LASEK and haze

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LASEK and haze

Postby GeneralPatientInquiry » Wed Jun 21, 2006 6:35 pm

Eleven days ago I had Lasek surgery on both eyes. My vision has improved only slightly since then. I went to the clinic yesterday to be told that my new presecription is "nearly zero" but that I have hazing where my corneal fibres are "not straight."
The opthomologist was unwilling to comment on what this could mean either short or long term and will not refer me back to the surgeon for at least another 10 days!
Can you help me! Is this hazing likely to clear over time on its own, will it need further surgery or will I be left like this for ever!
The very extensive paperwork I had to sign before surgery seems to absolve the clinic and doctor from everything!
I am now very scared that my eyesight will not improve and I will be left in a worse state than when I started.
The only advice I have been given is to use Visco tears at night to soothe my eyes but with no explanation of what these drops can do to help correct the problem.
I can find no answers on the Internet other than that the risk of hazing is reduced with Lasek over other procedures but nowhere can I find if this is a common complication and whether it improves over time.
I am really frightened! Can you put my mind at rest or at least prepare me for what the next step might be!
Many thanks
Hannah
This post is a reprint of a previously requested inquiry received by USAEyes.org via email.
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Postby LasikExpert » Wed Jun 21, 2006 6:41 pm

Hannah,

First of all, don't panic. Anxiety can only cause you unnecessary stress and may make you make poor decision. You can always panic later. 8^)

Pick up the phone and call your surgeon. There is no legitimate reason why you should not be able to be evaluated by your surgeon when there is a complication involved. If your surgeon's office will not accept you directly, then politely ask them for the name of a surgeon who they recommend that you use for a second opinion to diagnose a complication that is interfering with your vision.

That should make it clear to them that you require attention and get you in front of a surgeon.

If you have any sudden changes in your vision, show up at your surgeon's office immediately. What you describe sounds rather benign, but a sudden change can indicate something more serious.

There are really two kinds of haze. One haze is in the epithelium, which is the outermost layer cells on the cornea. The epithelium was loosened during your LASEK with an alcohol solution, moved aside, the laser reshaped your cornea, and then the mortally wounded epithelial cells were repositioned over the treatment area. Repositioning the cells is to lower the risk of haze and increase comfort. They act like a bandage.

These epithelial cells are dead or dying. Your body has to determine which are dead and need to be expelled, which are not quite dead yet, and which are probably healthy enough to survive. New cells will take the place of dead cells. Epithelial cells are the fastest reproducing cells on the human body, but this process takes time. A known consequence of this process is the formation of hazy epithelial cells. They often present in the form of a three-pointed star the shape of the Mercedes emblem. These can look like fibers.

You have little reason to worry about haze in the epithelium. These cells will be replaced over time with healing, but that may take several weeks.

Haze in the lower levels of the cornea is rare for someone with your relatively mild refractive error. It can occur, but it does not occur very often. If you do develop corneal haze then the doctor can apply a solution of Mitomycin C. Mitomycin C is a strong medicine that is probably best avoided if possible, but is appropriate when needed. If after 3-6 months haze persists and it is corneal haze, not epithelial haze, then you will want to discuss Mitomycin C with your doctor.

There are three things you can do to help your situation.

You want to make your eyes conducive to healing. A regime of preservative-free artificial tears can be helpful. There are many different brands. Try a few to find what works best for you.

Vitamin C (yes, plain old vitamin C) has been shown to reduce the development of corneal haze. A high risk patient (which you apparently are
not) would start with 500mg twice a day one week before surgery and continue for at least two weeks after surgery. Unless you have some sort of allergy, taking vitamin C cannot hurt your situation.

Wear 100% UVA and UVB sunglasses if you even think of going outside. It does not make any difference if it is cloudy. Use those glasses to protect your eyes while they are healing.

As you can see you have several options depending on what is actually happening with your eyes. You do need a proper evaluation, so make that phone call. You will probably be told to just be patient, but knowing that there is nothing else going on is going to give you some needed peace of mind.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
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Postby GeneralPatientInquiry » Wed Jun 21, 2006 6:41 pm

Dear Glenn,
Many thanks for your prompt email. Your calm explanation of the possibilities has allowed me to think more positively about the situation. What you don't know is always more scary as you tend to dwell on the negatives and the "what are they not telling me" scenarios.
I still have the same level of sight, or lack of it, and the accompanying headaches from straining to see at home and work are really beginning to wear me out but at least you have given me some hope that this is a temporary situation.
I am seeing the ophthalmologist again on 28.6.06 and fully intend to push for referral back to the surgeon who undertook my surgery.
With your blessing, I will let you know the outcome of this visit and will ask your advice again when I have a clearer idea of my options.
Many Thanks
Hannah
This post is a reprint of a previously requested inquiry received by USAEyes.org via email.
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