It's now between 8-9 months from original Intralase and this ongoing nightmare only seems to be getting more depressing. Yesterday I was scheduled for enhancement to correct .5 astigmatism but at the last moment, my surgeon decided it was too risky. My vision is still wandering all over and I doubt if I could score the same refraction twice in a row over a 20 minute span. So here I am at 4;30 in the morning, unable to sleep, after laying in bed and watching ghosts oozing from my led alarm clock all night. I should have gone ahead and taken the valium that they had sitting on the counter for me.
In the past, the people in the Lasik office always seemed to act like this story would somehow, eventually have a happy ending. When I left there yesterday though, I could tell that they don't have a clue and they all seemed to be just as depressed as I am. I need another opinion but I have called two other lasik offices in this town and nobody seems to want to get involved. I get the impression that they have heard this before, too many times.

What is your main issue with your result? I had intralase last Friday. The visual fluctuations are driving me nuts, but other than that, I am doing well. What problems are you experiencing? Personally, I won't risk an enhancement for myself. And, I certainly wouldn't want to if the doctor was hesitant.

I've had fluctuations from day one. I was on steroid Pred forte for most of the 8 months with the hope of alleviating some of this. My eyes have been irritated ever since surgery and it seems to be more inflamation than dry eye which causes discomfort.
Often I have a "saran wrap" effect. It literally looks like I'm peering thru a thin sheet of saran wrap. My doctor said it is higher order abberations. Refraction tests are very difficult because the amount of lighting in the room varies the result. Ghosting and starbursting is a regular thing even in daylight.
Night is worse. I see two-three moons that pulsate while I'm staring at it. It actaully looks like it is raining off the moon.

What was your initial prescription for myopia/hyperopia and astigmatism? I was warned strongly about starbursts, etc., but I have always experienced those, even with gas permeable contacts. They are not too bad, but I haven't driven at night, yet.

Personally, I feel like I am looking through water because I am using so many drops. I see clearly for a minute and then it blurs again. But, I am only 4 days out instead of 8-9 months. I don't blame you for your frustration.

I had -7.25 with 3.25 astig in the left and -6.5 with 2.25 astig in the right.

Dee,
You might try Soothe by Alimera. These drops work better for me than the others for seeing more clearly. I can't use refreshTears. They make my eyes burn and itch worse. GenTeal feels good but disrupts my vision for close to 30 minutes.
Your prescription was worse than mine. My left eye was mostly astigmatism but i don't remember the exact numbers. Have you gone outside at night yet and looked at the stars or moon? Or have you tried a refractive test yet? (What's better, one or two?) That test drives me nuts because I see so much ghosting thru the lens and the tech just doesn't seem to understand that neither one or two look much better. All she has to do is take a step back and it changes because of light coming thru the lens.

Just relax and hang on till then.

I did a search for past threads and there appears to be three or four "johns" who all got intralase. This is bizzire you all have the same name, all got intralase and all have complications! I think you tried RGP contacts before and they were very uncomfortable and didnt help much. Perhaps your aberrations are beneath the flap or the flap itself is causing aberrations. What was your pescription before lasik? How much fluctuation is your vision doing? Maybe if the reason why it flux can be found, some relief can be comming.

I have never tried rpgs yet. My eyes have stayed very irritated since Intralase and would not tolerate contacts. As for the other johns with Intralase complication, most of the people that I have talked to with severe complications did Intralase. The technique itself seems to be flawed bigtime and takes forever to heal afterward.

What was your pescription before lasik? How much fluctuation is your vision doing? Maybe if the reason why it flux can be found, some relief can be comming. Please answer :)

Thanks for the heads up on intralase. I see ads for intralase all the time touting how good and revolutory it is. It appears to be the next big thing. People like it because they dont need a blade or any problems with a microkeratome. Also intralase has been a boon for those with thin corneas cause intralase can make a thin flap. If intralase keeps having problems like that, it will die out and epi-lasek will replace it completely. Its already getting popular because it avoids the problem of a flap totally. Many people are still set on getting intralase. I am talking to a guy and telling him to go epi-lasek but hes not convinced and is probably gonna get intralase.

I just called my old Optometrist to get my old scrip. Before surgery i was -1.75-150 62 deg left
Right was 1.75-2 deg114. Now supposedly I'm down to .55 astig but with ghosting.

You wanted to get an enhancement for that astigmastim but your surgeon backed out. Maybe it wasnt gonna do much and too risky. Safest option is to get a thin pair of glasses

Now ace,
Surely you must realise that when you combine glasses with higher order aberrations, you have lousy vision regardless. I bought glasses. They help under certain light conditions. At night they suck even worse than with no glasses at all. Light reflections are amplified.

many people do see an improvement with glasses, especially at night. Its common for them to wear glasses to drive at night as it reduces the "effects" But I guess in your case it does nothing since your pescription is all high order aberrations despite being plano as far as myopia and astigmastim go. RGP contacts often do a good job masking the aberrations by providing a smooth surface. I have seen some get enhancement to take away some of their aberrations.

have this result Ace? Other people who flip burgers with you?

