I had my Lasik surgery seven months ago. My eyes feel great and I'm seeing about 20/40 with both eyes. I'm generally very satisfied with my results since I was 20/400 in both eyes prior to surgery. I wear a light pair of prescription glasses only occasionally to boost my distance vision(mainly when I'm trying to read text at a distance) and sometimes for reading (depending on the lighting I need readers). My current prescription is:

Sphere Cyl Axis Add
------ --- ---- ---

O.D. +.25 -1.25 5 +1.50
O.S. -.25 -1.00 135 +1.50

My one problem is that I've had double vision in my left eye since about two weeks after surgery...my doctor says this is due to a small amount of irregular astigmatism that was introduced by the surgery. He told me that 99% of irregular astigmatism introduced by Lasik resolves itself by the one year anniversary and he expects mine to be gone by October 1st--my one year anniversary.

This was very good news but something I had not heard before on any of the websites or literature I have read...can any of the doctors on this site comment, based on their experience, as to whether they agree that 99% of irregular astigmatism typically resolves itself within one year after Lasik?

Thanks,

Sue

Irregular astigmatism can improve on its own, but I could not quote 99%. Certainly there are many people out there (read these questions) who have not had the irregular astigmatism resolve on their own, and I have seen some cases where irregular astigmatism persisted even after a year.

There really is very little treatment available for irregular astigmatism today, although we are hopefully that customized LASIK (including wavefront technology) will allow for accurate reduction of irregular astigmatism

Dryness is certainly a major issue after LASIK, and it is possible that your work will make your eyes even more dry.
It is impossible to know whether you would have signicant problems -so you should talk with a surgeon such as Dr. McDonald in New Orleans and discuss the risks for you versus the benefits

I hope this helps

Bill Trattler, MD
Miami, FL

Dear Dr. Trattler:
When you say that there is really little treatment available for irregular astigmatism, do you say there is no treatment availabele or that there is one?

There are doctors who are investigating laser techniques for helping with irregular astigmatism - but they are still investigational. They often input the results of tests, such as the corneal topography,and program the laser to custom reshape the cornea
With time, the specialists performing this research will publish more of their results and we will be able to determine which methods are safest and most effective

Best of luck

Bill Trattler, MD
Miami, FL

I had surgery 02/18/00 which resulted in de-centered ablations in both eyes - due to a machine failure. I got the right treatment, but in the wrong places.

I am scheduled to have corrective surgery in Antwerp, Belgium on June 8th and 9th with Dr. Frank Goes. This will be with a topographically linked Mel-70 laser manufactured by Meditec. Here are the outcomes of his study of 39 patients with de-centered ablations, as quoted by my surgeon:

"The Mel 70 is still the only available machine to have a direct link between the topographer and the laser. Dr. Goes presented a paper on his results treating irregular corneas (primarily decentered
ablations). His paper reported on 39 patients who recieved customized ablations. The most important figures relate to improvement in subjective symptoms(ghosting, blurring , and doubling).
With one treatment:
- 50% were markedly improved and extremely happy with their vision.
- 13% were significantly improved and happy with their vision
- 30% were unchanged in symptoms
- 7% had worse symptoms

The later two groups are still candidates for further treatments.

Change in BCVA;
- Increased in 6/39
- unchanged in 26/39
- decreaded in 4/39

Change in UCVA
- increased in 9/39
- unchanged in 26/39
- decreased in 4/39

"I am confident that right now Dr. Goes has as much as and perhaps more experience than anyone in the world in dealing with problems such as yours."

So there you have it. Topographically linked treatment is available, but the outcomes are not as great as I had hoped. Fully 37% experience either no improvement or a worse outcome - and I'm worried about that figure. Comments?

Forget about it and wait. That is really not worth the risk and money.

There are many investigators working on being able to provide customized laser ablations for patients, and as I have mentioned the work is progressing well but there is still a way to go.

I expect that there will be continued progress in this area

Bill Trattler, MD
Miami, FL