final outcome.

megeed wrote:4) The docter didn't say, but he intended these results for better long term results. Do you think he was targeting monovision and/or avoiding reading glasses in the future?


I doubt the doctor intended the +2.25 result. I can think of no legitimate reason to target that much overcorrection. The +.50 overcorrection seems reasonable to balance expected regression.

Expect that your doctor will recommend enhancement surgery at about 3-6 months postop. Consider enhancement surgery with the same care and concern as the initial surgery.
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Postby megeed » Thu Sep 21, 2006 12:43 pm

Thank you.
megeed
 
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Postby ColdFrixion » Thu Sep 21, 2006 3:04 pm

I had LASIK two weeks ago to the day and can tell you first hand that your vision will fluctuate. According to my doctor, it takes 6 weeks for your vision to stabilize and 3 months to heal completely. My vision is still fluctuating daily, so try not to be overly concerned at this stage; worry and stress will not help you heal any faster. However, if your vision doesn't fluctuate very much or at all over the next few weeks, I'd probably discuss it with my doctor but you're less than a week out, so hang in there and best wishes.
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update

Postby megeed » Fri Sep 22, 2006 12:15 am

Thank you,
I saw my optometrist today and my numbers are better.
OD +1.25 -0.50x169
OS -0.50 pl

So both eyes changed by 1 diopter within a week. He said that most likely I was dilate when my day 1 measurements were taken. Which is most likely true because I don't think the dilation went away for nearly 3 days. The astigmatism also got better in my left eye.

Summary so far:
Pre lasik
OD -6.8 pl
OS -6.0 pl

Day 1
OD +2.25 -0.25x142
OS +0.50 -0.75x175

Day 6
OD +1.25 -0.50x169
OS -0.50 pl


Does it look like I am on track to good vision?
Thanks
megeed
 
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Postby LasikExpert » Fri Sep 22, 2006 7:55 am

You are most certainly going in the right direction. Let's hope regression continues and resolves the remainder of your hyperopia. Patients will be a virtue.
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Postby ColdFrixion » Fri Sep 22, 2006 2:37 pm

Patience, too. :)
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Postby LasikExpert » Fri Sep 22, 2006 6:45 pm

LOL

Yes, patience is just as impotant as patients.
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Updated

Postby megeed » Fri Oct 20, 2006 1:29 pm

I went to my doctor for my one month checkup and I was happy and dissappointed at the same time.

Before Lasik
OD -6.8
OS -6.0

Day 1 (May be high due to still being dialated)
OD +2.25 -0.25x142
OS +0.50 -0.75x175

Day 6
OD +1.25 -0.50x169
OS -0.50 pl

One Month
OD +1.50
OS Pl -0.25x180

So my left eye seems better correct. However my right eye got worse. I thought I read that a .25 variation in diopter is normal and dryness or blinking can affect it. So I can't say I got worse in my right eye, but I am not thrilled that it didn't get better. Can I expect to see any regression over the next 3 months when I really haven't seen any in the first month?

The good news is that I was able to read 20/20 in both eyes, and 20/15 after puting drops in. Which means my eyes are very dry. The doctor prescribe Restasis.
megeed
 
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Postby LasikExpert » Tue Oct 24, 2006 1:24 am

You won't know your final destination until you get there, but expect that at six months postop you doctor recommends enhancement surgery.
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3 Month Update

Postby megeed » Fri Dec 15, 2006 2:32 pm

Well I went for my 3 month check up and it seems I am getting worse.
I still can see 20/20.

Before Lasik
OD -6.8
OS -6.0

Day 1 (May be high due to still being dialated)
OD +2.25 -0.25x142
OS +0.50 -0.75x175

Day 6
OD +1.25 -0.50x169
OS -0.50 pl

One Month
OD +1.50
OS Pl -0.25x180

Three Month
OD +1.75
OS +1.00

So I can't even say it is regression because I was originally nearsighted, so you would expect to regress in the opposite direction. For me it seems that I am getting more and more farsighted.
megeed
 
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Postby LasikExpert » Sat Dec 16, 2006 5:23 am

Your right eye (OD) seems to have come close to stabilizing and appears to be acting as would be expected. I believe that what you are experiencing in your left eye (OS) is not quite what it seems.

Going from -0.50 to plano to +1.00 indicates to me that you are accommodating during the manifest refraction (which is better, one or two?). Accommodation is when the natural lens of the eye changes focus. I suspect you were "focusing around" the hyperopia to achieve the low myopia and plano. This may be occurring automatically without your direct knowledge or effort.

Ask your doctor if a cyclopegic refraction in addition to a manifest refraction would be appropriate. Cyclopegic would use eye drops to paralyze your natural lens and keep it from focusing. This will provide a more true optical refractive error and may give a more stable measurement. A comparison between manifest and cyclopegic may provide some insight into you refractive error's unexpected behavior.

Instability in refractive error after overcorrection from moderately high myopia would be expected, but I find the myopia to hyperopia changes very unusual if your eyes are otherwise healthy - such as no dry eye problems.
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Postby megeed » Sat Dec 16, 2006 4:57 pm

The last result was with cyclopegic refraction. The doctor got similiar results with an objective refraction. He also did a simple subjective refraction and couldn't get good results in the OS eye. First test (subjective) indicated +1.00, the second test (objective) didn't give difinitive results, and he said I actually read -0.50. The final test (cyclopegic refraction) gave me the +1.00, which was closer to the first result.
I do have dry eyes, and the difference between this visit and all the previous ones is that I have been on restatis.
megeed
 
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Postby LasikExpert » Tue Dec 19, 2006 4:19 am

It would appear that the exam that indicated a small amount of myopia was an artifact of accommodation. It appears your refractive error actually is +1.00.

Dry eyes can cause vision fluctuation. According to the manufacturer, Restasis requires about 90 days to become fully effective. Keep in mind, not all dry eye is caused by inflammation, which is what Restasis treats.
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Postby megeed » Wed May 09, 2007 3:05 pm

Well I went for my 6 month check up and it seems I am getting slightly worse.
I still can see 20/20- (Not exactly 20/20)

Before Lasik
OD -6.8
OS -6.0

Day 1 (May be high due to still being dialated)
OD +2.25 -0.25x142
OS +0.50 -0.75x175

Day 6
OD +1.25 -0.50x169
OS -0.50 pl

One Month
OD +1.50
OS Pl -0.25x180

Three Month
OD +1.75
OS +1.00

Six Month
OD +1.75
OS +1.00

I talked with the doctor and he recommend an enhancement.
What do you think?
What are the risks?

Thanks for all your help.
megeed
 
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