Laser eye-surgery (PRK), to redo or not?

[beepbeep]

Hi there!

I hope there are some oculist or at least expirienced people who can help me on this issue.

I had in-situ laser keratomy done on both of my eyes. Previous to operation, interferometer measurments showed that my cornea was too thin to use LASIK (where they make a small incision on cornea) so they used PRK (laser directly on cornea, with epitel removed).

Previous to operation i had -2.75 on one eye and -2.25 on the other, with some astigmatism on both.

Post operation and one year later i have -0.25 on right eye (pretty perfect) and -0.5 on the left one (less perfect).

I'm slightly irritated by the fact that my left eye isn't better as my vision is slightly blurry, especially in low-light when iris is fully open.

When corrected, i can read even the smallest letters (down to 2.0 line, i don't know if those things are the same in US) which my eye-surgeon says is pretty unusual and is better than most people with perfect vision can do (bull**** or not?!?).

When returning to clinic to control the eye, my surgeon was surprized "not to find any scar mark and that eye is so perfect", until i said to him that they've done PRK and not LASIK at which point he looked little umbarassed (he was the one who did all the work on me) and said "ah, yes, of course"... That didn't raise my confidence , to say the least.

Nonetheless, he doesn't think that this -0.5 left eye near-sightness is worth additional operation. He said that there are complications with incision that can happend until i reminded him for 2:nd time that they did PRK on me. I still have the posibility to redo it for free though.

It's not my area so i would like second opinion on this.

Thanx!

[BlueSkyJaunte]

I have -8.0 in both eyes w/ massive astigmatisms. I can't see anything without my glasses, and can't wear contacts anymore because it's too dry here in Arizona. I say don't screw with your eyes any more, you've only got one pair, and your eye doctor doesn't seem to inspire any confidence in his abilities.

[beepbeep]

Well i guess he has many patients so he kinda forgets what he has done on me (as it's pretty unusuall to do PRK nowdays).

However, i did this at most prestigious (and most expensive) eye-clinic in sweden and are of course interested to have it as perfect as possible. Unfortunately i don't have anough knowledge to decide if they are just trying to dodge another surgery that they have to do for free or not.

He said that i can decide that for myself and give him a call.

P.S. Of course, I wouldn't do this just for fun. It hurts a lot to do it.

[cstreit]

Why not visit a few other clinics, and tell them right up front that THEY will not be doing the work, just giving a second opinion, that way they won't try to get you into surgery that you may not need, or that may not help.

[Paco Anton]

Originally posted by cstreit
Why not visit a few other clinics, and tell them right up front that THEY will not be doing the work, just giving a second opinion, that way they won't try to get you into surgery that you may not need, or that may not help.

I agree with this. Think PPI.

[LeRoux Strydom]

I had both eyes done in 1997 with good results. My eyes were similar to yours before. Afterwards, my left eye also developed a 0.25 difference to the right eye, so I was also left with slightly uneven vision. I was told this is common, and was convinced to to re-do the left eye, which returned it to the same -.50 as the right eye. Only disadvantage now is that the left eye developed some "shadow" images in low light due to some scar tissue right on the edge of the cornea, but this is only a minor issue when the iris is fully open. I now have perfect longrange vision, only reading glasses required for reading but's that because I'm past 40 and counting.

I think you have to assess the risk of re-doing your left eye in terms of the cornea thickness, ocular pressure and existing scar tissue, before deciding.

BTW, I certainly had the LASIK procedure, which is the laser ablation method after surgically "slicing" a small flap away from the surface of the cornea, laser ablating and replacement of the flap. The radial incision method (don't know what it is called) is old-fashioned and very risky and unreliable. Are you sure you have the terminology correct, or did you have a procedure with laser ablation without cutting the flap? If your cornea was too thin for LASIK to begin with, I would advise caution. You only have two eyes, take care of them.

See http://www.fda.gov/cdrh/lasik/ for more info.

Good luck

LeRoux

[beepbeep]

LeRoux:

Thanx for your input.
Shadow artifacts you are talking about are specific to LASIK and small scar tissue on the edge of the "flap". As i stated, i didn't have LASIK but PRK so there was no incision that could leave scars.

PRK is roughly the same as LASIK, but there is not flap removed but cornea is ablated by laser directly, after removing thin epithel layer.

It is actually less risky and more precise than LASIK but reconvalescence is much longer and so are the pains. LASIK was developed to eliminate pains and speed up healing, not beacuse it yields better results or is safer.

So as far as surgery goes, there are no risks of "halo" effects in my case. I hurts as hell for days though...


Hard to describe the pain but it's like somebody scrubbing your synapses with wire-brush for few days. Eventually epithel grows back and sight stabilises.