Fixing damaged flap with PRK? PLEASE HELP!

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.

Fixing damaged flap with PRK? PLEASE HELP!

Postby Pollux » Fri Jul 18, 2008 1:16 pm

Here's the breakdown:

I had traditional lasik done 6 months ago. Few months later the doctor said there's inflammation/ingrowth on my left eye, then she said that it was not harmful and that scraping was not necessary. Also the lasik did not do much of a correction and am very unhappy with the results. My left eye is now seeing some double vision and is out of focus due to the epithelial ingrowth according to my 2nd lasik doctor (more respected, legit place).

I had my eyes examined last week from my 2nd doctor and was told that the flap on my left eye is really messed up, but it's not an emergency because the cells have stopped growing. He said out of the tens of thousands of surgeries he's done, he's never seen a flap like mine which was very hard and saddening to hear... He basically told me this: what he can do is completely cut the flap on my left eye and do PRK on it to do an enhancement on it. I was very shocked/disturbed to hear about actually cutting the whole flap off because it was in such bad shape, and that the only way to correct my vision on my left eye was to cut the flap and do PRK on it. He said think of it as a "fresh start" like I would walk in for PRK surgery for the first time. As comforting as that sounded, does PRK actually involve removing the flap to begin with? Would doing this really be considered having a fresh start?

He said give it a couple weeks to think about it. Again, this is not some emergency situation but I really would like to get my vision fixed on the left eye. Even glasses can't fix it (man do I REALLY regret doing this). I am 26 years old, male. I'm really freaking out, and disturbs me since I'm still at a young age and for this to happen to me. Should I go with the PRK? And again, does PRK involve removing the flap to begin with (that's what I really want to know). Any advice/input/comments is appreciated, thanks.
Pollux
 
Posts: 3
Joined: Sat May 24, 2008 5:29 pm

Postby LasikExpert » Fri Jul 18, 2008 9:24 pm

If the Lasik flap is beyond repair or healing, then it is possible to remove the flap completely. Traditional Lasik with a flap created using a mechanical microkeratome creates a meniscus shape. That means that the edge of the flap is thin, the mid-center is thicker, and the center is thinner. The underside of the flap (corneal bed) will be equally irregular. When the flap is removed, you will be immediately and probably significantly hyperopic (farsighted, longsighted).

Hyperopic PRK is more challenging than myopic (nearsighted, shortsighted) PRK. Since you will likely be significantly hyperopic after Lasik flap removal, it is reasonably possible that you will require more than one PRK to bring you back to plano (no refractive error). If you ultimately go this route, do not expect instant success and be patient regarding the time needed for recovery.

If your flap was created with a femtosecond laser, the flap will be much more regular in thickness and the underlying bed will be more regular. This would make PRK a bit easier, but still challenging.

In nearly all cases it is best to attempt to resolve the flap problems, but it sounds like you have a competent surgeon who has advised you well. Unless the epithelial ingrowth continues or progresses, you should have plenty of time to consider what course is best for you.

Fortunately Lasik only affects the cornea (clear front of the eye). Since all your problems relate only to the cornea, the absolute worst case scenario that you could face in this situation is a corneal transplant. You want to avoid a transplant if at all possible, however hundreds of thousands have been successfully performed. When getting to that "freak out" point, keep in mind that the worst case scenario - which does not seem likely to be needed - is not quite so scary.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
Site Admin
 
Posts: 3309
Joined: Fri May 12, 2006 6:43 am
Location: California

Postby Pollux » Wed Jul 30, 2008 4:08 pm

are there any disadvantages/risks on having the flap removed completely? Will I ultimately have a "fresh start" by doing this? I forgot to mention I don't really want any other Lasik enhancement done again, I just want the flap fixed and have that fresh start and just go back to glasses. Thank you so much for your detailed and prompt response, Glenn.
Pollux
 
Posts: 3
Joined: Sat May 24, 2008 5:29 pm

Postby LasikExpert » Wed Jul 30, 2008 8:37 pm

It will be a fresh start, but a long way behind the starting line.

After removal of the Lasik flap you are likely to be very, very hyperopic (farsighted, longsighted) and with an irregular corneal surface. These problems may not be able to be successfully corrected with glasses or even rigid gas permable (RGP) contact lenses.

If you are considering having the Lasik flap removed, then you need to accept that you probably will need laser vision correction like PRK to rehabilitate your corneas enough that you can use glasses or (hopefully) so you will have no need for corrective lenses.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
Site Admin
 
Posts: 3309
Joined: Fri May 12, 2006 6:43 am
Location: California


Return to Had It A While Ago

Who is online

Users browsing this forum: No registered users and 0 guests