I received LASIK surgery on 1/16/04 with pre-op prescription of L -1.75 and R -1.5. Within week 1, I was seeing 20/15 in the left, and 20/30 in the right, and the right came around within a month to nearly 20/20. By my fourth month post-op visit, my left eye had regressed, needing a -0.75 lens to see 20/20, and the right at -.25, I believe. I went back in at 6 months, and the left had regressed to -1.00, and the right to -.5. The doctor told me they could perform an enhancement then, or that the more conservative approach would be to wait for another three months to see if the regression stabilizes. I opted to wait, but I have a few questions I'd like to have answered from an independent source. It's not that I think my doctor is lying; I'd just like to hear from other sources(plus I forgot to ask a question or two).

First off, I didn't realize it until after my appointment, but it sounds as though they should be able to re-use the existing flap. If so, will they have to cut it, or do they just literally go in there and pull it up manually?

#2. Is the level of regression I experienced extreme for someone with my pre-op vision?

#3. Am I just as likely to experience regression after an enhancement? If not, what are the statistics? If I do experience regression, is it likely to be less significant?

#4. If you have any advice, considerations, I'd appreciate anything you might add.

#1) Normally, the existing flap would be lifted. A new flap would not be cut.

#2) The level of regression you have experienced is extreme. There is something very wrong here. It is not at all normal for someone with such a small amount of refractive error to encounter any regression, let alone 1.00 and 0.50 diopters. That is 60% of preoperative myopia and 33%, respectively. The fact that about half of this regression occurred after three months postop is also troubling. I am concerned that you are demonstrating an instability or lack of strength of the cornea that may be unique to you, or may indicate a diseased cornea. The other possibility is that the amount of untouched cornea behind the flap and under the ablation is not enough to keep your cornea stable. This all would need to be thoroughly evaluated before having any additional surgery.

#3) Your situation is so unique, I do not believe there are enough cases to form reliable statistics.

#4) My advice is to do absolutely nothing until the cause of the unusual regression is identified and accommodated. Without regard to the quality of your surgeon, I recommend you seek a second opinion from a corneal specialist, preferable in a university teaching hospital environment. If you would like a referral, feel free to contact me directly.

Glenn Hagele
Council for Refractive Surgery Quality Assurance
http://www.USAEyes.org
http://www.ComplicatedEyes.org
Email: glenn dot hagele at usaeyes dot org

I am not a doctor.