Lasik Eyes Surgery - Lasek Recovery Problems

Author

Lasek Recovery Problems

MetalSpine

2004-10-26, 7:28 pm

On October 7th I had Lasek surgery. By the 12th the vision in my right
eye was getting good, 20/30 and the left eye was not quite as good.
After the eye test they removed the contact from the left eye and all
was fine. When they removed the right contact, the Dr could not get it
off my eye on the first try. She tried again and it came off -
painfully despite the numbing drops. She put a dye in my eyes and
checked them one more time. She was walking me out and I noticed that
the right eye was blurry and I thought the dye was in my eye blocking
my vision, as I drove to my office it started burning.. then the pain
got a lot worse and finally unbearable. I went back to the doctors
office and they said it just needs more time to heal and put the
bandage back on my eye.

My vision did not clear up after they replaced the contact.. it was
horrible, I could not see the chart on the wall at all. Now I have
double vision in my right eye and I get constant headaches. I am told
this will clear up. My left eye is 20/20 now, and right is 20/30 with
a double or shadow type effect on everything I read. They told me some
of the cells came off when the contact was removed and it happens
about 10% of the time. Is this true, could this have been prevented. I
am really worried about my eye and my vision is driving me crazy.

Please someone advise me.

2004-10-26, 7:28 pm

I hope an expert does weigh in and advise you. sounds scary. perhaps
you may also want to go see an independent opthalmologist for peace of
mind.

In article <2e827918.0410261048.616cb53f@posting.google.com>,
markmcqueen@gmail.com (MetalSpine) wrote:

> On October 7th I had Lasek surgery. By the 12th the vision in my right
> eye was getting good, 20/30 and the left eye was not quite as good.
> After the eye test they removed the contact from the left eye and all
> was fine. When they removed the right contact, the Dr could not get it
> off my eye on the first try. She tried again and it came off -
> painfully despite the numbing drops. She put a dye in my eyes and
> checked them one more time. She was walking me out and I noticed that
> the right eye was blurry and I thought the dye was in my eye blocking
> my vision, as I drove to my office it started burning.. then the pain
> got a lot worse and finally unbearable. I went back to the doctors
> office and they said it just needs more time to heal and put the
> bandage back on my eye.
>
> My vision did not clear up after they replaced the contact.. it was
> horrible, I could not see the chart on the wall at all. Now I have
> double vision in my right eye and I get constant headaches. I am told
> this will clear up. My left eye is 20/20 now, and right is 20/30 with
> a double or shadow type effect on everything I read. They told me some
> of the cells came off when the contact was removed and it happens
> about 10% of the time. Is this true, could this have been prevented. I
> am really worried about my eye and my vision is driving me crazy.
>
> Please someone advise me.

Dr. Leukoma

2004-10-26, 10:08 pm

markmcqueen@gmail.com (MetalSpine) wrote in
news:2e827918.0410261048.616cb53f@posting.google.com:

> On October 7th I had Lasek surgery. By the 12th the vision in my right
> eye was getting good, 20/30 and the left eye was not quite as good.
> After the eye test they removed the contact from the left eye and all
> was fine. When they removed the right contact, the Dr could not get it
> off my eye on the first try. She tried again and it came off -
> painfully despite the numbing drops. She put a dye in my eyes and
> checked them one more time. She was walking me out and I noticed that
> the right eye was blurry and I thought the dye was in my eye blocking
> my vision, as I drove to my office it started burning.. then the pain
> got a lot worse and finally unbearable. I went back to the doctors
> office and they said it just needs more time to heal and put the
> bandage back on my eye.
>
> My vision did not clear up after they replaced the contact.. it was
> horrible, I could not see the chart on the wall at all. Now I have
> double vision in my right eye and I get constant headaches. I am told
> this will clear up. My left eye is 20/20 now, and right is 20/30 with
> a double or shadow type effect on everything I read. They told me some
> of the cells came off when the contact was removed and it happens
> about 10% of the time. Is this true, could this have been prevented. I
> am really worried about my eye and my vision is driving me crazy.
>
> Please someone advise me.
>

Yes, it does sound as though the epithelium was still a bit "fragile" when
the contact lens was removed, and could have been disturbed when the lens
was removed. It isn't all that unusual. Could it have been prevented?
Possibly, but unlikely. There is still a good chance that the epithelium
will eventually smooth itself. However, in the meantime, ask them if they
would consider placing another contact lens on that eye, such as a thick,
high DK soft lens like Focus N&D, as this may facilitate the smoothing
process.

