CK surgery split prior RK wound

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CK surgery split prior RK wound

Postby Caron » Fri Dec 21, 2007 5:04 am

Dear moderators and other docs: I'm a 52-year old in the Philippines. I had RK surgery in 1991 and have been told over the years that my wounds healed well. Like all RK patients, it trashed my near vision almost immediately. My far vision deteriorated over the years. An opthomologist in my Rotary Club told me about CK and I had a consultation with him. One Friday, he put 8 or so CK spots in my eye, which had absolutely no effect. He convinced me to try an inner band of spots, which I had done the next Friday (Dec. 14). This was awful and I've never had worse vision. He was perplexed: I went in to my follow-up and he said the effect was very good, except that one RK slice had split, comprimising my vision. He suggests a suture now, but I'm a bit fearful. What if a suture pulls together that split, but splits two more cuts...would it ever end? Since it happened so recently, and healing is still underway, he says there is a chance that the split could heal itself. My problem is that it is hard to get advise or second opinions, since he is the best and most experienced doc here (has about 10,000 lasik surgeries under his belt in the last 10 years), but has only seen 6 RK patients. 5 of the CKs by the RK cuts were successful, but mine wasn't. Advise? (note I'll be in the Salt Lake then Las Vegas areas Christmas week, but wouldn't expect a doc's office to be open for a second opinion or advise.)
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Joined: Fri Dec 21, 2007 12:51 am
Location: Manila, Philippines

Postby LasikExpert » Fri Dec 21, 2007 6:31 am

It was my understanding that CK was generally avoided for RK patients for the very reason that you have suffered. It is interesting that your doctor has had apparent success with previous RK patients and CK.

With one RK incision opened you likely have irregular astigmatism that will provide poor vison quality at all distances and especially in low light environments.

I would imagine that if suturing was done it may not be just across the split RK incision, but all around the outer edge to help pull the RK incisions together. A suture will only help promote even healing, but it will be the healing that will restore your cornea's stability.

In a situation like yours I would normally recommend visiting a corneal specialist at a university affiliated teaching hospital. You may want to investigate the University of Utah in Salt Lake City.
Glenn Hagele
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