LASIK

(copied from the old geocities page)
Matthew Reiser's experience with LASIK

History

At age 10, I developed increasing myopia (below) which stabilized around age 30.  I also developed astigmatism.

Pre-operative perscription (September 1998):

  • OD: -8.50D spherical, -2.50D cylindrical
  • OS: -8.00D spherical, -2.25D cylindrical
  • Using corrective lenses (glasses or contacts) I had roughly 20/25 of clear vision in both eyes
  • My pupils widen to 8.5mm in dark conditions
  • I had no other visual problems.
First surgery:
  • Performed: Friday, October 2, 1998 9:00am (Both eyes)
  • Surgeon: Douglas Steel and Advanced Sight Medical Group, Los Angeles, California
  • Laser: Summit (model unknown)
  • Intent: Routine LASIK procedure to correct vision and reduce dependence on corrective lenses
  • Result:  See "Complications" below
Second surgery:
  • Performed: Tuesday, April 20, 1999 at 11:00am (Right eye)
  • Surgeon: Douglas Steel and Advanced Sight Medical Group, Los Angeles, California
  • Laser: Summit (model unknown)
  • Intent: To correct remaining polyopia ("irregular astigmatism") in R eye
  • Result: Introduced flap striae, R eye becomes even more far-sighted
Third surgery:
  • Performed: Tuesday, July 20, 1999 7:00am (Both eyes)
  • Surgeon: Thomas S. Tooma, Newport Beach, California
  • Laser: Nidec
  • Intent: (1) Correct polyopia in both eyes by removing central islands and (2) Remove flap striae on R eye
  • Result: All original complications remain (see below)


Post-operative Complications 
All symptoms below (except flap striae) were introduced during the first surgery.  Neither the second nor third "enhancement" surgeries corrected any symptom below, with the exception of dry eyes which have slowly improved over 4-5 years.
 

SymptomCauseSuspected medical errorIs this symptom common?
Halos around light sources in low-light Ablation smaller than pupil (5.5mm vs 8.5mm)Surgeon didn't measure pupils accurately
No, unless pupil diameter > 7mm
Loss of contrastEpithelium / Stroma HazeUnknownUnknown
Polyopia (multiple images)Central islands (irregular astigmatism)Laser didn't use scanning technologyHappens in ~5% of LASIK patients
Flap striae (folds)Tenting, wrinkling,Surgical error?
Happens in ~3% of LASIK patients
Hyperopia (Farsightedness) in R. eye
OvercorrectionSurgical error, and/or healing problem
Happens in ~3% of LASIK patients
Moderately dry eyes (until 2003)
UnknownUnknownYes

Condition 1 year after first surgery (November 1999)

Refraction:

  • OD: +1.25 spherical, -2.25 cylindrical
  • OS: +0.75 spherical, -1.75 cylindrical
Comments:
  • Moderate farsightedness on R eye with moderate and irregular astigmatism
  • Uncorrected, I have 20/25 in the left and 20/80 in the right
  • With correction (glasses) I have about 20/25 in both eyes
  • I need glasses to drive
  • I need glasses to read for more than about 2 minutes
  • Have been told I cannot use soft contact lenses any longer due to LASIK procedure reshaping my cornea
  • I continue to have all the complications listed in the above table
Condition 2 years after first surgery (November 2000)

Refraction:

  • OD: +1.50 spherical, -2.25 cylindrical (over-correction has worsened slightly during the past year)
  • OS: +0.75 spherical, -1.75 cylindrical
Comments:
  • Uncorrected, I have 20/30 in the left and 20/100 in the right
  • With correction (glasses) I have about 20/30 in both eyes
  • I need glasses to read for more than about 30 seconds
  • I continue to have all the complications listed in the above table
Condition 3 years after first surgery (November 2001)

Refraction:

  • OD: +1.25 spherical, -2.50 x 25 cylindrical
  • OS: +0.75 spherical, -1.75 x 5 cylindrical (over-correction has worsened slightly during the past year)
Comments:
1. One reason my halos are so obnoxious at night is because I endured (or have) all the possible causes mentioned on LASIK Disaster 
2. I was told my irregular astigmatism (which is only partially corrected by wearing glasses now) could be helped by contacts but I don't want them because:
  • Wearing contacts was what I was trying to avoid by persuing LASIK(!!)
  • I'm not as irritated by it as I once was (I'm adapting mentally)

Condition 4 years after first surgery (November 2002)

Refraction:

