Hello! I am almost 4 weeks postop. My astigmatism is causing my vision to be very poor. As you can see below, my astigmatism became significantly worse after surgery than before.

PreOp
Left: -9.25-1.50 x 080
Right: -6.25-1.50 x 095

3weeks postop
Left: -2.00-2.25 x 097
Right: +0.50 -1.75 x 100.

My surgeon claims that due to drying variations of tissue during surgery, the astigmatism outcome is not predictable. He also claims that I have a 90% chance of success rate with an enhancement.

I have 3 major concerns:

1) Is it is common for the astimigtism to get worst during the Lasik operation?

2) What is the probability that will it continue to worsen or get better?

3) If the Astigmatism outcome is unpredictable, how can the enchantment produce a reliable correction and not worst, when I am further away from the goal then when I started?

Thank you for any advice,
Mark

Mark,
This is the same thing I am dealing with. What was the outcome for you? I'm not sure you will read this since you posted a while ago, but if you do check in I can tell you all the details. I am driving myself crazy with this, especially not knowing if I will "heal with astigmatism" again if I do need an enhancement. Please respond.

Which Laser was used for your surgery?

I had a similar problem after 2 enhancements. When I was preparing for another enhancement with the Autonomous laser (I had used Nidek previously) - the Dr. discovered that my eyes rotate a bit when I lie down - which changed the Axis on which the Laser was working. The Autonomous tracks the eye and can compensate for that.

You might want to get your enhancement with a Laser that has tracking capabilities.

That is one of the nice features of the autonomous. However, all of the lasers can treat astigmatism, and the key is for the doctor to mark the eye prior to lying down to watch to see whether there is any rotation of the eye.

Best of luck

Bill Trattler, MD
Miami, FL

I had the procedure with the autonomus Ladar vision laser. My pupils are 7.8 so that is why I choose this instrument, along with the tracking feature. My main concern is that something went wrong during the procedure. The right eye was no problem and is having no problems now. The left eye was completly different. I felt pain during the application of the suction device and after the flap was cut it was very difficult to look at the flashing light. It was like looking through dirty dishwater when I could see it at all. As a result, the Dr. had to stop the laser several times and the surgey took twice as long on that eye according to my husband. Now, perhaps coincidentally, the left eye has "healing problems". I have had punctal plugs (lower), and am using genteal for extreme dry eye several times a day. I am still optomistic for an enhancement (450 microns left) but am afraid perhaps I will heal incorrectly again. Currently I am experiencing horrible headaches within hours of waking due to the difference b/t my eyes. I am being told to just to be patient.
Pre surgery RX OD: -3.50 -.75 x ???
OS: -3.25 -.75 x ???
Wore disp cls for the last 8 yrs (-3.50sph) but wore glasses for 1 month prior to surgery.
Surgery 4/26/2001
1 day post op Rx OD: +1.25 -1.00 x ???
OS: +1.25 -2.00 x ???
5 weeks post op OD: pl - .75 x 005
OS: +1.25 -2.00 x011
They say that I have not healed complety due to the dry eye and that is the reason for the overcorrection. My question is why only the left eye? How can my astigmatism be double what I started with? The right has only slight dryness problems. The plugs have helped but I am still much more aware of that eye either due to dryness or decreased vision. I have an appt on Friday to see if the plugs helped reduce the dryness damage. I have been assured that all went well with the procedure even with my inability to look at the light. What do you think?

I wonder what the corneal topography shows. Do you have irregular astigmatism? One cause of over correction that is of significant concern is flap wrinkles, so you should ask your doctor about these.
Otherwise, it is so hard to know since I am not part of your care. It is possible that the autonomous had some type of problem, but that should manifest in the topography as well.
Overcorrections can occur even if everything goes perfect, but obviously since there were some problems, I can understand why you are concerned.

I wish I had more words of advice. 5 weeks is early, and I have seen some people improve from the 5 week visitis to the 3-6 months visits.

I also do not have a good answer as to why you now have more astigmatism.

Best of luck

Bill Trattler, MD
Miami, FL

Thank you for your input, it is greatly appreciated. One correction, at the last check my left eye was refracted to +.75 not +1.25, all the rest is the same, so I guess some healing has taken place. I am going to request new orbscans as you suggested. I don't think I have an irregular astigmatism because I can be refracted to see an improvement on the eyechart with the line they are using for the better one or two part of the exam. I'm not sure if I can get to 20/20 or not b/c they didn't try. Is that a correct assumption for ruling out irregular astigmatism? Uncorrrected I can see 20/20-2 od and 20/50 os. At all of the checks my flaps have always been fine according to them. Could that eye be drier due to the extended amount of time it was exposed w/o flap? They said each eye would require 60 sec. of laser, and the left eye was at least double due to the problems I described eariler. The only reason I am not holding out much hope for the left eye is that the day of the surgery, vision in my right eye was sharp while I could tell my left eye was fuzzy when looking at a distance. Unless you can blame the extended procedure time for that with swelling or something. Sorry to ramble but I am thankful to be able to discuss this with an objective forum. These problems can be consuming b/c you are reminded of them whenever you use your eyes.

Stlgrl,
I am also having some of the problems you are. I am from the St. Louis area and was wondering where you had your lasik surgery done.
I had lasik done on 5/7 and then went back on 5/17 to have the flap lifted to remove wrinkles.
The last time I went to see my doc I had him give me a presciption for glasses which help me see a lot better. My prescription is
OD: +.25 -1.00 x172
OS: +1.25 -1.00 x170
I was wondering if your astimatism has gotten better with time and how you are doing. I know how frustrating this is.
Thanks,
Christie

Hi Christine,
Sorry to hear we are in the same boat. I have remained stable as of my last check up on 6/15 (7 weeks post op). The doctor has since informed me that during the procedure he had to manually stop the laser several times because my left eye wandered out of the area of the tracking device. That makes sense to me because I couldn't see any light to focus on, although I still don't have an explanation for that. It also explains why that eye took twice as long. The doctor said that could be the reason for the induced astigmatism. He also said that I could have an enhancement at this time. I have decided to wait one more month though, due to the fact that the left eye is still very dry. I still am over corrected (+1.25)as I was in my right eye at first, and that may go away with healing, as my right eye did. I still experience daily headaches and reading is difficult, but fortunately I am very satisfied with the outcome on my right eye and it is dominant so my distance vision is not so severely effected. My surgey was performed at the Morey - Mulqueeny Eye Center by Dr. Kirk Morey. The left eye can be refracted to a crisp 20/20 so I still have faith that I can be fixed. I am scared to undergo the enhancement; I have done a lot of research and it seems to be more painful and there is a greater risk of complications post op. I also hate to start the healing process over again since I have had such a dry eye but if my vision can be improved to match my right eye it will be worth it. I really don't think I could go on this way anyway. Please keep me updated with your progress. Although I AM NOT placing any blame on my Dr., I am curious as to where your surgery was performed.
Best Wishes,
Stlgrl

stlgrl,
Hi, I am glad to hear that you are doing somewhat better. I had my surgery done at the Advanced Eye Center in Creve Coeur by Dr. Short. I go tomorrow for a checkup and I am going to talk with him about an enhancement. I'm glad to hear that an enhancement could help the overcorrection because that is what I now have. I was kind of worried that this was it for my vision. I have been wearing my glasses all of the time now, because I just finally got so frustrated not being able to see. I will keep you posted with what my doc says. I hope everything turns out okay for both of us!!
Christie

stgrl,
I was just rereading your entry and it dawned on me that we had surgery at the same place but different docs. My doctor is right next door to yours, but he uses their facilities to do the surgery. What a small world!!!
Christie