Tweet
Right now I am 6 weeks post lasik and had a wrinkled flap in right eye immediately after surgery, which was re-floated at 1 day post op and my vision is still pretty lousy and lots of pain/discomfort still. I'll be going back to surgeon for yet another exam and another corneal mapping in 2 weeks (so 8 weeks along at that point).
At that point, the dr. is proposing, unless I'm better which seems highly unlikely, that they may want to re-float my lasik flap again in the right eye and irrigate with steroids underneath the flap. The theory being that if my ongoing problems (poor vision quality, pain and discomfort - will explain more below) if it all has to do with slow healing and inflammation at the deepest layer of the cornea that they cannot see with the slit lamp, then the idea is that putting the steroid directly under the flap will finally resolve that inflammation. Doc says they have had a few other patients see immediate results of clear vision after doing this.
But first, they said they would like me to go back on Lotemax twice a day for two more weeks (I've been off it for a week and things have gotten worse again, though not sure if it's dropping the steroid or allergies making things worse).
Then when I go back in 2 weeks, before doing the flap re-float, they said they can numb my eye and put on a hard contact lens on it and test my vision with that on to determine whether the re-float with steroid will actually work. The way they explained it, the hard contact lens would temporarily reshape my cornea the way it would be if it didn't have inflammation deep down. If my vision clears with that, then it should clear w/the steroid?
Does this make any sense?
Would going on a stronger steroid with more frequent dosing not be an option instead of putting steroid under flap? Or does topical steroid not penetrate that deep into the cornea? (I thought of this question after I left clinic today - wish I had asked it.)
I found out they do offer aberrometry, though I'd have to travel to another city where there other surgery center is b/c they don't have the machine at the clinic in my town. I'm willing to do this of course, but they seem to think it's better to do this re-floating thing before aberrometry. Will the aberrometry not be conclusive if I have inflammation?
I'm so confused by all this and terrified of causing more problems. After what I've already been through touching the flap at all scares the hell out of me!
Oh also should mention I'm on Restasis (only about 3 weeks in so probably not doing much yet) and using artificial tears. Was on Lotemax for about a month and tapered off. Been off it for one week.
I do have some dryness still, but at this point everyone (surgeon, another corneal specialist, optometrist) seems to agree that dry eye isn't the main cause of my poor vision quality b/c my dryness is not severe.
My vision in the right eye still fluctuates a lot. On the WORST days, it can be completely hazy all over and blurry to the point that I can't read a license plate on the car in front of me (with both eyes open I can, just not with right eye). Sometimes there is also doubling/ghosting, but not always, and the night halo thing is still about as bad as day 1 (while left eye it has almost gone away completely). On the BEST days, things don't look crisp and have fuzzy edges and contrast is poor.
The weird thing that near vision in right eye is clear. It's just when something is more than a few feet away that the vision gets bad. Except when the haziness comes back, that's all over, but it's very light haze.
What the docs all say is that everything looks perfect clinically - cornea totally clear, vision 20/20 (in right bad eye) and 20/15 in left eye. Today I measured with slight astigmatism (.5) in right eye, which I had no astigmatism a few weeks ago (which I also don't understand - can it still be changing?), but anyway during my exam they checked and the vision did not correct with refraction, so they are now saying (which I figured out from this site a few weeks ago) that something sub-clinical is causing me to have poor vision quality. Thankfully they are no longer telling me "it's normal" over and over again!
Anyway, I'd love to know what others think of this flap re-floating proposal. Maybe it is a good idea. I'm just worried about it!
At that point, the dr. is proposing, unless I'm better which seems highly unlikely, that they may want to re-float my lasik flap again in the right eye and irrigate with steroids underneath the flap. The theory being that if my ongoing problems (poor vision quality, pain and discomfort - will explain more below) if it all has to do with slow healing and inflammation at the deepest layer of the cornea that they cannot see with the slit lamp, then the idea is that putting the steroid directly under the flap will finally resolve that inflammation. Doc says they have had a few other patients see immediate results of clear vision after doing this.
But first, they said they would like me to go back on Lotemax twice a day for two more weeks (I've been off it for a week and things have gotten worse again, though not sure if it's dropping the steroid or allergies making things worse).
Then when I go back in 2 weeks, before doing the flap re-float, they said they can numb my eye and put on a hard contact lens on it and test my vision with that on to determine whether the re-float with steroid will actually work. The way they explained it, the hard contact lens would temporarily reshape my cornea the way it would be if it didn't have inflammation deep down. If my vision clears with that, then it should clear w/the steroid?
Does this make any sense?
Would going on a stronger steroid with more frequent dosing not be an option instead of putting steroid under flap? Or does topical steroid not penetrate that deep into the cornea? (I thought of this question after I left clinic today - wish I had asked it.)
I found out they do offer aberrometry, though I'd have to travel to another city where there other surgery center is b/c they don't have the machine at the clinic in my town. I'm willing to do this of course, but they seem to think it's better to do this re-floating thing before aberrometry. Will the aberrometry not be conclusive if I have inflammation?
I'm so confused by all this and terrified of causing more problems. After what I've already been through touching the flap at all scares the hell out of me!
Oh also should mention I'm on Restasis (only about 3 weeks in so probably not doing much yet) and using artificial tears. Was on Lotemax for about a month and tapered off. Been off it for one week.
I do have some dryness still, but at this point everyone (surgeon, another corneal specialist, optometrist) seems to agree that dry eye isn't the main cause of my poor vision quality b/c my dryness is not severe.
My vision in the right eye still fluctuates a lot. On the WORST days, it can be completely hazy all over and blurry to the point that I can't read a license plate on the car in front of me (with both eyes open I can, just not with right eye). Sometimes there is also doubling/ghosting, but not always, and the night halo thing is still about as bad as day 1 (while left eye it has almost gone away completely). On the BEST days, things don't look crisp and have fuzzy edges and contrast is poor.
The weird thing that near vision in right eye is clear. It's just when something is more than a few feet away that the vision gets bad. Except when the haziness comes back, that's all over, but it's very light haze.
What the docs all say is that everything looks perfect clinically - cornea totally clear, vision 20/20 (in right bad eye) and 20/15 in left eye. Today I measured with slight astigmatism (.5) in right eye, which I had no astigmatism a few weeks ago (which I also don't understand - can it still be changing?), but anyway during my exam they checked and the vision did not correct with refraction, so they are now saying (which I figured out from this site a few weeks ago) that something sub-clinical is causing me to have poor vision quality. Thankfully they are no longer telling me "it's normal" over and over again!
Anyway, I'd love to know what others think of this flap re-floating proposal. Maybe it is a good idea. I'm just worried about it!
Comment