I had lasik surgery in October 2002. I now have a central island in my right eye that is causing some vision problems. ( my left eye is perfect). Before lasik my right eye was -6.00, one week postop was -3.00 and one month post op it was
-2.00. My vision in my right eye is now 20/50. I am still able to function very well, drive, read, and do normal daily activities however, at times I have a hard time reading the computer and in stores looking at a lot of things. I almost didn't pass my driving test. I will soon be going back to have my 6 month check up and was told that after 6 months we would decide if it could be corrected or if we should leave it alone. I am wondering if it is left uncorrected if it will cause strain on my left eye? Should I leave well enough alone or is there a good option for me? Please give my any advise to help make my decision. Has anyone had a central island corrected?

Lucy,

I'm sorry that your surgeon gave you a central island. I also have central islands in both eyes from my lasik in August 2000. I see two and three images from each eye. I was initially promised that wavefront lasik would be able to fix them in early 2001 but here at the beginning of 2003 there is still no reliable way of treating central islands and it looks like a fix is still 3-5 years away. Anything that they would offer you now is high risk and could make the problem much worse. You will find lots of information on central islands at www.surgicaleyes.org. So far, of the thousands of participants there not a single person has reported being successfully treated for central islands.

Best of luck,
Terri

Thanks for your advise, do you know anything about the new Visx laser that was approved to fix central islands? I am being told that this would be my option. I also had double vision in my right eye but that has improved. Are you corrected now with glasses? or how do you deal with the double vision?

Lucy,

You are probably speaking of the Visx CCAP. The results published in the industry journals indicate that some people have been helped, some made much worse and some left the same. I recommend that you let them experiment on other people until they get it right.

Glasses do not correct my double and triple vision. I just live with it. I don’t work anymore and can’t see well enough to drive so I spend most of my time listening to the radio and searching the internet for possible solutions. Because I am technically a success since I can see 20/40 I don’t qualify for disability even though I can’t see well enough to do most things. RGPs (hard lenses) are supposedly able to mask some of the multiple images but my eyes can’t tolerate them.

Best of luck,

Terri

I'm disappointed to hear about your central islands. They have become much more rare these days, but obviously have not been eliminated.

The Visx C-CAP that Terri discussed has been receiving mixed reviews. It would not be appropriate to say it is an assured fix for central islands. Wavefront guided ablations hold the possibility of correcting central islands, but it will be some time before there is enough practical experience to know if the reality is as good as the promise.

There are two possibilities that may help you. CLAPIKS and RGPs.

Contact Lens Assisted Pharmacologically Induced Kerato Steepening (CLAPIKS) is the use of a topical medicine to make the cornea somewhat malleable and temporary use of extended wear contacts to mildly reshape the cornea. A modification of CLAPIKS may help with central islands.

I recommend that you consider Rigid Gas Permeable (RGP) contact lenses. Unlike the old hard lenses of the past, current generation RGPs are more comfortable and often provide correction of minor central islands. Discuss this with your surgeon and ask for referral to an optometrist who has experience in fitting RGPs for post LASIK patients.

I’m sure contacts are not what you wanted from refractive surgery, but it is possible that these will provide quality vision until a reliable fix becomes available.

Glenn Hagele
Council for Refractive Surgery Quality Assurance
http://www.usaeyes.org

I am not a doctor.

Lucy,

I don’t know where Glenn gets his information but the CLAPIKS method has not been very successful. The use of contact lenses and acular to thicken the epithelium has not been proven to be effective in treating central islands and its main use in treating overcorrections for myopic refractive surgery is definitely iffy. Since my doctor left me with central islands I have consulted a number of top doctors who are supposedly the leading people working with the latest technology. Without exception they have all told me to do nothing but wait for technology to advance to the point where it can treat my central islands. I was first promised that wavefront custom ablation would be able to fix my central islands early in 2001 but it never happened. It still looks like it will be 3-5 years before the technology is ready.

Glenn, please post some links to peer reviewed studies that indicate that CLAPIKS has been successful and has been determined to be save and effective.

Terri

Each person is different. It is unfortunate Terri has not found a treatment that has a high probability of success, but Terri's situation and Lucy’s situation may be very different. What does not work for one may work for the other. Lucy needs to explore all possibilities.

Anyone who desires specific information about CLAPIKS may contact me directly at . I will gladly provide a copy of the protocols and put you in touch with the doctor who first published this approach.

Glenn Hagele
Council for Refractive Surgery Quality Assurance
http://www.usaeyes.org

I am not a doctor.

Glenn,

Please post the links to the peer reviewed studies showing that CLAPIKS has been demonstrated to fix central islands. I find it odd that you have a doctor whose name you will only share in a private e-mail when I know top doctors who recommend against it (from Dr. Reinstein in London who participates on www.surgicaleyes.org to Dr. Machat in Toronto). I’m not positive but I think that even Dr. Salz (who participates both on SE and here) has advised against it and recommends waiting on technology.

Lucy,

Good luck to you! There is nothing wrong with investigating CLAPIKS but make sure you personally interview at least 20 patients who have had successful outcomes before you consider allowing them to experiment on your eyes anymore. Your doctor has harmed you once. Be very careful about letting him harm you twice.

Terri

I also have my LASIK surgery on 1999. The result is as expected - Central Island on my left eye. After several years of medication, nothing can be done. Last month, my doctor tried to use PTK to tackle the problem. The result is acceptable, the effect of double image is minimized but haze become obvisous. He told me that haze can be controlled by using drugs. That all for my case. Good luck to all of us.