Hello,

I urgently need advice as to what I should do.

I had my LASIK done in both eyes early January. The surgery went well and my postday checkup showed almost 20/20 in both eyes. My one week checkup also showed the same results. However, my vision started to get blurry at that time and about a 1 1/2 week after the surgery, my vision deteriorated from 20/20 to 20/150. Based on my doctor's advice, I switched eyedrops from Tobradex to another type of steroid drops (although at that time, no mention of DLK was given...just that I had dry eyes and I need to use eyewetting drops more often). My vision improved just a little to roughly 20/70 but after a week, my ocular pressure increased giving me headaches and neckaches. I switched steroid eyedrops again, this time to FML and increased the frequency of the addition to almost every 3 hours (also took some other eyedrop to lower my ocular pressure). My vision has steadily improved to where it is now stabilized at 20/40 (it has been over 3 1/2 months since the surgery). However, it looks like it will not improve any further. I am not able to drive, see people's faces clearly across the street, etc due to my vision deterioration after the surgery.

My doctor states that it was a DLK, stage II. However, I am confused since originally, he stated that it was a DLK and then he said it was not a DLK. Now he says it is again. Does this look like a typical progression of a DLK stage II? Did I really go through a DLK? I have not gone through any kind of topographical mapping since the surgery. Is there anything that I should insist from my doctor in terms of evaluating my eyes?

As of now, he is recommending that I do not have
an enhancement done due to the risk of the same
thing happening again. That means that I will
have to end up wearing glasses and contact lenses
because my vision (roughly 20/40) is not well
enough to play competitive sport, drive or see
far enough at work. Why can I not have an enhancement done? My vision improved when it was at 20/150 to 20/40 using FML at a greater frequency. If I do an enhancement and use FML at the greater frequency right after the surgery, won't that prevent the deterioration that I
experienced the first time?

I am worried that I took the eyedrops in the wrong order, ie, I first took the Tobradex than I immediately used the eyewetting drops (thereby washing out the Tobradex that I put in my eyes). I was not aware the effects of the different eyedrops and I am concerned that the inflammation
in my eyes was the result of basically not letting the effects of the Tobradex take effect.

Thanks for any help.

Doug

i would first consider a second opinion so that you can better understand where you stand. I can not comment on whether a retreatment is advisable, since I do not quite know what happenned with your eye. If indeed you had DLK and this caused some corneal problems, then it may not be safe to lift the flap with the current technology.
Instead, if you need to wait, ask your doctor to write for you a letter saying that when the technology comes where you can be retreated, this would be included at no charge (or whatever charge he promised you).
In the future, we will be able to make flaps with a laser, and this may allow for a retreatment.
I wish you the best of luck, and hope my answer is helpful

Best of luck

Bill Trattler, MD
Miami, FL