David,
Unfortunately, the sad fact is that people with surgery complications can get about the same quality of advice from burger flippers as they can get from degreed doctors. For example, i went to get a second opinion from another Opthamologist last week. A tech gave me yet another useless Snellen test and then the Dr. came in and shown a light in my eye for 4 seconds. She then preceeded to tell me that she knew nothing about corneas or lasik and referred me to someone else after taking my $100.
This crap goes on all across America every single day and people cannot figure out what is wrong with our medical profession?! Can you imagine a tv repairman or auto mechanic standing there and telling you that he didn't have the foggiest notion how to fix your tv or car but that he was going to charge you $100 anyway?!!
So far the only difference that I have seen between a doctor and a burger flipper is that the burger flipper is actually providing you with an honest product.

John, the fact is that your vision seems to be unacceptable and nobody is willing to perform additional surgery. Furthermore, your surgeon blamed the problem on "higher order aberrations." The question is, higher order aberrations from what? Is it a tear film disorder, a problem with irregular epithelium, or something else? You mentioned that eyedrops seem to clear the vision, which means that the aberrations are created by the corneal surface.

Under these circumstances, you should have a dry eye work-up, and then have a diagnostic RGP contact lens fitting to see what improvements might be gained with a good set of contact lenses. The lenses we use today are not "your father's hard lenses." Indeed, they can now be just as comfortable as soft lenses.

DrG
http://www.copfameye.com

I think he tried RGP already. They didnt do much and he couldnt tolerate them anyway. His aberrations is both on the surface and under the flap. If there was a good chance an enhancement would help, it would be done already. Im thinking once wavefront glasses get improved, itll be the solution for alot of post lasik patients. Of course itll suck to be back in glasses after lasik and glasses wont help dry, irritated eyes.

Your answer to my post is exactly why I don't post much here anymore. Nobody seems to respond except you, Ace.

I doubt -- in fact, I am sure that he has not tried the RGP lenses I am talking about. In fact, I'm not sure he is even interested.

Ace definitely has me confused with someone else. Maybe it's because so many people seem to have similar problems after undergoing Intralase surgery. You know, the surgery being advertised as "No Worries".
I'm using the drops because my eyes have always felt inflamed and irritated ever since surgery. I cannot say that drops really make me see any better. In fact, if I use anything other than Soothe, my vision deteriorates.
My surgeon will do enhancement if she can ever get the eyes to stabilise but so far, they seem to change several times a day and I am going on 9 months. With all the burning and itching, I doubt if I could tolerate contacts.
Thanks for your response. You have made sense in the past and I know that people appreciate your input.

Precisely what is it that your surgeon would retreat if your eyes could be "stabilized"? Is there any prescription of a magnitude large enough? Certainly an average can be calculated. Sure, higher order aberrations can theoretically be treated with a laser, but not well, and not predictably.

You keep mentioning irritation and inflammation. Do you have a diagnosis for this? Is it dry eye? Is it allergies?

DrG

Theres 3 John's here who got intralase with bad results. Sorry if I get confused.

Ok lets see.

1. As Greg mentioned, do you have any alergies? Has your surgeon found out any ideas why your eyes always feel irritated? Is there anything trapped under the flap? Is there any visible damage to the cornea? Do your eyes feel dry? Maybe punctual plugs might help?

2. What is your pescription now? In what range does it fluctuate and do you have any temp pairs of glasses?

3. If you and your doctor ever decide an enhancement approperate, maybe just to reduce the high order aberrations? If this isnt possible, then wavefront is misleading since it cant do anything about high order aberrations despite what it claims! In fact it induces aberrations, perhaps to a lesser extent than conventional lasik.

I still have .5 astigmatsm in my left eye that she will try to enhance. According to the second opinion doctor, the left eye also has a slight myopia although my surgeon had told me that we only have astigmatism to deal with. Even though they claim my right eye is plano, I don't feel that it can see fine detail. The right eye also sees greater distortions at night. Sometimes I see double. Quite often I have this feeling like I'm peering thru a thin sheet of saran wrap or even looking thru a screen. The screen look is during sunlight hours, especialy when the sun is low in the sky.
I was told the inflamation was due to healing and I was on Pred Forte for 8 months. My eyes feel best and see best when doing the prednisone.

I seriously doubt that 0.5 diopters of astigmatism is responsible for your problem. It almost sounds like there is still some haze in the interface? Does anybody see haze when they look at you under the microscope?

At the expense of sounding like a broken record, if someone would just put a diagnostic RGP lens on your cornea, and it eliminated 100%, or even 90% of the problem, then this would pretty much isolate the cause of the problem to the surface.

In any event, the inflammation needs to be brought under control first, but you certainly cannot live the rest of your life on Pred Forte.

DrG

Nobody has used the word haze. My surgeon did say that she could tell from the topography why I'm having higher order aberrations but she didn't explain it. She last told me that I may always have them and that enhancement would not correct this, only the astigmatism.

If glasses dont help with .5 astigmastim, why would an enhancement? I think you should wait till something comes out that can also reduce your high order aberrations. Save your cornea for that. I woulda thought wavefront lasik today could help :(