Lasik Complication; DLK

[DEEZOS]

Hi,

I had Lasik performed on both my eyes in August 2007. The next day I developed blurry, hazy vision & went back into surgery where they lifted the flap & rinsed out my eyes & treated me with Predforte. They told me I have DLK, a rare complication in Lasik. I struggled for a month or so before I could see clearly again as i couldn't read, watch Tv or expose myself to light, was very sensitive. I was on predforte, lubricants & now am on pilocarping drops & another one for the pressure in my eyes.

My eyesight went from 2.25/2.50 to 6.5/7.5. I'm wearing specs permanently & I've still got scarring in my eyes. I'm now almost totally blind without my specs but the surgeon says only time will heal & my vision might or might not improve. And an Orbscan revealed that my cornea's are thinner. I'm totally irratated infuriated that there is nothing else that can be done. Or is there? Can someone please advise me on alternatives. Thanks.

[Rocksville]

So you were seeing clearly, and then it deteriorated to the point where you can't see? Was the dr. monitering the drastic vision change? It sounds pretty unusual that it cleared up after a month and has since become drastically worse. Hopefully it works out for you over time.

I have/had dlk in my right eye and had the flap lifted on day 4 to rinse i out. I'm 8 days out from that and see about 20/30 in my right eye, but it is slightly far sighted. I'm expecting it to gradually improve over time...but hopefully it doesn't go the other way.

[faithworks]

Hey DEEZOS,

I had Lasik in July 2007 and like you I developed DLK as well. The white patch that the DLK created is almost completely gone now but I have a little scarring which should improve with time. It actually has improved in the past 10 months. Its not a major change. Actually you won't realize since we see with that same eye everyday and the difference is very difficult to determine but yes it does improve without you knowing. You doctor is correct in saying it might take 18 months or more for scarring to go and for us to actually realize a noticeable difference. I mostly believe your DLK patch would also have cleared by now but you would have a scarring like I do. However, my eye which had the DLK has 20/20 vision but there is still slight bluriness , LED lights seem funny, slight ghosting, glare etc.

The most satisfying think I found out that with a help of a soft contact lens my eye which had the DLK is 20/15 !!! Its absolutely clear with the lens. I wonder if I can achieve that with the help of glasses like you do (Can you please tell me the type of glasses your doctor has provided? because I prefer glasses instead of lens). So surely, there are contact lenses in the market which help you clear the scarring. Fortunately, I did not have as much scarring so as to wear an RGP (these lenses are for worser case with high aberrations in the cornea and higher scarring). I do not know what amount of scarring you have but I am sure that you can get rid of the scarring with the help of a contact lens and you would find them very comfortable. If you are on with the medications than please be sure to regularly have checkup as excess use of such preservative anti-inflammatory drops can lead to glaucoma and other diseases in the eye.

I am going to my doctor again in a months time. I can get you the name of the lens, its actually a special type of soft contact lens (some vapour-something, I actually dont know I am sorry) But if you can wait I can get you the name.

Hope this helps.

And ya Faith in God really works in such helpless cases.

Take care. Faith Works... Indeed !!!

[faithworks]

You can also read my progress on:

http://www.usaeyes.org/ask-lasik-expert ... c&&start=0

[DEEZOS]

Hi Faithworks,

Thanks for the reply & encouragement. I really don't know what type glasses I have, but do know that they were made overseas (I'm in South Africa). They were specially made for me 'cos of my script of 6.5 & 7. I'd have had to wear really thick & heavy glasses if they were made locally but this one really looks thin although it gives me good vision-but i still hate wearing them & I don't want to wear glasses! I know it's a transition lens, looks really flat. I've mailed my Opthamalogist to give me the name of the type of glasses & asked him some questions that I gathered from this forum, but he hasn't answered me yet. Please get me the name of the lens you referring to as I'd like to source it locally. My next check up is only in July I'm hoping for the best. I'd like to try taking Vitamin C & visit a Corneal specialist. What do you think...or anyone? Is there anything else I can do? Thanks.

[LasikExpert]

Diffuse Lamellar Keratitis (DLK) is an inflammation at the plane of the Lasik flap that causes hazing. Its treatment is normally aggressive use of steroids, as you noted. If treatment is delayed, scaring of the cornea can occur and the cornea can digest itself, called "flap melt". This would normally make a person hyperopic (farsighted, longsighted).

Yours is a more unusual case where you are more myopic (nearsighted, shortsighted) after DLK. This would appear to be from inflammation; however your surgeon reports that your corneas are thinner. I am assuming that means thinner due to the DLK. It would appear that the DLK caused your corneas to reshape enough to induce the myopia, not inflammation or thickening.

What you can do depends greatly on the exact condition of your corneas. They very likely have irregular topography. This would cause blurring and multiple images, which I assume you have and is worse at night when you do not use Pilocarpine or Alphagan P to shrink your pupils. You may want to discuss with your doctor using rigid gas permeable (RGP) contact lenses to help smooth the surface. There is also a technique called CLAPIKS that possibly would provide some improvement.

It is likely that the doctor will want all irregularities to resolve as much as possible before recommending any treatment. The doctor may recommend Phototherapeutic Keratectomy (PTK) to smooth the cornea's surface, and then follow with additional laser surgery. It may be that your corneas will become regular enough that PTK is unnecessary.

There is not much you can do but keep your eyes healthy and lubricated (only preservative-free artificial tears) and wait. The eyes do an amazing job of healing if given enough time. I know of one patient who in the late 1990s had DLK with delayed treatment and had significant scaring. Her corneas are now clear.