  • OD: +1.25 spherical, -2.50 x 25 cylindrical
  • OS: +0.75 spherical, -1.75 x 5 cylindrical 
Comments:
  • More on halo-risk from big pupils on Surgical Eyes:
    "Patients with refractive errors greater than -4D and scotopic pupils 8 mm or larger are contraindicated for 6-mm-zone excimer surgery…The onus is on the surgeon to choose the right patient…Not screening for these patients preoperatively is a critical oversight on the part of the surgeon because these complications cannot be remedied with currently available refractive techniques."
    ...
    Stephen Trokel, MD, Enlargement of the PRK Optical Zone, Journal of Cataract & Refractive Surgery, 11/96. 
    Peter Hersh, Jack Holladay, Corneal Optical Irregularity After Excimer Laser PRK, Journal of Cataract and Refractive Surgery, 3/96. 
    Gregory Klonos, MD, John Pallikaris, MD, A Computer Model for Predicting Image Quality after PRK, Journal of Cataract and Refractive Surgery, 2/96. 
    Yair Alster, Anat Loewenstein, Tami Baumwald, Isaac Lipshits, Moshe Lazar, Dapiprazole for Patients with Night Haloes After Excimer Keratectomy, Graefe’s Arch. Clin. Exp. Ophthalmol, Vol. 234, 2/96, S139-S141.
Condition 5 years after first surgery (August 2003)

Refraction, as measured by Stein in Manhattan Beach:

  • OD: +1.00 spherical, -2.00 x 018 cylindrical (slightly improved from last year)
  • OS: -0.25 spherical, -1.75 x 002 cylindrical (slightly improved from last year)
Comments
  • Visual complications listed in above table are still present, neither worsened nor improved. 
  • Adjusting to these defects has taken time, but my brain has somewhat adapted to the injury (what choice does it have?) and I'm learning to cope.
  • I've been contacted by ~6 people in 2003 who've asked me whether they should have LASIK performed and I caution them to (1) find the right surgeon and (2) only proceed if they feel they can no longer live with their current, corrected vision because it's a precious gift that cannot be restored easily.
Condition 6 years after first surgery (August 2004)

Refraction, as measured by Stein in Manhattan Beach:

  • OD: +1.00 spherical, -2.00 x 018 cylindrical (same as last year)
  • OS: -0.25 spherical, -1.75 x 002 cylindrical (same as last year)
Comments
  • Visual complications listed in above table are still present, neither worsened nor improved.  
  • I've learned to cope, and I try not to re-live the experience, and mental pain of LASIK.
  • I've finally stopped focusing on LASIK, my woes and loss, and am moving on with my life.
  • In Dec-2004, I was contacted by a fellow LASIK patient, Marianne, who had similar complications.  While speaking with here, I sent her this "consolation":
I have been where you are.  

It's lonely because doctors, family and friends don't really know what you're seeing and feeling.  But you can find some peace in knowing we're luckier than others (e.g. blind people).  Remember we're all born with (and quickly and unconsciously learned to live with) our limited five senses.  For example, we can only hear 20Hz-20kHz of the sound spectrum, 
and we can only see 400nm-700nm of a vast spectrum of light.  What you don't have now, you don't really need.  Let your brain adapt.

You must consciously adapt to your new limitation.  You can do it.  It's tough because we're all hard-wired to protect (and fix) ourselves to survive and prosper.  So our brain clings to problems it finds.  Let go, focus elsewhere, and you might feel less frustrated.  Keep yourself distracted. 

I'm not apologizing for imperfect medical or legal systems.  In fact, I was angry for three years and fought to understand and prosecute those who wronged me.  But eventually we learn we have to spend our time elsewhere, and that will help brain to adapt to the new limitation in eyesight.

Epilogue

I am dissatisfied with the outcome of all three surgical procedures because:

  • None of the surgeries delivered what each surgeon indicated.
  • Each surgery introduced complications difficult to correct.
  • My pupils were not measured properly and I have halos caused by a relatively small ablation zone.  It is thought that this will be likely never be correctable.
  • My post-operative best-corrected-vision is worse than my pre-op with lenses.  Only 1% of LASIK patients shares this condition.
  • My gift of eyesight has been permanently damaged, due to voluntary surgery and imperfect medicine.
The good news is that I'm not a "horror case" who needs a corneal transplant or is legally blind.   Nonetheless, I wish I'd never had these surgeries.

Looking Ahead

I hope someday a topographically-linked laser can help me.  But even when solutions such as these are claimed to be effective, I'll hesitate to use them, as I have learned to distrust the medical community; especially any for-profit professionals.  I avoid thinking about this topic, because I become frustrated, angry and depressed.   Instead, I am moving on, and trying to forget this piece of my past.

Contact
Considering refractive surgery?  Contact me at:

Matthew Reiser 
+1(424)644-6288, pacific timezone
Related Links
page created: December 1999 
page last mod: May 2007
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