Temporary Plugs / Intralase

[Poogada]

Three years ago I was treated by an opthamologist for chronic dry eye with Restasis. I was told that I was not a candidate for lasik surgery.
Monday I saw another opthamologist who claims I am a candidate. He
put in the temporary collagen plugs and prescribed Restasis. I am to
return in two weeks to be reevaluated.
When the plugs were inserted I could feel them in my eyes. Forty-eight
hours later, my vision is still blurry with my glasses on. I understand this
is a temporary symptom.
My concern is that should I proceed with the surgery will my eyes become
even more dry. Will I possibly need to use Restasis for the rest of my life.
Has anyone seen one doctor and been told they are not a candidate for
lasik now a candidate for Intralase?

[Rebecca Petris]

Hi Poogada,

If you're looking for any encouragement to proceed I'm afraid you're unlikely to get any here... since frankly a large percentage of people on this site have dry eye caused by lasik.

I can understand your concern about the inconsistency though. It is not uncommon to get different answers from different doctors about your suitability for surgery. Candidacy (eligibility) is a fairly simple matter - age, eyesight, ruling out a few basic diseases, then most people are candidates. But suitability is another matter and that is where risk factors come into play. The variety of advice you get is like any other medical opinion: It will vary by doctor, and by their experience and by how aggressive or conservative they are. It will also vary according to which laser procedure. It is generally agreed that LASIK is the biggest laser culprint when it comes to dry eye but there are many here to attest to the fact that Intralase, and even the surface ablations (PRK, epi lasik, etc) still carry real risk of joining the ranks of the severely dry.

Will I possibly need to use Restasis for the rest of my life.

Frankly, there are worse things to worry about with dry eye than having to use Restasis. There are many here who cannot get comfortable even with Restasis and many other medical and natural remedies.

As you have probably divined by now, I am against LASIK being performed on anyone with existing dry eye because not only of the risk but the life impact when surgically induced dry eye is severe.

[Guest]

Poogada

It doesn't matter what name they give it is still lasik in some form.

Intralase uses a laser to make the flap as rather than a mechanical microketatone (??sp). Either way there is still risk of corneal nerve damage.

Intralase is possibly the safer of the two options but given that you already have dry eyes, it would be my advice to stay clear of laser surgery.

I didn't have pre-existing dry eyes and after epi-lasek (less invasive than lasik (either form)) and I have horrific dry eyes since my surgery.

I am sure that there will be a number of posters on this Board that will support my comments.

Ultimately, the decsion is yours, and you have to make an informed choice but if I were in your position, I would run a mile.

Have a look on this board under My Stories, you will find some factual and opinion based data there.

regards

Ian (Prattstar)

[bostonlover]

I say defnintely don't do it!! I was not diagnosed with dry eyes prior to Intralase, but was contact lense intolerant and of course was told I was a great candidate. Here I am a year later though stlll dealing with very uncomfortable dry eyes despite the fact I have punctal plugs and have been on Restasis for about 7 months. I can only manage to work everyday by wearing my Panoptx sunglasses most of the day as I work at a computer all day. I would be pretty embarrassed if not for the fact I work mostly by myself in a company owned by my family! LOL! Most of my friends and relatives have pretty much ruled laser eye surgery out as an option for them since I had mine.

You of course have to make your own decision; I just hope that like me you don't decide that the risk is worth it based on what a Laser Doctor tells you. I had no idea what risk I was actually taking! Dry eyes sucks!!



Tera

[Jade9923]

After reading about everyone who suffers here, you would have to be out of your mind to do it. There are dry eyes (like millions of people suffer, minor in nature, drops seem to take care of it) THEN there are DRY EYES. The kind the folks here talk about. This type of dry eye ruins lives. It makes you non functional. It makes you want to keep your eyes closed forever. It is pure torchure. No amount of vanity about having to wear glasses warrants making a potentially life altering decision that may change to your eye comfort forever. If sticking pins in the middle of my eyes would have cured my dry eyes at their worst, I would have done it all day. That's how painfull and disabling this problem can be.

[Majorglory]

DON'T DO IT! You will regret this for your whole life. Lasik on an already dry eye leads to complete disaster. Listen to us mate. Lasik, intralase, epilasik, lasek, prk.. they are all the same, they damage irreversibly corneal nerves.
So many patients without prior symptoms deal now with everyday hell pain.. what will happen to you who already have dry eyes issue??
Believe me, Im pretty sure this Im giving you is the best advice I ever gave and probably will give to anyone: don't do it.

[Judy]

DITTO ON THE DON"T DO IT! I did not even have lasik surgery and have dry eyes so painful at times I want to die. IT IS SO NOT WORTH THE 'convenience' of not wearing glasses or not having to deal with contacts'!!! If you already have dry eyes, you really really need to reconsider having any kind of surgery near your eyes (even cosmetic surgery from what I've read). PLEASE RECONSIDER!!

[Natalie06]

Hmmmmm..

Do you even know what is causing the dry eye? Have they checked for MGD, ocular rosacea/and or blepharitis? Do you have any autoimmune diseases? I would highly recommend you get some answers before the surgery. Finding out that you have an underlying disease after you have Lasik really s&&&ks. Take my word for it.

Are you peri or post menopausal? Are you taking any birth control or other hormone therapy for anything? High risk factors for severe dry eye after Lasik. If you already have dry eyes, then you will increase your risk.

Do you know that there is evidence that people with chronic dry eyes are more likely to not get the best correction with the first surgery? Are you okay with that? People over 40 have higher rates of undercorrection and regression according to the American Academy of Ophthalmology. So be mentally prepared to require another surgery.

You might ask your surgeon specific questions about any former dry eye patients he has and how many of them are still dealing with dry eye after 6 months.

Are you financially prepared to spend anywhere from $40.00 (cheapest restasis I could find was $40.00 copay per month) to $100.00 a month on dry eye care which is what it is costing me? Are you willing to deal with punctal plugs for the rest of your life or having your punctums cauterized closed to have Lasik?

If he tells you to go ahead with the surgery anyway, ask him to sign a "consent form" requiring him to pay for your possible lifetime medical care for chronic and/or severe dry eye and see what he says. Only partly kidding here.

Good luck with your decision.

Natalie