Help me please please

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.

Help me please please

Postby Ali » Thu Jun 19, 2008 10:50 am

Hi everybody. I had a Lasik in my both eyse some 6 weeks ago now. My pre Lasik numbers were -5.00 and -4.75 with some astigmatism. I went through detailed pre surgery (cornea topography, dryness test and cornea thickness etc.) and I was told I was a good candicate. No unusual problems immediatley after srgery apart from redness and little discomfort which lasted for few hours only. my vision was blurry and better than pre surgery (but worse than pre surgerywith glasses). The next day, I went for check up and was told that ther is slight overcorrection i.e. +.5 in both eyes. The doctor recommended that I take Alphagan at night for 4 weeks.

The shock came after six weeks when I went to see the doctor and expressed my frustration on lack of improvement in vision. He did detailed checking again (tomography etc) which indicated that my eyes are both +2 with some astigmatism. After reading the tomograph printout the Doctor told me that I am suffering from a rare problem called ABNORMAL CORNEAL HEALING. He explained that my cornea is over healing and as a result creating some abberation. He put me on a drop called FML? and said will see me in 3 weeks time.

I have the following Qs to Glenn:

1- Has any body experience such a complication before? and if so, what are the options.
2- How serious is this abnormal corneal healing as explained by the red rings in the detailed tonoprapgy.

I look forward to ypur assistance and support

Ali
Ali
 
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Re: Help me please please

Postby LasikExpert » Thu Jun 19, 2008 6:50 pm

All laser vision correction surgery treatment is based upon a "normal" corneal response. This works for the vast majority of patients, however the cornea may react differently to the laser energy and the surgery process. For this reason some patients will experience significant changes in corneal curvature after Lasik that can result in dramatic changes in refractive error. It is rare, but it does happen.

Steroid eye drops are used to control the healing response and your doctor has you on these now. You need to see how well steroid drops work. It is very early in this process. You will probably need to wait 3-6 months after the initial surgery to know your final result.

Now that your doctor knows how your cornea responds it may be appropriate to consider enhancement surgery after everything has settled down.

In the interim you will need glasses or possibly contact lenses to provide vision correction.
Glenn Hagele
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Postby Ali » Sun Jun 22, 2008 6:59 am

Thanks Glenn for your prompt and valuable response.

Is there a way to test for such abnormal cornea reaction prior to doing the surgery? This should reduce alot of undesired comlications [in my caase, I was told I was a good candidate for the procedure].

I am schedule to see my doctor in about 2 weeks time and will update you on any progress.

Regards
Ali
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Postby Ali » Thu Jul 10, 2008 8:28 am

By way of an update, I saw my doctor early this week. He told me that there were some improvement in both the eyes (from +2 to +1.75 or around). He suggested to do correction during next visit (mid August) using customwave starting with the left eye (worst one).

I feel, from reading other peoples experiences, going for such an enhancement 14 weeks post initial surgery may be not wise, especially given the kind of complications encountered with my cornea (abnormal reaction to the laser energy).

Glenn, I would appreciate any thoughts on this as I am required to book now for mid August procedure.

Thank you again for such a wonderful forum.
Ali
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Postby LasikExpert » Fri Jul 11, 2008 6:45 pm

There would be virtually no harm in delaying enhancement surgery and there may be an advantage that your eyes will continue to regress from their hyperopic (farsighted, longsighted) state. The only downside is that you will be dealing with this poor vision until correction, but if contacts or glasses are adequate, it seems prudent to wait longer.
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Postby boston » Sun Jul 27, 2008 3:49 am

It seems like they are putting some pressure on you. You are "required" to book now, "if" you want an enhancement done, in August, ...which is probably a slow month for them ???
I would definately wait. Its a no-brainer!!! Shoot, wait a year. I would!!???
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Postby Ali » Thu Aug 07, 2008 4:20 pm

Thanks boston and sorry for the late reply. I went on holyday to lovely Dubai and almost forgot about my eyes issues.

To be fair I do not think they are excercising any kind of pressure on me. While I am frustrated because of the complications, I must say that I found the Doctor to be very professional, experienced and genuine. Like Glenn, he told me there will be no harm in waiting and the longer I can wait the better. He thought that I was anxious to get rid of the glasses and that in my case, given the latest exam details, it would be safe to do the enhancement.

Two days back, he personally phoned me and after inquiring about the status of my eyes suggested that I go and see him on Monday 17th August to do another detailed exam.

