Flap Lifts

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.

Flap Lifts

Postby DryEye » Sat Jun 09, 2007 4:17 pm

Is there a certain time limit from one's initial surgery on when a flap can be lifted?
How is it done? Do the eyes get suctioned again?
Is the healing a bit faster/easier the second time around?
Has anyone on this site had an enhancement 1 to 5 years out?
How did it go?
I read that Tiger Woods went in for an enhancement after 8 years. It sounded like he had his flaps lifted since they said in articles he played a few days later, which I can't imagine would happen with PRK?
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Re: Flap Lifts

Postby LasikExpert » Sat Jun 09, 2007 7:37 pm

DryEye wrote:Is there a certain time limit from one's initial surgery on when a flap can be lifted?


In theory, the flaps can be lifted forever. The longest of which I know is 13 years. "Lift" is probably the wrong term. It is more like separating the cornea at the location of the original incision.

DryEye wrote:How is it done? Do the eyes get suctioned again?


A lift does not require a microkeratome and its suction ring. The surgeon manually manipulates the flap with a tool similar to a tiny surgical hockey stick.

DryEye wrote:Is the healing a bit faster/easier the second time around?


Healing time should be about the same with a primary Lasik or flap lift.

DryEye wrote:I read that Tiger Woods went in for an enhancement after 8 years. It sounded like he had his flaps lifted since they said in articles he played a few days later, which I can't imagine would happen with PRK?


I believe Tiger woods initially had PRK. News reporters often use the term Lasik for any type of laser eye surgery to reduce the need for corrective lenses.
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Postby babiesforme » Mon Jun 11, 2007 3:45 am

Well, as of tonight, I am planning on having an enhancement done on Wednesday to correct some underlying astigmatism-but I have about 12 hours to back out. I'm 16 months out. I'll let you know how it goes. I had custom LASIK done and I know my flaps are well sealed. My doc has said if he can't lift them, he'll have to do PRK. When I talked to him Friday, he said he thinks there is a 99.99% chance he will be able to lift the flap and he's only had 2 people he can remember not being able to do so on enhancement.

I will say I can back out b/c I am very happy with my results in general - had terrible vision "20/1000" according to doc (but about -7 near sighted and -4 astigmatism from some numbers I had written down). Now he says I'm "20/30" but I think it's all astigmatism. So I'd be correcting the "warbled" vision I get sometimes.


So we'll see.
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Postby DryEye » Mon Jun 11, 2007 3:52 pm

Interesting.
I had custom lasik last June. I didn't go well immediately (microstriae & dry eyes). I have seen a few different doctors since then. In March, I finally started to understand what is going on after visiting with a top surgeon - astigmatism and some HOA's.
Last week I saw someone who I saw preop, but never went with. He said the machine never got all the astigmatism. So, I maybe doing an enhancement on my right eye (which is worse) in August.
What's weird though is that after inserting artificial tears my vision becomes more clear and crisp still (it did this from the start after surgery).
Babies - Do you have that effect?
Are you using your same surgeon?
I imagine your vision isn't crisp and clear on the eye chart at various levels and some other real world scenarios (VCR clock across the room, Some TV lettering from a distance, etc.)
Glenn - Do artificial tears act as a refractive enhancement or is it all dry eye related if one's vision clears up temporarily?
How does astigmatism affect one's vision? I don;t really see double images except at times around green stoplights and stoplights at night aren't crisp and clear. Other than that it is a more blurry type effect around lettering on my computer and TV.
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Postby LasikExpert » Mon Jun 11, 2007 5:07 pm

DryEye wrote:Glenn - Do artificial tears act as a refractive enhancement or is it all dry eye related if one's vision clears up temporarily?


Tears, be they artificial or natural, provide refractive correction and a smooth surface for clarity.

DryEye wrote:How does astigmatism affect one's vision? I don;t really see double images except at times around green stoplights and stoplights at night aren't crisp and clear. Other than that it is a more blurry type effect around lettering on my computer and TV.


