Decentered ablation

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Decentered ablation

Postby purplehaze » Sat Jan 12, 2008 3:05 pm

Glad I found this site. It is good to know that I am not alone in dealing with post LASIK issues.

I had a standard LASIK procedure on both eyes about eight months ago. I was roughly a -9 in both eyes. The right eye responded fine and has settled in at about 20/40 (which is fine with me because my reading vision is good in that eye).

The left eye is a different story. Although my treated vision was much better than the original -9, my vision in the left eye was never really clear. I had the ghosting, blurring, and double vision that others on this site have described. My doctor said that the left eye was overcorrected and just needed an enhancement.

I had that enhancement last week (I did not have my right eye enhanced). My vision in my left eye was substantially worse after the enhancement. I know the healing process takes awhile (from my first experience) however something did not seem right.

I went back the day after my post op visit and spent a lot of time with the doctor. He indicated that in fact it appeared my problems all along were because of a decentered ablation on my left eye. He uses the all the latest technology so how this can happen I do not know (and can't spend a lot of energy dwelling on it).

He seems to think my problem can be allevaited (after I heal from the "enhancement") by either doing PRK on the surface or by cutting a second flap using the Interlase technology. He seemed to favor the "second flap" approach" because of the precision the Interlase technology provides in determining flap depth.

I have several questions:

1) Has anyone one ever had a second flap "cut" and is this a common procedure? It does not sound too appealing to me.

2) Has anyone ever had PRK to correct the problems related to a decentered ablation?

3) Is there any risk that my right eye (the good one) will regress because it is now having to do all the work? I could only see the largest "E" on the eye chart with my left eye and it has taken me about 30 minutes to type this post.

Any input would be greatly appreciated!

Thanks,

Purplehaze
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Re: Decentered ablation

Postby LasikExpert » Wed Jan 23, 2008 3:24 am

Decentered ablations are quite rare now that eye tracking software is available on most laser platforms. It is still possible (obviously), but quite rare.

purplehaze wrote:1) Has anyone one ever had a second flap "cut" and is this a common procedure? It does not sound too appealing to me.


Before you have another flap cut, I highly recommend you seek a second opinon from a corneal specialist. Creating a second flap is rather uncommon these days, not matter how accurate the microkeratome. Lifting the exiting flap or PRK on the Lasik flap seems to the preferred method for enhancement surgery. You should discuss in detail why your surgeon wants to create a second flap.

purplehaze wrote:2) Has anyone ever had PRK to correct the problems related to a decentered ablation?


It has been done with limited to excellent result. Much depends upon the exact nature of the decentration, the type of laser platform used for enhancement surgery, if good wavefront data is able to be captured, etc.

purplehaze wrote:3) Is there any risk that my right eye (the good one) will regress because it is now having to do all the work?


Not because it is doing all the work, but Lasik regression after correcting 9.00 diopters of myopia (nearsighted, shortsighted) vision would be a reasonable expectation.

purplehaze wrote:I could only see the largest "E" on the eye chart with my left eye and it has taken me about 30 minutes to type this post.


Yet another reason you should seek a second opinion. I recommend you consider the ophthamology department at a nearby university affiliated teaching hospital.
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Decenterd ablation

Postby RAJAVELU » Thu Nov 13, 2008 2:25 pm

I am a surgeon. had -8.5 in both eyes. Had All Laser Lasik 1st oct2008 in India. My left was distorted reading between 2/6 to 5/6 lines depending on the intensity of light in snellens. I saw top 2 Lasik surgeons in UK and they diagnosed-Decentric ablation. They where reluctant to operate due to poor outcome. Has any one had surgery for decenterd ablation? Has any ones vison became better over a period of time.thanks
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