I would like to know what the latest techniques are for removing wrinkles.

Dr. Tennen, there is a doctor in Pittsburgh who uses a bandage contact lens plus pressure patching for three days. Is that similar to your technique?

I was finally able to get an appointment with Dr. Maloney, and Dr. Salz has e-mailed me and wants to see me. I am not familiar with the Agoura area, but would like to see you too.

Thanks,
Elizabeth

no ratty i would not do what the doctor i npittsburgh does. iw ould remove the epithelial surface of the flap, lift the flap, use a compression instrument, and then replace the flap and place a bandage lense while the eye was healing. at least that's what i say unitl i can evaluate your own case. dr maloney and salz are wonderful surgeons and you would do well to see them. don't make yourself crazy getting too many opinions..make sure what you are hearing sounds reasonable and then trust in the surgeon.

debra tennen, md

Hi Dr. Tennen,

Does removing the epithelium help in keeping the flap wrinkle-free? Sounds like I'd have a rough couple of days afterwards.

Right now, I've got doctors disagreeing as to what is causing my loss of vision, and I want to go with a majority opinion. Having a few doctors on one side of the fence and hopefully just one on the other will help my mental state.

Thanks!
Elizabeth

The procedure for removing wrinkles can vary, but the goal of the procedure is generally to make the flap swell and stretch out. Some people believe the wrinkles in the flap can get locked in by the corneal epithelium, so many doctors now remove the corneal epithelial surface during the procedure. A Bandage contact lens is then placed to allow the corneal surface to heal.
I hope this helps answer your question

Bill Trattler, MD
Miami, FL

elizabeth-
you are right, a cornea without epithelium can be uncomfortable to say the least, which is why we use the bandage lens. some doctors feel that the wrinkles are actually formed in the layers of the epithelium, so that removing that layer will solve the problem.

debra tennen, md

Well, that eye started out at -3.5, went to +3 with the Sands of Sahara, and now it's -2.75, 2 1/2 months after the hyperopic enhancment.

PRK is one option, after some more healing. Would you wait until then, or try to remove the wrinkles now, and then do PRK in a few months?

Also, can PRK help with irregular astigmatism?

Thank you,
Elizabeth

elizabeth-
what's up with the prk discussion? didn't you have lasik originally? most doctors will not perform prk over a flap because of increase risk of scarring.

again, it's impossible to give advice over the net...if the using a -2.75 lens gives you sharp vision, then there are no significant wrinkles and you should have a retreatment as soon as the refraction is stable. if the vision is still blurry with the -2.75 lens, then get rid of the srinkles first, and you might still need a retreatment for the residual refraction at some later point.
debra tennen, md

Hi Dr. Tennen,

After both lasiks, my cornea is now just 420 microns. My first 2nd opinion surgeon told me that PRK to smooth my cornea and take care of any remaining prescription might be the way to go, but he wanted to wait four months. Or, if the astigmatism goes away, Intacs.

Today, I saw Dr. Maloney, and he feels that he can remove the wrinkles without removing the epithelium. The relift is scheduled in two weeks. If the quality of my vision improves, he will probably do more laser about a month after that, for the myopia.

My original surgeon is probably having trouble sleeping tonight. With some hope back in my heart, I will sleep for the first time in weeks.

Hi Dr. Tennen,

After both lasiks, my cornea is now just 420 microns. My first 2nd opinion surgeon told me that PRK to smooth my cornea and take care of any remaining prescription might be the way to go, but he wanted to wait four months. Or, if the astigmatism goes away, Intacs.

Today, I saw Dr. Maloney, and he feels that he can remove the wrinkles without removing the epithelium. The relift is scheduled in two weeks. If the quality of my vision improves, he will probably do more laser about a month after that, for the myopia.

My original surgeon is probably having trouble sleeping tonight. With some hope back in my heart, I will sleep for the first time in weeks.