Just had LASEK!!! Need help!!!

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Just had LASEK!!! Need help!!!

Postby leo » Thu Jun 01, 2006 11:38 pm

Hi, I just had LASEK three weeks ago. My left eye is now 20/70 and my right eye is now 20/30. Why there is such a big difference? As both eye were minus 3.75 and had exactly same procedure and done on the same day.

Also how long do I have to wait before I get to 20/20 as my surgeon promised?

Thanks very much for your time!
leo
 
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Postby LasikExpert » Fri Jun 02, 2006 12:35 am

Hi Leo,

I'm sorry to hear of your delayed vision recovery with LASEK. I'll try to respond with what information you have provided.

For those who don't know, the process of LASEK is almost identical to PRK. The outermost layer of cells on the cornea (epithelium) are destabilized with an alcohol solution applied for a few seconds just before surgery. The epithelium is moved aside, and the laser reshapes the underlying cornea. After the laser has finished, the epithelium is repositioned over the treated area. You may want to read http://www.usaeyes.org/lasik/faq/lasek.htm for LASEK Detailed
Information

The advantage of keeping the epithelium is that these cells work like a bandage and protect the cornea. It is believed that LASEK has a lower probability of corneal haze and other problems than traditional PRK, which does not save the epithelium.

A disadvantage of LASEK is that the alcohol solution mortally wounds all those epithelial cells and they need to be regenerated. Corneal epithelial cells are the fastest reproducing cells in the human body, but it does take some time. Also, the healing process needs to sort out which cells are totally dead and expel them, which are not quite dead yet and let them stick around a while, and which cells are probably going to survive. This process can delay vision recovery. So, the advantage of LASEK is a lower probability of complications, but the disadvantage is that for some people vision recovery is slow.

Something you can do to somewhat test your potential vision quality is to apply preservative-free artificial tears. There are several brands available over-the-counter at your pharmacy. If you momentarily get good vision with artificial tears, that is a very good sign and the momentary quality is what you can reasonably expect. This is NOT by any means an alternative to your doctor’s exam, but it is something you can try at home.

Most laser eye surgery can induce a bit of temporary dry eye. Dry eyes can damage the epithelium and make regeneration slower. You can make your eyes an environment friendly to a quicker recovery with the use of good artificial lubrication regime. Artificial tears are probably the first line of defense, but always be sure they are preservative-fee. Preservatives used in artificial tears can cause irritation. You should read http://www.complicatedeyes.org/dry_eye_treatment.htm for LASEK Dry Eye Treatment

There may be other issues that we can discuss, but with the limited information you have it would be difficult to speculate. Your sympoms are consistent with delayed epithelial healing after LASEK and dry eyes, but you absolutely need to notify your doctor of your symptoms and allow the doctor to determine what is best for you. If the doctor reports no unusual problems, then it is reasonable to expect continued improvement in vision recovery over the next 2-4 weeks.

Please feel free to post any additional information your doctor reports.
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1 month after LASEK, bad vision.

Postby leo » Fri Jun 09, 2006 8:00 pm

Hi, I had LASEK for one month now, before the surgery, both eyes were -3.75, now they are still 20/40 instead of 20/20 as my doctor promised. As there were no infections, please can you suggest what's the reason that they are not 20/20 yet? Thank you so much for your help!
leo
 
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Postby LasikExpert » Fri Jun 09, 2006 8:22 pm

Healing after a surface ablation technique such as PRK, LASEK, or Epi-Lasik can be slow. It appears that you have had a small amount of improvement from 20/70 to 20/40 in the last week or so. That is a very good sign.

If with corrective lenses your vision quality is good, then your problem may be related only to simple refractive error. When you were examined did the doctor perform a manifest refraction (which is better, one or two?) and provide you with a current prescription? If you are slightly overcorrected or undercorrected, this could explain the problems you describe. If you have your prescription numbers, please post them.

Is your vision poor at all distances? Can you see things near to you very well, but not distant items? Can you see things at a distance but not objects near?

What is your age?

Is your vision better when you apply preservative-free eye drops? If yes, for how long?

Your surgeon, who has the benefit of actually examining your eyes, will be much better able to tell you exactly why you have not achieved the desired result. What did the doctor say about your current results?
Glenn Hagele
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LASEK follow up.

Postby leo » Sat Jun 10, 2006 9:59 pm

Thanks for the reply Glenn.

Yes, the doctor did perform a manifest refraction on my eyes. But I am not too sure about the prescription number though, sorry.

In regards to your last question, my vision is good at near but poor at distance.

Apparently my doctor said that my eyes still have some haze, so they are not completely healed yet, could this be the reason that I haven't reach 20/20 after LASEK? If yes, will my eyes eventually be healed? How long does it normally take?

Thanks again in advance!
leo
 
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Joined: Tue May 30, 2006 9:07 pm

Postby LasikExpert » Sat Jun 10, 2006 10:22 pm

The fact that your vision is good at near but poor at distance is actually good to hear. This means that you are currently myopic (nearsighted, shortsighted) and have not been overcorrected into hyperopia (farsighted, longsighted) vision.

Having a little haze may be good or bad. Haze in the cornea is never good, however it may not be interfering with your vision quality and may resolve with additional healing. Haze in the epithelium - the outermost layer of cells on the cornea - will almost always resolve on its own with healing.

If you were able to see clearly distance through the phoropter (the device with all the lenses for the manifest refraction) or you are able to see objects near clearly, then this would indicate that any haze that is present is not causing vision quality problems.

Haze is a wound healing response. So is edema (inflammation). If your cornea or your epitheliums are a little swollen, this can cause a small myopic shift. In other words, your current undercorrection may be a symptom of wound healing response in the cornea and/or epithelium. If it is, it may resolve on its own with additional healing.

Everybody is unique and how each person responds to surgery is equally unique. From what you have said it sounds like your doctor took the appropriate steps and there was nothing that would indicate you have an elevated risk of a poor outcome, however your eyes' response to surgery is apparently to swell slightly and haze. These are both more likely with a surface ablation like LASEK and both are wound responses that tend to run their course.

My bet is that your doctor has told you to just wait and see him again in a month or so. That is probably good advice, along with keeping your eyes a friendly environment for healing by using preservative-free eye drops, wear 100% UVA and UVB sun glasses if you even think about going outside, and just give your eyes more time to heal.

If you have any sudden changes, report them to your doctor. If after three months you still have poor distance vision, you will want to discuss the relative advantage and disadvantage of enhancement surgery. Do not be in a hurry and do not make any rushed decisions. You can have enhancement surgery at any time, however most patients have it between 3-6 months after initial surgery.

Your doctor is much better qualified to predict when your eyes will fully heal, but refractive surgery is very often more of a six month process than a 20-Minute Miracle.
Glenn Hagele
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USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
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