I shall keep you all posted.
Ali
 
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Postby Ali » Wed Aug 20, 2008 7:01 pm

I have seen my doctor two days ago. The detailed examination of both eyes, showed a slight "improvement" in both eyes (from +2 to +1.75). He told that my eyes were stable and that I am ready for enhancement. He is suggesting to do the enhancement using the custom wavefront on both eyes and that he is ready to do it immediatly. i told him that I prefer to wait for a little bit more and will fix a date next month.

Glenn- I need your help on the following two poits:
1- given my earlier complication, is it better to do one eye at a time or both at the same time?

2- If you recall from my earlier posts, the doctor indicated that my complications were due to [unusual corena reaction to laser energy or over healing]. He confused me this time when I have asked him how he would calaculate the energy to ensure no abnormal reaction- he told me that he thinks that I was overcorrected i.e. he does not think that the complications to do with abnormal or overhealing. Why do you think he is saying this NOW.

Appreciate your thgoughts.
Ali
 
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Postby LasikExpert » Wed Aug 20, 2008 7:48 pm

Ali wrote: 1- given my earlier complication, is it better to do one eye at a time or both at the same time?


There is likely not going to be a difference in the outcome if you do one eye at a time or both at the same time, however it is my opinion that you would be much more comfortable doing one eye at a time, starting with the non-dominant eye.

You will very likely have some depth perception and even vertigo problems with two eyes so imbalanced, however glasses and/or a contact for the hyperopic eye should get you by.

Ali wrote: 2- If you recall from my earlier posts, the doctor indicated that my complications were due to [unusual corena reaction to laser energy or over healing]. He confused me this time when I have asked him how he would calaculate the energy to ensure no abnormal reaction- he told me that he thinks that I was overcorrected i.e. he does not think that the complications to do with abnormal or overhealing. Why do you think he is saying this NOW.


The doctor may have entered the wrong data. It happens. The doctor may have entered the correct data, but your corneas over-reacted. The doctor may have entered the correct data, but there was a delay after the Lasik flap was lifted that caused some dehydration and the dehydrated cornea ablated more tissue than normal. You should ask for clarification so you are assured that you have the highest probability of the desired result.
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Postby Ali » Sun Oct 12, 2008 7:22 pm

Hi every one-
I had a custome wave enhacement surgery yesterday. The process took little longer that the initial one and with little discomfort. My eyes were very itchy and tearing few hours after the surgery but were reasonably comfortable since I wake up in the morning.
I was very pleasantly surprised to see that I can read without using my reading glasses.Howver my ability to see from far was afftected. I went to see the Doctor in the morning who told me that the improvement in my reading was due to the fact that my both eyes are now -.75 {were +1.75 before enhancement}adding that he expects my eyes to regress a bit and my vision will improve further in the coming days.

My questions to Glenn:
1- Is it normal to again overcorrect and hope that a regression will make the trick?

2- What if they did not regress or go the otherway i.e. to -1 or more ? is this possible and if so what is next?

Look forward to your usual valuable input and enlightment.



Ali
 
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Postby LasikExpert » Mon Oct 13, 2008 3:59 am

Ali wrote:1- Is it normal to again overcorrect and hope that a regression will make the trick?


Absolutely. Hyperopic correction commonly regresses.

Ali wrote:2- What if they did not regress or go the otherway i.e. to -1 or more ? is this possible and if so what is next?


If you are left a little myopic your near vision will be improved, albeit at the cost of a small amount of distance vision quality.
Glenn Hagele
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Postby Ali » Mon Oct 13, 2008 11:58 am

Thanks Glenn,

Just to clarify, is regression is common on "natural" hyperopia or "created" hyperopia, i.e. does common regression also apply to hyperopia that is created through lasik overcorrection?.

I am now more concerned as it is my third day since the enhancement and my far vision is not getting any better.
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Postby LasikExpert » Tue Oct 14, 2008 7:08 am

It is hyperopic laser vision correction that regresses. The surgical effect regresses back toward the starting refractive error.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
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Posts: 3309
Joined: Fri May 12, 2006 6:43 am
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Postby Ali » Tue Oct 14, 2008 3:30 pm

Thanks Glenn for all your input which has been very useful for me as well as hundreds others who visits this wonderful forum.

I will keep you posted of any progress going forward.

Ali
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Postby Ali » Sun Oct 19, 2008 4:35 pm

Glenn,

Few days after my custom wavefront enhancement I have experience severe double vision. The ghosting will go soon after the blink drops but only for 2 to 3 seconds. I know from other postings that this could be a good sign and may be due to eye dryness and or edema.

My question is can the actual reason for thes be established at this stage i.e. 8 days post enhancement or one has to wait for the vision to stablise. If the latter, then what is a "reasonable" waiting time?

Regards
Ali
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