DrG

MetalSpine

2004-10-27, 11:09 am

>
>
> Yes, it does sound as though the epithelium was still a bit "fragile" when
> the contact lens was removed, and could have been disturbed when the lens
> was removed. It isn't all that unusual. Could it have been prevented?
> Possibly, but unlikely. There is still a good chance that the epithelium
> will eventually smooth itself. However, in the meantime, ask them if they
> would consider placing another contact lens on that eye, such as a thick,
> high DK soft lens like Focus N&D, as this may facilitate the smoothing
> process.
>
> DrG

They have told me that the contact stuck to the new cells and when the
contact was removed the new cells went with it. And they just need to
regrow. Is that something the eye will recover and lay down the new
cells again the same way or is there a chance that the resurfacing has
been comprised in such a way that the vision will be different than if
it didn't happen.

When they took the bandage off the second time, they did not just
stick the finger in my eye and remove it. They used a device to gently
take it off. I was told this will prevent any cell removal. And that
cell removal when a contact bandage is taken off only happens 10% of
the time. I am just wondering why they didn't remove the bandage the
first time with that device and what the common procedure is when
removing the bandage.

Thanks for your post.

Dr. Leukoma

2004-10-27, 11:09 am

markmcqueen@gmail.com (MetalSpine) wrote in
news:2e827918.0410270454.74c3840d@posting.google.com:

>
> They have told me that the contact stuck to the new cells and when the
> contact was removed the new cells went with it. And they just need to
> regrow. Is that something the eye will recover and lay down the new
> cells again the same way or is there a chance that the resurfacing has
> been comprised in such a way that the vision will be different than if
> it didn't happen.
>
> When they took the bandage off the second time, they did not just
> stick the finger in my eye and remove it. They used a device to gently
> take it off. I was told this will prevent any cell removal. And that
> cell removal when a contact bandage is taken off only happens 10% of
> the time. I am just wondering why they didn't remove the bandage the
> first time with that device and what the common procedure is when
> removing the bandage.
>
> Thanks for your post.

My personal method is to irrigate the contact lens copiously with saline
until it is loose, and then remove it as gently as possible.

Persistent ghosting is due to either a problem with the ablation, or a
problem with the epithelium. It sounds like the ghosting occurred after
the first contact lens was removed, and therefore is due to irregular
epithelium. Time will tell. It can take several weeks for disturbed
epithelium to remodel itself. However, it may be that there was an
underlying problem in the first place, such as a dry eye, which caused the
contact lens to become excessively tight. Dry eye can interfere with
healing.

In the meantime, you need to do something about the headaches and the
annoying visual disturbance. You need to go back.

DrG

ycdbsoya

2004-10-27, 11:09 am

With the double vision following difficult removal of the CL, it is
possible that flap folds or striae have been induced. While epi loss
is the most likely culprit (this happened to me), other causes may be
a factor. A slit lamp exam should reveal the presence of folds/striae
if there are any. These can be smoothed with a fairly high success
rate, but needs to be assessed and done ASAP.

Glenn - USAEyes.org

2004-10-27, 11:09 am

Your analysis is correct Frank, except that the patient had LASEK so
there is no flap to wrinkle. That is one of the advantages of LASEK
over LASIK. What this person is experiencing is the disadvantage -
pain.

From the symptoms and the doctor's description, it appears clear that
some of the epithelial cells detached from the retina when the bandage
contact lens was removed. I personally believe that this happens
virtually all the time (no data to back me up, just hypotheses) but
that normally the number of cells is small and does not cause the
patient pain or significant vision loss.

The corneal epithelium is the outermost layer of cells on the human
body. They also happen to be the fastest reproducing cells on a
human. Within 10 days the cells should have regenerated, covering the
area that was damaged by the contact removal, and starting to remodel
and smoothing the outer surface. Within three weeks the surface
should be significantly smoothed and vision quality will improve.

The doctor can prescribe medication for the pain - especially for the
headaches. What the patient can do to promote healing is keep the
cornea moist. Using preservative-free eye drops on a regular routine
(say, three times a day as an example), additional drops whenever the
need arises, and a lubricating ointment or jell (again, preservative
free) at night will help the eyes heal. Do this with both eyes.

If after 10 days vision has not vastly improved and pain subsided,
then go back to the doctor for an additional evaluation.

Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance

Email to glenn dot hagele at usaeyes dot org

http://www.USAEyes.org
http://www.ComplicatedEyes.org

I am not a doctor.