Only more severe astigmatism would cause doubled vision. We have a detailed article about astigmatism.
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refractive power of drops

Postby amilli » Wed Jun 13, 2007 7:04 pm

Glenn,
I mentioned the issue that I have to my doctor: that when I put in drops my vision is very crisp and clear, but after a few blinks, it returns to slight double vision in one eye and hazy vision in the other. I asked him about the drops acting as a sort of "contact lens" making my vision clear for the few seconds/minute and he said that drops have no refractive power and that the issue would be due to dry eye and when I blink the drops out they are dry again. Does that sound right? Seems I read on these boards that drops can act to bend the light enough to clear up slight errors. Also, I am 40 years old, and the doctor told me that in order to maximize the time I had before needing reading glasses, he wanted to correct my eyes as close to 20/20 or slightly myopic as possible. He tends to use "laymans" language with me so I understand, and my last visit at 3 monts I was 20/30 in each eye with a combined vision of 20/20. He said I had 1 tick of astigmatism in my right eye and 2 ticks in my left and that my flaps were healing "ideally". However, I don't feel my distance vision is great. I have continued to see very gradual improvement, however, I see double visions far away in my left eye (the one with 2 ticks). It has improved overtime where the doubling seems to be converging or merging together. And, when I put the drops in it is clear. Do you think my double vision is due to the astigmatism and that it won't go away, or due to the dry eye and my eyes adjusting and focusing as my doctor suggests and that it will clear up by 6 months, or do you think it is an issue and I should get a second opinion. Right now I am at I am at about 3 1/2 months and he did not want to discuss enhancement at this point, but suggested my issues will resolve over time. His rule of thumb is 1 month per diopter of correction and since I was at 20/500 (-500, that is) and I'm continuing to see incremental improvement, I should wait until 6 months to determine what may be more longer term issues. What are your thoughts? I am going back at 4 months, any suggestions on what I should be asking?
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enhancement

Postby bada5150 » Tue Jun 19, 2007 10:19 pm

Hi Dryeye, long time no talk!!!
I went back to my doctor few weeks ago for check up. Month ago, I went for 4 month check up and Doctor told me my eyes are still changing so he wants to wait few more months. Two weeks ago, I went back for check up and this doctor said that I don't have to come anymore.

Every month, I am seeing different doctors and they all have different opinions.

My major problem is my astigmatism on my right eye (-.75) that bothers me at night and under very low light condition. It still sees everything blurry at all distance. I think I have very similar problem like you, Dryeye.

I was doing reading chart test with this doctor and he told me that I am seeing 20/20 both eyes. So I shouldn't do enhancement. He asked me if this is uncomfortable. I felt I could live with when I am doing eye test in doctor's office. But, when I come out and see things with my right eye, still everything is blurry.

Somehow, I manage to read and feel comfortable in doctor's office and I was thinking "hmm.... it is not too bad". Once, I come out of there, I see things blurry. He also mentioned me that there is chance that my right eye can turn into hyperobia since my right eye sees 20/20.

When they try to fix astigmatism, moypia gets fixed automatically, so doctor didn't not recommend me doing enhancement.

But, I am still not happy with my right eye. I was getting headache and it was very uncomfortable for first three months. But, now my brain adjust it and when I see things with both eyes, I don't really recognize blurry but I still see ghost on traffic lights with only my right eye.

Maybe my brain ignores blurry and see things with left eye but it still sees ghost through my right eye?

I am now very worried. I can call them up and have enhancement, but I am very afraid of becoming hyperobia. I am so lost at this moment.....

Any suggestions are welcome.
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Postby DryEye » Wed Jun 20, 2007 3:01 am

Bada:
Interesting
I have seen a few top docs. The last one was someone I saw preop, but never went him. He compared my preop data to my post op data and said I have astigmatism in both eyes? My right is definitely blurrier than my left. He said I could do enhancements on both, but to do them with a specific surgeon who I saw prior to him. He is in another state. I am going to visit with him in August and then decide on whether or not to proceed with an enhancement. Right eye first.
It's a close call visually speaking, but the blurriness is there and being that I am 12 months out and have not seen much progress since doing it last June I think it's worth it, but only with someone who is considered top notch.
This site has been great and if I only knew about it before doing it the first time I'm sure things would have gone differently.
Depending what state your in there are some docs who have more experience in handling these things than others I am told.
One of them is part of this site under the state of Kansas.
Does your vision crispen/clear up with tear usage still?
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Postby DryEye » Thu Jun 28, 2007 5:29 pm

Diane:

Did you have your enhancement?
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Postby Remander » Sat Jun 30, 2007 4:25 am

What's weird though is that after inserting artificial tears my vision becomes more clear and crisp still (it did this from the start after surgery).


My vision was the same in the days and couple of weeks afterward. Kind of crappy ordinarily, but clear with drops (for a little while).

As time passed, my natural tears came back and my vision got more and more clear. Now, about 6 months out from the original Lasik and 2 months post-enhancement, my vision is great.

Patience paid off.
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