Three weeks post epi-Lasik, and having some trouble

Research your concerns in this forum or post your questions if you have had Lasik, IntraLasik, PRK, LASEK, Epi-Lasik, RLE, or P-IOL within the past three months.

Three weeks post epi-Lasik, and having some trouble

Postby TeacherAmy » Mon Feb 23, 2009 2:27 am

Hi all! As of tomorrow, I will be three weeks past CustomVue epi-Lasik (PRK using a microkeratome to remove the epithelium), and I'm concerned.

In case it's relevant, here's some basic info:
*Right eye: -1.50, mild astigmatism
*Left eye: -3.00, mild astigmatism
*Treated pre-op for chronic dry eye with Restasis
*was good candidate for Lasik, but chose PRK/epiLasik because of dry eye concerns

The surgery itself went very well and the surgeon told my husband I was the "ideal patient". Although my vision was blurry, I technically got 20/20 with the right eye the next day, which delighted my surgeon. Five days later, he removed the lenses as my epithelium had healed over. However, on the way home, I started to experience major pain which turned into excruciating pain once home. My eyes were tearing incessantly, but since my husband had to return to work and we live 40-45 minutes from the office, I had no choice but to deal with it. I did call the eye clinic, and the technician said that it sounded like the epithelium hadn't fully healed over, but when she checked with the surgeon, he said it had. They called in an antibiotic ointment which helped for the next few days until it resolved.

Unfortunately, my vision has continued to be odd since then. Major ghosting, and I still don't feel I can drive safely. I have had such severe headaches that Tylenol and Motrin weren't helping, though a prescription muscle relaxer did (thank heaven). My husband had PRK done two years ago and so I had a good idea of what to expect--particularly the ups and downs and the fact that the progress is not linear--but when I went for a checkup on Friday (2.5 weeks or so), my vision was noticeably worse than it was the first few days. My right eye is significantly worse than the left and has been bothering me much more than the left. When the surgeon entered, he was baffled by the notes the technician had left and wound up having them run the refraction again. He noted that my eyes were healing well with intact epithelium and no hazing, but he was visibly surprised at my vision test. He eventually told me that it looks like I was undercorrected, and he wrote me a prescription for eyeglasses (-.25/-1.00 and -1.00/-1.00) and began to plan for enhancement in three months.

I'm shocked. I thought this was all normal. I know things can happen, but after having a mild to moderate myopia, being relatively young (34), and all things being uneventful, I'm really disappointed. My husband kept saying how normal all this was, but I don't think he realized how bad my vision was. Thankfully the surgeon told me he would not charge me the $200/eye enhancement fee because I'm a 'great patient', so my biggest concern is resolved.

I know that none of you are ophthalmic surgeons, but I'm wondering if anyone had a similar experience. My concerns are:

1) Will wearing eyeglasses in the interim interfere with the possibility of my eyes healing to acceptable vision?

2) Do I still have a good chance of all of this resolving and not having to go through an enhancement? (It's difficult to be unavailable for several days when you have a toddler.)

3) Could the incident with right eye pain have anything to do with why that eye is noticeably worse?

4) Could I be interfering with recovery by "pushing it", i.e. reading, working on the computer, etc.?


Thank you... I greatly appreciate any insight or advice y'all may have. :)
TeacherAmy
 
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Postby Indept » Mon Feb 23, 2009 3:51 am

Just curious TeacherAmy, what meds are you on for your eye, Pred Forte, or Lotemax steroids etc? I have seen where some have had bad vision until these are stopped, then it improves. It took me days after my bandage contact was removed for my vision to get better, I have a thread in this forum "Just got PRK after RK" showing my progress. So your doctor has already decided you need a redo, sounds awful early to determine that. Good luck, hopefully your eyes do a turn around.
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Postby ajdaniel » Mon Feb 23, 2009 10:17 am

man 3-4 weeks post epilasik i was still in pain and blind as a bat....it was bad and i was labelled a "delayed" healer. I'm 9 months out now with damn near perfect vision....it just took several months to reach that. I'm awful surprised he prescribed you glasses just 3-4 weeks into the healing process. I mean i was told at 4 weeks you should be mostly clear but there is room for further healing. Yeah I wasn't mostly clear at 3 weeks so whatever.
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Postby TeacherAmy » Mon Feb 23, 2009 2:26 pm

You two have made me feel quite a bit better. Thank you!

I'm on PredForte drops and have just gone from 4x/day to 2x/day. I'm also on Restasis 2x/day and Refresh Plus 4x/day (though I use it more like 12 or more!).

I don't think the doctor had so much 'decided' as put it on the table as a possibility. I was just surprised at how he discussed the enhancement and glasses more than he did any reassurance that this can be normal. Between my age, lack of complicating factors, and mild prescription, it seemed he was expecting things to be quite a bit further along. That's what worried me.

The glasses are largely because we discussed how I really can't drive safely yet. Not being able to see around the house is one thing, but I'm not going to risk my child or someone else's out there if I'm not fully ready to be on the road. That definitely hamstrings a young mom who needs to do some major grocery shopping!

If I may ask, when did you two get far enough along to drive? And did one eye consistently feel different than the other one, e.g. smeary?
TeacherAmy
 
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Postby Indept » Mon Feb 23, 2009 7:15 pm

I didn't have any trouble driving from day 3 on but to be fair, I only had the right eye done now and will follow uo in about a month with the second. Given that, I could still have driven on day 3 since the light sensitivity had subsided if both eyes were like that. Also I had my bandage contact out last tuesday which was day 5 for me & my eye went from pretty good 20/20 clear vision with some cloudiness to pretty blurry. My doctor had me stop the pred Forte 2 days later @ my 1 week anfd start Lotemax and my eye was back to pretty good by Friday night & very good as of Sunday.
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Postby TeacherAmy » Fri Feb 27, 2009 5:22 pm

Okay, here's the prescription for eyeglasses:

Right: Sphere -1.00, Cylinder -1.00, x180
Left: Sphere -0.25, Cylinder -1.00, x165

Today's vision is even worse--I wanted to drive down the street to get groceries but am not seeing well enough for that. We're nearly at the four-week mark and I realize that, at its very best, my vision is still quite blurry and ghosting. I am really disappointed to think that, even with a mild prescription and everything going fine, it seems I indeed was likely undercorrected and will need to do this all over again. After waiting another few months. :(

I'm starting to wonder if there's any hope of it improving on its own.
TeacherAmy
 
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Postby Indept » Sun Mar 01, 2009 4:31 am

TeacherAmy,

Does your doctor think that your eyes will recover or rebound at this point? The eye I had done has very good distance vision but still has hazieness which is most noticeable when trying to read, look at a computer monitor at normal distance & at night around lights.
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