Hi,

I am an RK patient with 8 radial cuts. I had a good run with great vision but now I am progressing to Hyperopia.

I have been Wavescanned by a ton of doctors both Ladarvision and VISX. ALL doctors are willing to perform surface ablation and they are ALL stating that they are having GREAT success and most patients coming out better then 20/40 or better and extremely happy.

Why is this data not reported?

I am going in before Christmas to get my right eye done with VISX S4 IR.

Here is sample data from a right eye scan:

• +1.63 DS -1.23 x 168 @ 12.mm (W.F. Diam: 5.5 mm)
• Corneal Thickness: 520
• K1 (D): 43.50 K2(D): 43.50

Dr. Trattler, it sounds like you have experience performing this type of surgery and are all of these surgeons lying to me stating that these PRK over RK are indeed turning out GREAT!?

Please comment to help my anxiety that I am feeling approaching my surgery date.

Thanks in advance.

I am not a doctor but enhancing RK is risky. Its even more risky doing lasik over RK. I will let the kind doctor Trattler give you advice and your options.

Both LASIK and surface ablation can do a nice job of enhancing previous RK. You should understand that the success rate, although good, is not as good as when we treat a virgin cornea. But in general - patients are happy with their results.
It is also important to understand that RK eyes are at higher risk of needing another enhancement down the line compared to virgin eyes. Please discuss this issue with your doctor.

Finally - I personally prefer surface ablation over LASIK when treating patients with previous RK. But each doctor has their own preference, so please disucss this carefully with your surgeon.

I hope this helps

Bill Trattler, MD
Miami, FL

I was told that not much tissue will be taken away since this is a somewhat mild hyperopic procedure.

Is it true that I will be ablated into mild myopia with the hope of regressing back to Plano? This is my dominant eye so I hope this is the plan. I would be okay staying around a -.5 at worst case. I do not have the luxury of talking with my surgeon. I am an out of town patient.

Dr. Trattler, I understand that you use a VISX laser. Have you used the new IR procedure? If so, how is it working?

How soon will I be able to see after my contact is taken out?

And lastly, do you feel more safe walking the streets know that Shaquille O'Neal is there to protect and serve Miami!? Can you imagine being arrested by him?

Thanks to all professionals for taking extra time in your day to help us out!.

Up to 40% of post-RK patients develop progressive hyperopia because of peripheral corneal ectasia due to the cornea being weakened by the incisions. Taking away tissue from the periphery, as is done with PRK or LASIK will not make the cornea any stronger.

DrG

I am blown away at this point at the quality of Vision I am gaining. Tomorrow I have one week follow-up but it seems like I am 20/20 right now. My reading vision is also pretty darn clear. I do not see a need for readers out of this eye at this point! Started steroid drops today. One drop four times a day. Still on anti-biotic four times a day until it runs out. Eye feels great. No dryness what so ever.

VISX S4 IR appears to have reduced my HOAs I was having from off center RK hyperopic progression.

Someone please explain what the steroid drops are used for? Is the purpose to clear up residual haze? Or control any regression that maybe trying to occur? I just do not understand.

I am happy to take questions if anyone is in a similar situation.

Jim

Thats good you have clear vision. I would wait some time after getting treated in the dormant eye to see if this clear vision holds up before doing the other eye.

First off my dominant eye (right) is the one I had PRK over RK on. The plan was to shoot this one for good distance. It is feeling like we may have got it.

My left eye is stilling holding at around 20/25-30 from original RK back in 1987, so I should not need surgery on this one at this time. This one does have HOAs but not near as bad as my right was.

I can only hope and pray that regression will not happen. I am told the refractor machine is saying I am plano and I hope it will hold. The topography readings also look real good. I am 45 now.

Tomorrow is my 1-week followup so it should be interesting.
Thanks!