I started reading your Bulletin Board last week. I had LASIK in one eye 2 weeks ago. My vision in that eye has been corrected from 20/400 to 20/200. This was to be my "distance" eye (tried for monovision). However, due to my astigmatism, it didn't quite work out as planned. How much more can my eye improve? And, if LASIK couldn't fix the astigmatism the first time, what are the odds it would fix it with an enhancement? Any advice you could provide would be appreciated. The Doc who did the surgery is Dr. Flavius Pernoud in St. Louis.

I had LASIK performed on my right eye 3 weeks ago.
My nearsightedness has been corrected; however, my astigmatism has not. Is there a chance for any improvement/change in my vision in that eye WITHOUT enhancements being performed?
Thanks for any responses.

deborah,

again, it is difficult to answer questions without examining a patient. i cannot be sure how much astigmatism you have remaining.

the important point is that it takes on average 3 months for most of the swelling of the layers of the cornea to subside. therefore, relax and wait. ask for spectacles if you are unable to work or drive. if the astigmatism remains at that time, you may be eligible for a retreatment to correct that problem.

debra tennen, md

Dr. Tennen,
Thanks so much for your response. I had my 4-week appointment and my Doc wants to do the enhancement. However, he said my procedure hasn't been approved by the FDA. I'm curious about this--are all enhancements/procedures run through the FDA prior to each procedure? I am the first of his patients to require any type of enhancement with the LASIK surgery--my astigmatism (5) is the highest of any of his patients thus far.

again, with limited information, it'shard to know what to say. enhancements are not a decision by the fda. what is the correction left over? it may be that the correction you now require is not yet available for the laser your doctor uses.

retreatments in my practice are needed about 3% of the time, so it's not unheard of for a doctor to have not done one yet.

let me know if you get more info

debra tennen, md

Here's my "numbers"---
Before LASIK my right eye was:
-4.75 +1.75 X 105 (manifest refraction)
-4.75 +2.00 X 95 (cycoplegic refraction)
After LASIK my right eye IS:
-2.25 +3.25 X 100

Am I reading this right? Did my astigmatism get worse? Could that be? And if so, why?

My left eye is -2.75 +0.50 X70
Maybe I should have switched from dominant eye (right) and gone with left eye for distance. Guess it's too late for that now...
Thanks for all your help with this.

What did your surgeon tell you about your post op
astigmatism in your right eye? Who is your
surgeon and at what center did you have the
surgery? What laser did he use? How old are you?
What was your pre op refraction in your left eye?
Leonard Friedman MD Washington DC ... .. .. .

Dr. Flavius Pernoud III performed the surgery at St. Luke's Hospital (eye institute)in West St. Louis County, Mo., using the Summit Laser. He was pretty surprised himself that the surgery (only performed on my right eye) didn't work out as planned. I am 47 (48 in Nov)--he is just bewildered and wants to perform an enhancement "after it is approved by the FDA". (See my previous post, please) As you can tell, I'm pretty frustrated with this whole situation. Thanks so much for your response.

your current prescription indicates hyperopic astigmatism, and as your surgeon has stated, this is not currently approved by the fda. we hope to get approval for performing this surgery in the very near future- maybe even before the end of the year.

as to why you need this enhancement, i'm afraid i don't really have any good answers. the flap may be distorted, the laser may have been running extra hot that day, and it may be due to your own healing characteristics. there are many other possible explanations, but your surgeon would be best able to help decide what are the most likely causes.

good luck

debra tennen, md

Dr. Tennen,
Thank you for your quick response. Now I feel better about my Doc--in that he wasn't feeding me an "untruth" about needing FDA approval. He doesn't know why the procedure didn't work, but does expect to receive FDA approval shortly. In the meantime, this is surely frustrating! Have you had this happen to any of your patients? I see from your bio that you have been doing this for some time and your experience with LASIK seems greater. Thanks so much, once again.

unfortunately i have had this happen to a few patients. most are functioning without glasses, or just use glasses occasionally until i get the software needed to allow the laser to correct the remaining prescription. so after all this, it seems that your doctor is telling you all the right things!

debra tennen,md