Starting at age 10, I developed increasing myopia (immediately
below) which stabilized around age 30
I also developed astigmatism, shown here:
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.
Symptom
Cause
Suspected medical error
Is 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 contrast
Epithelium / Stroma Haze
Unknown
Unknown
Polyopia (multiple images)
Central islands (irregular astigmatism)
Laser didn't use scanning technology
Happens in ~5% of LASIK patients
Flap striae (folds)
Tenting, wrinkling,
Surgical error?
Happens in ~3% of LASIK patients
Hyperopia (Farsightedness) in R. eye
Overcorrection
Surgical error, and/or healing problem
Happens in ~3% of LASIK patients
Moderately dry eyes (until 2003)
Unknown
Unknown
Yes
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, primarily because:
None of the surgeries delivered what each surgeon indicated
would
be delivered
Each surgery introduced complications difficult to
correct with available technology.
My pupils were not measured properly and I have halos caused by a
relatively small ablation zone. This will be tough to EVER
correct.
My post-operative best-corrected-vision is worse than pre-op with
lenses. Only 1% of LASIK patients shares this condition.
My precious gift of sight has been damaged, probably
permanently, due to
voluntary surgery and imperfect medicine/practice.
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 something like a topographically-linked laser will
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 surgical "professional".
<>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
If you're considering LASIK, or any type of refractive surgery, feel
free to contact me at:
