I had Epi-lasik Surgury on June 20, about 18 days ago.
My initial vision was great after sugury. After removing
the "bandage" contact, my right eye has been extremely
blurry and my doc said I have a bunch of epithilial cells
on my cornea that need to smooth out. I have lost faith
in him mainly due to his poor attitude regarding my
progress and conflicting info he and his staff have given
me. He has me on a Lotemax, a topical steriod and
initial put me on Pred Fote, another steriod post-op for 4
days. My concern is that the package insert said the
lotemax should not be used beyound 14 days. His staff
infroms me he tends to have patients on it for 2-3
months!!! They said I should not be concerned
because its a small dose. However, the doc said the
FDA are all bureacrats and he ignores package
inserts. He has been patronizing and has changed the
story he gave me about the pronogsis for my vision
from pre-op "you will see 20/20 and you will be driving
in 1 week, riding a motorcyle in 2 weeks" to now, "Well,
it's just your vision, nobody died. " He now says I should
be happy that I am correcte tyo 20/100 because pre-op
I was 20/800.

I accept responsiblity for my decison ot risk the surgury.
HOWEVER I do not trust this guy.

I need to know if the steriods are safe to use for 2
months as he directs.

He also prescibed restasis for me for dry eyes but the
package insert says they don't work with punctal plugs
which I have.

I am not happy with my current vision. Driving is scary.
The slower recovery time is effecting my work and
income. The doc said that will improve. I am skeptical
due to his story changes and conflicting info from his
staff.

I realy appreciate this site. Lots of helpful encouraging
info. Thanks!

Here is some general information about the medications you are talking about.

Restasis works great with punctal plugs. However, Allergan (the company) did not have patients with punctal plugs in their FDA approval study. So the package insert has to say that they do not know whether Restasis works with punctal plugs. In my experience - Restasis works great with punctal plugs - and also is very helpful after Epi-LASIK.

As for Lotemax - it is a low dose steroid that I use for 1 -4 months after LASEK and epi-LASIK - depending on the case. The package insert may say 2 weeks (I haven't looked at the package insert for lotemax for a long time) - but we routunely use it for longer. The eye pressure can still go up with lotemax - so you do need to go in for checkups on a regular basis to monitor the eye pressure. As well, long term use of steroids can predispose to the development of cataracts. But with lotemax - one would have to use it for many, many months typically before the risk went significantly up.

So I hope this helps answer some of your questions. The one thing to remember is that it can take many weeks to months for the vision to reach its final point - so hopefully your vision can keep improving. As well, some patients can end up over or under-correcrted - and need a touch up.

Best of luck

Bill Trattler, MD
Miami, FL

you said:

" He now says I should
be happy that I am correcte tyo 20/100 because pre-op
I was 20/800.

If this 20/100 is with glasses then even I would be concerned. This is no excuse when pre lasik you most likley were 20/40 or even better with glasses of about -7 diopters.(what was your actual pescription though?) You have every right to see other doctors for 2nd opinions. I hope things will be right for you

No I see 20/100 in my right eye WITHOUT glasses. The
doc gave me a contact to try to smooth out my epithilial
tissue and it corrected my vision for the time I wore it.
Now he's taken it out to see if the skin heals. My left eye
is corrected to 20/40 I think for monvison. After reading
up more on it though the monovison only lasts til I am
50 then I would need a recorresction. Never would
have done it if I had known this!!

I have my second opinion visit on Tues.

Thanks this info really helps. My doc did not tell me any
of this. I think my doc has poor communication skills.
But I hope he's a good surgeon.

how long does it take to smooth out epithelial tissue?
Should I try another contact (this seemed to help.)