I got lasik exactly two weeks ago, an developed the sands of the sahara problem. I know that there are 4 levels of it, and I want to know at what level does "corneal melting" occur? I read that it occurs at levels 3 and 4. My doctor told me a few days after the surgery that I had DLK 2, and started the standard treatment. One of my eyes was irrigated a week ago. Apparently the condition is now improving. The doctor hasn't told me whether my DLK is at or ever got to level 3. If it did, that means to me that I'll have permanent damage.
I hope a doc here can answer my question, because I'm a mess since this ordeal started.

DLK is a distressing to both the doctor and patient. There is nothing that can absolutely prevent it from occurring. Fortunately most cases of DLK do not result in permanent vision loss. Even stage 3 DLK may not cause permanent vision loss. Untreated stage 3 DLK can result in flap melting or corneal scarring. Most surgeons feel that stage 3 DLK should be treated with flap irrigation. Hopefully your condition will continue to improve.

Demetri Dornic, MD

Thanks for the reply. My doctor said that my left eye got to level 2, but my right eye had gotten to level 3. They are both getting better now, but very slowly. The doctor said that we won't know whether my right eye had corneal melting for months. Is there any way to tell right now? I don't like the uncertainty.
My doctor did say that corneal melting tends to cause farsightedness, and I haven't developed any farsightedness. That indicates to him that I didn't have corneal melting. He also said that my right eye is actually less inflamed that the left one now, but the vision in the right one is worse because the opacity developed right in the middle. The right one was irrigated about 11 days ago. The topography of my left eye is normal, but there is a "purple spot" in the topographical map of my right eye.
Apparently, if I'm going to have permanent damage, it's already been done. I think that my right eye was at level 3 for a few days, but less than a week.
The doctor now has me on Lotemax 3 times a day, Econopred one time a day, and tears 4 times a day.
What do the doctors on this website think about my case?

It is difficult to comment on a specific case of DLK without having seen the patient. Most physicians agree that if DLK reaches stage 3 irrigation is advisable, and your right eye has already been irrigated. At this point you probably need to continue the steroid drops and have close followup with your physician to make sure there is no ongoing inflammation.

Thanks Doctor. Well, there is still ongoing inflammation. My doctor said that it could last for months, and that that is normal. Does that sound right? Should I get a second opinion? My vision hasn't improved much in the past week, and I'm worried. It has been 3 weeks since the surgery, and 2 weeks since the irrigation.

I am generally in favor of second opinions. They can be re-assuring to the patient, plus occasionally a second viewer may have some other ideas or thoughts on how to resolve a situation.

Best of luck

Bill Trattler, MD
Miami, FL

P.S. Dr. Gabianelli may be one option for a second opinion if his practice is near where you live

Can the doctors here please tell me which steroids they use to treat grades 2, 3 & 4, and the dosing intervals?

My topography recently showed that I have a "bump" on my cornea, in the eye that had stage 3 DLK. What is this raised spot, and what does it mean for my vision? I've had blurry and triple vision in that eye, which I guess is called astigmatism. What can be done in a situation like this? Thanks.