Over correction????

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Over correction????

Postby renae » Thu Jan 25, 2007 1:04 pm

I had lasik about 2 weeks ago and I'm worried I've made a terrible mistake. The doctor told me that the 2nd eye would take 42 seconds to do. I counted (1 one thousand,etc) and got up to over 200! I was too afraid to speak as I thought my head would move too much. Boy I'm kicking myself now for not saying something! HOw stupid! I did see smoke and smell tissue burning.(I'm an OR nurse and I know the smell). That didn't happen with the 1st eye. Previous vision was -7.5 approx in both eyes and now I need +2.5-+3.0 to see clearly. the 1st eye vision is fine for distance, a bit of ghosting and some flare. I can live with that. It's the 2nd eye that I think is too 'fried' to render any useful vision. Is it possible to fix this. Why did this happen? Did the doctor not make sure the machine was set correctly? What do I say to him at the next appt. Do I trust him to fix it? should I just live with it? Do I talk to someone else.
renae
 
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Postby LasikExpert » Thu Jan 25, 2007 5:34 pm

As an OR nurse you must know doctors make mistakes. Whether or not that is actually the case is not quite clear because you are in the early stages of healing.

You were a rather high myope (nearsighted, shortsighted) before surgery. It is common for a high myope to have a bit of regression of effect. Some doctors will deliberately overcorrect Lasik to place a high myope into hyperopia and allow regression to bring the patient back to plano (no refractive error).

It is possible that you have edema (swelling) at the edge of the Lasik flap interface. Swelling at this outer ring of cornea could induce hyperopia. It is possible for one eye to have edema and the other not.

You diagnosis of a +2.50 to +3.00 diopter overcorrection because your vision improves with reading glasses of this power is a good general indication of your current refractive error, but you require a refraction (which is better, one or two) to know your actual refractive error. There are other reasons why reading glasses would improve your vision, including general magnification.

If you are at or past age 40, you may be dealing with what I call Sudden Presbyopia. If your other eye was actually undercorrected, it would make sense that it would not require reading glasses to see objects near.

It is way too early in the healing process to come to any conclusions about your final outcome. A significantly longer ablation time on one eye compared to the other would be expected if you had custom wavefront-guided ablation or if your eye moved and the tracking system needed to reset repeatedly.

A second opinion is always a good idea, but it sounds like you really don’t have a first opinion yet. You need to discuss your concerns with your surgeon. The surgeon can review the information from the laser to affirm the correct numbers were entered and the correct ablation was provided. You can have a refraction to determine your current refractive state. You may want to consider a pair of glasses to help during the healing period.

It is possible you were overcorrected into hyperopia. Lasik enhancement surgery may be appropriate to resolve resulting refractive error, however this decision really cannot be made until several months after surgery when the eye has settled down.

BTW: The Lasik burning smell you experience during surgery is not actually tissue burning. The wavelength of the excimer laser used to ablate tissue causes a disruption of the bonds that hold together the corneal cells. There is no heat. Friction from these cells rapidly escaping raises the temperature of the cornea about 11 degrees Fahrenheit, which is certainly not enough to burn tissue, but the chemical reaction of the release of the molecular bonds creates the same smell. It is a quite disconcerting and just for comfort I personally feel all lasers should have a vacuum system to pull the cells away from the patient's nose.
Last edited by LasikExpert on Tue Jun 05, 2007 6:57 am, edited 1 time in total.
Glenn Hagele
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Postby jturner29 » Fri Jan 26, 2007 1:40 am

i had this same type of surgery , a little diffrent, but with the laser treatment, and i kind of wish my md would of overcorrected me a little, because pre surgery i was -5.75 and -6.0 and after the first laser treatment i was -1.25 and -1.75 so i just had and enhancement done to get me closer to normal vision......just out of curiosity how could you tell through your vision that you were over corrected, was everything just really blurry .
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Postby renae » Sun Jan 28, 2007 3:34 am

I was told to get cheap reading glasses to assist with reading. after testing they said a +2.5 would be good for now. But I bought +2, +2.5, +3 to cover any changes. My right eye is "perfect" for distance vision- I need my +2's to read. With my left eye nothing is clear at any distance unless I use my +3's for reading and the +2 or+2.5s for middle and far distance. It's a pain because I have now more than 1 pair of glasses to consider. The other problem was that the ablation went for far longer than the doctor said it would. 240 seconds as opposed to 43 seconds. The only reason I know that is because I counted the seconds. I didn't dare speak because I thought it would move my head too much. I'm kicking myself now. I worry now that I don't have enough cornea left for any enhancements. It's early days yet and I hope my eye regresses enough not to require any more treatment. Your perhaps in a better position for better correction.

Glenn, am I right?
renae
 
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Postby LasikExpert » Sun Jan 28, 2007 5:51 am

Yes, you are correct. You started with a moderately high refractive error. Regression is a reasonable expectation at this point.

Based only upon how the reading glasses work for you, it appears that your right eye is currently plano (no refractive error). Needing reading glasses to see items near would be expected if you are past about age 40.

Your left eye may be a little bit overcorrected into hyperopia, based upon the need for greater power reading glasses and the poor quality vision at all distances.

As stressful as it may be, what you need is the patience to not come to any conclusions about your outcome until your eyes have had time to heal. We are talking 3-6 months. Yes, I know that is much easier said than done, but there is little choice. Enhancement surgery so soon would not be appropriate.

If you are hyperopic, you may want to download the CLAPIKS protocol for your doctor and discuss if this would be appropriate while you heal.
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