Enhancement, Flap lift and epithelial ingrowth

[ohredwood]

Hi all, back in 2008 I had the following prescription
Prescription was 20/70 or nearsighted
Right SPH CYL AXIS
-1.oo -0.25 092

Left -1.25 -0.25 092
I had my Right eye custom Lasik, with Intralase, on a Ladarvision system, and the left eye, untouched, so I would have a good reading eye or a classic monovision case. So I did it, and as I said, that was back in 2008. Although the brainwashing of tricking the brain to accept the new eye was a bit challenging it was I felt a Good deal. Monovision is not a best, or crispest vision scenario, but I feel it afforded me good vision, good enough that I didn't need reading glasses and I didn't need distance glasses. Sure if I had put my distance glasses on for the reading eye, it would of made it all the better but that's the point of the procedure to eliminate glasses. Now I started noticing at some point over the last year my distance vision being not so good as it was when I had the Lasik done. So I figured after 2.5 years I ought to get a routine checkup anyhow. So here are the results...
OD -0.50 (sphere) -0.25(cylinder) 165 (axis)
OS -1.50 Sph.

Not entireley sure of the meaning, but as I already knew my distance was not as sharp in lasik, (right) eye and the Doctor wanted to put my in glasses or contacts. I told her I wanted to get in touch with Lasik surgeon and discuss options since it cost about 2500. to have one eye done.
Talk with surgeon after they ran more tests, confirmed my sharpness wasn't quite there, all tests like cornea thickness and such and surgeons opinion said if I wanted to do an enhancement, I was a candidate, go ahead.
My wife who had the blade procedure done 15 years ago, felt I should not do it, but I figured this surgeon has folks coming in from over all over the world for eye problems to see him so I'm on board.
So Two weeks ago April 7th, I went back on the table. Surgeon lifted flap, not laser or cut a new one... And although I had a valium a few minutes prior, and eye drops, I deffinitely could feel and remember all of it. Not gonna say it was painful just very anxious, and scary. But they talk to you and one of his assitants holds your arm to comfort you. Anyway, seemed to me he had a bit of a challenge going around in a semicircle to pry up the original flap, as he talked me through it and finally got it up, had me maintain looking at the red dot and the laser did a few seconds of it's thing. Irrigating and then laying the flap back down. Then like spreading frosting on a cake, smoothing the flap back down with like paste or gel or something, I think anyway.
A few minutes later he looked at me in the microscope, said everything went well and looked very good. I had a terrible time that day with my eye crying, even with my sunglasses on, on the way home, with my wife driving, my eye teared and nose ran. I got home, had lunch and tried to lay down and maybe slept a half hour, my eye wouldn't quit crying.
Next day, optomotrist guy, looked at my eye through lighted magnifier and said it looked very good, and I had 20/20 again, hooooray...
I tried to take care of keeping water out of eye when showering, not doing anything stupid, and limiting my outside time. In fact I took a week off work since I work outside in a dirty job enviornment. a few days later, you know the ole placing hand in front of one eye and checking vision compared to other. Well I started noticing my distance vision eye was barely better than other eye. Whooooaaaa. That seemed odd. I figured must be inflamation, so I'll keep an eye on it. By day 5 or 6, my distance was the same as untreated eye and my close up vision with lasik eye was blurry, bad. I couldn't even read up close stuff like the clock on the stove. Something was wrong...
Day 7 was my one week check up, the girl had me try to read the first chart she threw on the wall, and I couldn't read it and I think it was around 20/90. In fact the only thing I could read was the huge E and the next one, that's it. I was scared baaaaaaad.
Optomologist Dr. came in, heard my story, looked at my eye through the lighted magnifier and said, I want to do a curvature test of your eye and then I'll tell you what's going on.
After the test he said, by covering up one eye look through these tiny pin holes, can you read any letters on the wall now, I said yea, the 20/20 line. He said yea, I thought so, you have cell growth under your flap, I can barely see it and the curvature machine shows it. Soooooooooooooooooooooooooooooooo
Now I'm scared, took a week off work, worse vision than I had, wife told me not repeat, oh man, what have I done, grieffff. Anyway, Dr said, we need to lift the flap and irrigate, and brush cells with a like microsponge, irrigate, and close up.
I looked it up on line, and I see it's a nice little side effect of attempting enhancement called epithelial ingrowth. Well 3 days later, back on the table. Flap came up suprising easy, imagine that, he irrigated,brushed,irrigated and closed up.
A few minutes later he looked again under magnifier, said it all looked good. I came back the next day, now thankfully my vision was returning, I think I got about 20/30 20/35 something like that, but it was not 20/20 like the week before. I asked dr. what could I have done differently that I didn't do last time or to prevent this, he said not much really, it's an uncommon thing that can happen after flap lifting, unlike initial laser cut where it's a perfectly clean cut laid back down. He did say that it was very rare to have to relift and irrigate after lifting and irrigating though, so Lord please let this be the end of it.
The only thing I can say that was not right first time around, they say you need to rest immediately after procedure which is critical for eyes to heal, I tried first time but eye were just crying and nose running, I couldn't stop it, so I only got about 45 minutes of sleep maybe. This time, I came home took two excedrin pm's and knocked out almost immediately for 4 hours. Also the first time, two nights I woke up and my clear patch/lense was no longer taped to my eye. I didn't have any eye pain but could I have just somehow nudged the eye in the sleep with a pillow or something, I don't know. This time, before I go to bed, I clean my forehead and cheek with a cottonball in rubbing alcohol, to remove any oil so the tape sticks good, and instead of two pieces of tape, I put five on it, it's not coming off in a hurricane. Drinking tons of water,fishoil, vitamins, fruits, vegetables and besides the vigamox and prednisolone 4 x daily I'm doing the systane preserve free drops about every 45 minutes from computer or tv watching to keep em well lubed. I don't know what else to do, but I sure don't repeat this mess.....

[ohredwood]

Update 4/27
So I had my right eye flap relifted now 6.5 days ago, and had one week follow up today. Doctor had me read chart on wall and I got a fuzzy 20/25 so that was pretty good to see, but my concern was more on any new epithelial growth under flap. So Doc looked at my eye with the lighted microscope machine and said the flap looked clean. He then put one drop of a brown liquid in my eye, which he said is like a black light effect if any growth is there is will come up glowing, and again, he said the edges have sealed down and now growth cells under flap. He said in 3 weeks, we'll look again, and at that point, I'll be out of the woods. Right now, he said I should be just fine as long as I don't touch my eye, rub it or, have some trauma to disrupt the flap. He thought it was a good idea to continue to wear my eye shield at night so to not misadvertantly rub my eye in the middle of the night, so I most certainly will. Right now, much relieved but keeping my fingers crossed to continued success.
He did also mention there is some swelling still he sees, which would explain my minor ghosting/haze and fuzzy 2025, which should subside with the decrease in swelling, sounds good to me.....

[LasikExpert]

This all sounds great and you are on the mend. Please let us know if the epithelial cells return at the three week appointment.

[ohredwood]

Yes, I certainly will. You know the first day after I had the enhancement a couple weeks ago, I noticed that the vigamox and predinisolone stung each time I put em in, and it seemed each day for about 6 days an eye lash type feeling in my eye. The latest time with the flap relifted and cleaned, I didn't notice the stinging of the drops or the eyelash feeling. If it gets dry like last night at work, it tends to feel a touch sticky irritated not eyelashy but I brought drops to work, it was just windy which intensified the effect. Anyrate just thought I'd mention those suttle differences from first time to last time. Doctor didn't really seem to have much comment, could all be coincidence I reckon.