I had wavefront assited lasik in August 2004. Started with -7 & -5.5 sight + small astig. My recovery from the 1st operation was very long - 4 weeks before sight really started to clear for vision around me so i could drive and do regular things. I was still unhappy with regular performance and the clinic decided to do a retreatment 2.5 months later. Things went extremely downhill from that. The quality was/is terrible (very changable through the day) - but the style of healing was not weeks as 1st time...but what i saw after they removed the bandage lenses the day after kind of stuck like that. Refraction is ok...BUT there is an underlying problem from constant heavy variable blurring which destroys what i see...any range..left eye feeling like it has always been very unstable. Bandage lenses weren't used 1st time round btw. I wake up in the mornings and will not be able to see things to read right infront of me and at distance in my left eye...almost like the vision i had when i walked from the operating theatre! The prescription is only +.5 and 0.5 in that eye...BUT if i place a contact lenses in it..WOW..any power (if its right or not)..alot of clearing is done. I have no troubles with dry eye - a different doctor hightlighted some wrinkles, but i have seen them and i know i had them from the 1st op (there is light scatter but this isn't the problem) - this blurring effect isn't a fixed effect from pupil diameter - but seemingly of surface pressure i think - very unstable effect. The LIGHTEST finger touch on eye lid while rolling the eye can bring on the blur much more. My clinic is puzzled and we are trying to rule out factors atm. I have no real topography problems and I have my 1st op data and personal response as a good reference.
I am thinking the answer is from the different way of initial healing created with 2nd time with the use of bandage lenses possible...as i was a LONG recovery for clearing 1st time. What if they were left in MUCH longer or not used at all?!
If there are any doctors who have an opinion I would love to discuss. it is a real life destroyer most days. thanks david

David, I'm not a doctor, but let me provide some thoughts on your situation. I will assume that striae (http://www.complicatedeyes.org/striae.htm) does not exist as you say this has been ruled out.

Movement under the eye lid with pressure disrupting vision quality, and that a contact lens of any power providing improved vision, indicates two things. One is that this is something that should be able to be resolved. The other is that it appears to be a problem with your epithelium. The epithelium is the outermost layer of cells on the cornea.

The unusually long recovery time, fluctuation in vision, ability to disrupt vision with light pressure on the cornea, and the clarity of vision with a contact lens indicates that your epithelium is not healing correctly, or is not holding on to the underlying cornea appropriately. It may be moving about and scrunching up like warm Jello.

This type of epithelial problem may not have been able to be diagnosed before surgery, but the LASIK process may have disrupted a delicate balance and the epithelium is now moving on its own.

Allowing time to heal is undoubtedly a good idea, but if this does not resolve, it may be a good idea to have the epithelium removed and allow it to grow anew. Corneal epithelium are the fastest reproducing cells in the human body. If the epithelium is not stable after removal and regrowth, it may be necessary to remove the epithelium again, apply a very light “dusting” of excimer laser energy, and allow the epithelium to cover the treated area again. Think of this as “rebooting” the epithelium.

Although you say you have ruled them out, I would first look to LASIK induced dry eye (http://www.complicatedeyes.org/dry_eye_treatment.htm) and striae as the culprit. If these are reasonably ruled out, epithelial basement membrane dystrophy may be the problem.

Glenn Hagele
http://www.USAEyes.org

I am not a doctor.

Glenn makes some good points, and I agree that your primary problem is very likely uneven epithelium. The "giveaway" that this is the problem is that your doc fitted you with a bandage contact lens after your enhancement. This is unusual, and generally indicates that a significant corneal abrasion or epithelial sloughing occurred during the creation of the flap. You need to check this out with your surgeon.

Bryce Carlson

Thanks Glenn and Bryce. I actually had an instinct that my problem is an unstable layer. My concern atm is my clinic. Although they are apparently one of the better ones in the UK, the main surgeon never inspiries me when I have talked to him and they have only ever done straight forward lasik eye surgeory..with few patients having strange problems. I chat and go through things with the owner...but he looks at things from only a techinical viewpoint not being a surgoen himself...but it's his say so on things that goes!
Obviously this is uncommon for the epithelium to be like this with a patient...if my clinic hasn't delt with this matter past normal healing..which i suspect...i am worried.

How easy is this lack of adhesion of parts of the epithelium for a doctor to actually spot?...past describing my symptoms. It is a clear channel afterall when looked at in a slit lamp. So how can i know if a doctor actually knows how to identify it, in front of him?
I feel i might have to take my case to another more experienced place/doctors to fix...i am not sure my clinic is willing/capable/knowing of doing this kind of thing.
Thanks for this help -the more info the better as this is a horrible unnatural sight killer to live with and i have to change it. David