2004-10-27, 7:11 pm

In article <ovfvn0tdf3fr26p0ci1pfugu51op01nei5@4ax.com>,
Glenn - USAEyes.org <glenn.hageleSTOPSPAM@USAEyes.org> wrote:

> From the symptoms and the doctor's description, it appears clear that
> some of the epithelial cells detached from the retina when the bandage
> contact lens was removed.

oops, I think you mean cornea here, not retina.

Dr. Leukoma

2004-10-27, 7:11 pm

Glenn - USAEyes.org <glenn.hageleSTOPSPAM@USAEyes.org> wrote in
news:ovfvn0tdf3fr26p0ci1pfugu51op01nei5@4ax.com:

> Your analysis is correct Frank, except that the patient had LASEK so
> there is no flap to wrinkle. That is one of the advantages of LASEK
> over LASIK. What this person is experiencing is the disadvantage -
> pain.

TRUE

>
> From the symptoms and the doctor's description, it appears clear that
> some of the epithelial cells detached from the retina when the bandage
> contact lens was removed. I personally believe that this happens
> virtually all the time (no data to back me up, just hypotheses) but
> that normally the number of cells is small and does not cause the
> patient pain or significant vision loss.

No, this does not happen 'virtually all the time,' at least from the
perspective of the slit-lamp. Remember, this patient had the bandage lens
on for 4 days. "In the day" of PRK, the bandage lens was removed on the
second or third day, post-op. If any epithelium was disturbed, I would
immediately insert another contact lens.
>
> The corneal epithelium is the outermost layer of cells on the human
> body. They also happen to be the fastest reproducing cells on a
> human. Within 10 days the cells should have regenerated, covering the
> area that was damaged by the contact removal, and starting to remodel
> and smoothing the outer surface. Within three weeks the surface
> should be significantly smoothed and vision quality will improve.

True, and probably so.

> The doctor can prescribe medication for the pain - especially for the
> headaches. What the patient can do to promote healing is keep the
> cornea moist. Using preservative-free eye drops on a regular routine
> (say, three times a day as an example), additional drops whenever the
> need arises, and a lubricating ointment or jell (again, preservative
> free) at night will help the eyes heal. Do this with both eyes.

What Glenn is suggesting is that you get some narcotics and forget about
the pain as you drift off into la-la-land. Moisture is important, and this
should already have been included in the post-op instruction kit. Right?
>
> If after 10 days vision has not vastly improved and pain subsided,
> then go back to the doctor for an additional evaluation.

What Glenn means is if your employer can still do without your functioning
for another 10 days, then wait.

DrG

Glenn - USAEyes.org

2004-10-27, 10:11 pm

>No, this does not happen 'virtually all the time,' at least from the
>perspective of the slit-lamp.

See. Nothing screws up a perfectly good theory faster than reality.
8^)

Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance

Email to glenn dot hagele at usaeyes dot org

http://www.USAEyes.org
http://www.ComplicatedEyes.org

I am not a doctor.

Glenn - USAEyes.org

2004-10-27, 10:11 pm

>oops, I think you mean cornea here, not retina.

Thanks RK. You are correct.

2004-10-27, 10:11 pm

In article <ebf0o0dugpstjke618ojr8j8263186dr9g@4ax.com>,
Glenn - USAEyes.org <glenn.hageleSTOPSPAM@USAEyes.org> wrote:

>
>
> Thanks RK. You are correct.

LOL. I think you mean RT.

ycdbsoya

2004-10-28, 11:09 am

RT <RTMD24@NOSPAMyahoo.com> wrote in message news:<RTMD24-D4520C.22033727102004@newssvr13-ext.news.prodigy.com>...
> In article <ebf0o0dugpstjke618ojr8j8263186dr9g@4ax.com>,
> Glenn - USAEyes.org <glenn.hageleSTOPSPAM@USAEyes.org> wrote:
>
>
> LOL. I think you mean RT.

I fully expect Brent to come on here and claim it's proof that Glenn
supports RK as an acceptable RS procedure.

Glenn - USAEyes.org

2004-10-28, 7:11 pm

On Thu, 28 Oct 2004 02:03:34 GMT, RT <RTMD24@NOSPAMyahoo.com> wrote:

>In article <ebf0o0dugpstjke618ojr8j8263186dr9g@4ax.com>,
> Glenn - USAEyes.org <glenn.hageleSTOPSPAM@USAEyes.org> wrote:
>
>
>LOL. I think you mean RT.

ROFL. It's been too many long days at the convention.