Dim light and night vision problems

[jazzy_jeff_1986]

Hello,

I would like to put here an update of my situation. A few weeks ago I finally decided to get my glasses done. They are 0.75 D cylinder in the right eye and -0.25 D in the left one. My reading ability (from computer, document, books) is very good with the glasses on. Same situation with watching TV. Also night vision is better for sure. Honestly I don't how I could work without this glasses since re-treatment in march 2012. Now I don't really imagine working without them. However I haven't stopped thinking about re-treatment of this astigmatim, because my vision without glasses is bothering me quite much and I don't really like wearing them. I have a few questions according to possible re-treatment of the astigmatism in my left eye:
1. What is the safe thickness of cornea to avoid risk of ectasia?
2. What would be the risk of haze in the left eye? It would be third surgery. Do You know many patiens who undergone 3 surface surgeries succesfully?
3. Is it difficult to correct 0.75 D astigmatim when there is no myopia/hyperopia?
4. What would be the risk od myopia/hyperopia?
5. What may are other risks?

Glenn I would be very grateful for Your help.

[LasikExpert]

1. What is the safe thickness of cornea to avoid risk of ectasia?

A minimum of 250 microns untouched, more is better.

2. What would be the risk of haze in the left eye? It would be third surgery. Do You know many patiens who undergone 3 surface surgeries succesfully?

Haze is normally associated with the amount of tissue being removed. Since you would require a tiny amount of tissue removal, the probability of haze is very low. Additionally, the use of Mitomycin C (MMC) would likely eliminate any haze.

3. Is it difficult to correct 0.75 D astigmatim when there is no myopia/hyperopia?

It is a greater challenge, but should be able to be accomplished without problem.

4. What would be the risk od myopia/hyperopia?

We are talking about very small amounts of correction. Almost within the margin of error. There is risk of overcorrection / undercorrection, but it appears that it would be a low probability.
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5. What may are other risks?

All risks associated with refractive surgery, plus the potential problem of epithelial cell ingrowth.

[jazzy_jeff_1986]

1. I think I still have more than 400 microns of cornea in the left eye.
2. If I remember well they are not using Mitomycin C in the clinic in London.
3,4. Sounds quite optimistic.
5. Is epithelial cell ingrowth possible also in case of surface treatment? I thought it is possible only in case of LASIK.

If i will decide to solve this astigmatism by 3rd surgery it will be no earlier than in October or November, because now I am changing my job. I think I will need to see with the English doctor eye to eye, before I will make any decision.

Glenn thank You very much for such a fast response.

[LasikExpert]

5. Is epithelial cell ingrowth possible also in case of surface treatment? I thought it is possible only in case of LASIK.

Quite right. Only affects Lasik.

[jazzy_jeff_1986]

Hello,

Just a little update in the beginning. At the moment I am wearing glasses (they are 0.75 stigmatism in the left eye and -0.25 in the right one) every day - for working in front of computer, reading books, documents, watching tv, car driving, going for a shopping or to the restaurant, etc. Honestly since I started wearing them I can't imagine functioning without it now... Lately I was in the clinic in Poland for a check-up and to speak with my doctor about possibility of treating the astigmatism in my left eye. My eyes are:
right one: -0.5, thickness of arround 460 um;
left one: astigmatism of -1.00, thickness of arround 460 um.
Doctor said that eyes look good - there are no signs of surgical intervention and my corneas are clear. I was trying to discuss with her possible risks of a third surgery (second enhacement) aimed to solve that astigmatism in the left eye. My only concern in possibility of corneal haze. My doctor said that she thinks there is a very small risk of a haze in my situation, but a few minutes later she said "you know it would be your third surgery in the eye"... If the haze would occur it might be a disaster for me.
Glenn do You know people who have undergone 3 surface surgeries succesfully? I mean especially without any haze...

[jazzy_jeff_1986]

Hi Glenn,

Another update of my situation. In the end of August I was in London clinic to see with my doc. I had to clarify my doubts. They did examinations of my eyes. I asked my doctor: If You were me would You do it? His answer was positive.
Another important question for me was risk of haze. The doc said that risk of haze in case of top up is exacly the same as it was last time. It made me optimistic.
He also said that I should wait a few months and check if my prescription is 100% stable. Well, it has been a few months now...
At the moment I am at the stage of setting date of treatment. Once again lots of planning, etc. It looks like I will book a term in January or February.
I have to tell You that I am a little scared... However it would be nice to read from computer screen, papers, etc. without glasses comfortably...

[jazzy_jeff_1986]

Hi there,

Another update of my situation. On the 3rd of January I had re-treatment of my left eye aimed to solve my astigmatim. It was in the London clinic and it was Epi-lasik. At this point (10 days after treatment) my close vision is good. I can read from mobile, computer screen and read a book easily with this eye. No signs of the astigmatim that was bothering me for almost last 2 years. However my distant and average away vision is still quite poor. According to refractometer (I've been at ocilist's today) it is -1.25 D, but I think the the eye is just stil healing, and the refractometer doesn't reflect actual state of the eye. So I hope and believe that the eye will impove in next days/weeks. I remember that after my last treatments my vision cleared up after 6-8 weeks post surgery, so there is still plenty od time to get better!

[jazzy_jeff_1986]

Hello,

Another update of my situation. I was very happy with the outcome of the treatment. Both my close and distant vision was very good. Unfortunately in mid April I started to notice changes in my vision. I thought that my astigmatism regressed (problems with reading from computer, worse night vision, etc.). I have seen with my doctor on April the 30th and she told me that I have corneal haze. Tha same day I started to use steroid drops (5 times daily), antibiotic (3 times daily) and corneregel.
My reflections after using these medicine:
1. The problem with close vision etc. is smaller.
2. On the other hand my distant vision started to regress. After 6 days of using drops it regressed from +0.25 D to -0.5 D. Moreover I have a feeling that this regression continues...

Glenn I have a question. Is this regression after steroid drops typical? I am really concerned about my distant vision. It is difficult for me to drive a car at this point.