I had lasik March 01. Surgeon never told me I had wrinkles or any complication even after I went back 8 times in 3 months complaining of very poor vision. I finally got the truth with a 2nd opinion. I went through flap suturing surgery and the wrinkles were eliminated fully. Now 8 months after the suturing, I still have poor vision 20/40 and 20/50 and everything is blurry and I'm told I have a high degree of astigmatism caused by the original lasik and flap complications. My eyes are severly dry, I've had plugs and they keep coming out, I've tried every drop out there including Dakrina. I'm also told that my corneas are too thin to support any more lasik.

I'm still miserable. I hate the way I have to struggle with everything. Even the dryness never gets better for me to even consider contacts. I never went back to my original lasik surgeon. But I feel I am getting excellent care by my Manhattan surgeon, but still I am frustrated and I just want to see. Any suggestions?

You certainly have a lot to consider. As far as treating your astigmatism, it is important to determine if it is regular or irregular. Regular astigmatism can be treated with glasses or contacts. Irregular astigmatism can only be treated with a rigid contact lens. The other thing that you can consider is astigmatic keratotomy, which can treat regular astigmatism and some irregular astigmatisms. This can be done without risk to further thinning or worsening of dryness. How much this would help your vision would depend on how much astigmatism you have and if you also have nearsightedness or farsightedness left. I have found this procedure to work well and can easily be done in the office.

As for your dryness, there are a number of different punctal plug maufacturers and styles which may allow the plug to stay in better. The tear duct can even be cauterized closed, although it is more difficult to reverse this.

I know things are very frustrating, but be patient and talk to your doctor about these suggestions.

Good luck.
Patrick Chin, MD
Westwood, NJ

Thanks for the reply. I do have irregular astigmatism. I'm not sure how to read the numbers but here is what I've copied from the last doctor's note for refraction.

right - +1.75 - 1.75 x 045
left - +1.50 - 2.00 x 90

I've tried glasses, but they do nothing for me. I used to wear soft contacts before lasik, and had a slight astigmatism on the left eye. I had in the past before lasik tried hard contacts and absolutely hated them. I don't think I would want to go through all the doctor visits, expense and emotion to try hard lenses when they are totally uncomfortable. Its really not an option for me.

Can I come see you? I work in Franklin Lakes and live in Hawthorne. I love my docs in Manhattan, but it is a hassle to go there, and they don't fit contacts. Do You? I'm interested in hearing more about the procedure you described.

thanks, Gloria

Irregular astigmatism is much more complicated to treat than just "astigmatism". If you have regular astigmatism, a refraction would improve your vision to a crisp 20/20. But with iregular astigmatism, refractions do not completely clear up your vision.
For now - the best option for irregular astigmatism is contact lenses. Eventually, wavefront technology will be able to determine the locations of the irregular astigmatism and reduce or eliminate the irregularities (but this is probably 1-2 years away).
If you have severe dry eyes - you should try to work hard to get this under control. Have your doctor determine whether you have tear insufficiency (where you do not make enough tears) or whether you have poor tear film quality. There are different treatments for each type of dry eye.
Once your dry eye is properly treated, you should be able to wear contact lenses.

I hope this helps

Best of luck

Bill Trattler, MD
Miami, FL

I understand your situation is a difficult one and am willing to see you (and help you if I can) especially if you are willing to come and see me. Treating the astigmatism may be difficult and may require waiting for wavefront, however, if there is any residual striae, further treatment may help alleviate your symptoms. If not, a contact lens solution may be possible.

Patrick Chin, MD
Westwood, NJ