Lasik – 8 months later

I posted about my LASIK experience last year. I’d like to share how it’s going eight (8) months after I had LASIK surgery.

They’ve been monitoring my eyes on a monthly basis since then. At first I was told there were dry spots in my right eye, but it didn’t bother me so I didn’t mind. I can’t remember when I learned that there was something under the flap of the my right eye – at that time I didn’t know the official term - epithelial ingrowth. As long as it didn’t affect my vision (i.e., I could still read 20/20) they didn’t touch it. Right after surgery, I noted in my post that my right eye was a bit clearer, though probably the difference wasn’t significant, and I think it fluctuated from time to time, like my right eye would be clearer, then my left, then my right. I probably attributed it to dryness because when I was wearing contacts that would happen as well, and tearing up, or washing my face, or putting lubricant drops occasionally would clear them. I can’t remember exactly when I started noticing that my right eye was constantly not as clear as my left eye, though I heard from a friend and my dad that usually their one eye is also clearer than the other so I thought it was normal and didn’t think much of it despite my OC-ness.  I thought since my right eye was my dominant eye, I used it more often, thus it was a bit blurrier than my left.

During my February post-op check-up at American Eye, which would mark my 7th month, they didn’t run me through the usual routine tests (manifest refraction via computer, check eye pressure, take picture, vision test for manual refraction) and led me straight to the slit-lamp eye exam to check on the ingrowth. So I didn’t get to verify if my vision had worsened already at that time.  Come March check-up, I could no longer clearly read the 20/20 line with my right eye, probably even the 25/25 line also. Under the slit-lamp, the doctors also noticed that the ingrowth had grown since the last time. This also validated the blurriness I had been experiencing with my right eye, it wasn’t my imagination after all. What’s weird is that I was charged a Php800 fee for this routine check-up – I thought all the post-op check-ups were supposed to be free.

Later on internet research would tell me that patients who’d undergone enhancement surgery (where the flap is re-opened) were in higher risk of developing epithelial ingrowth, and one of its effects would be to induce astigmatism – that’s exactly what happened to me. I had enhancement surgery the day after my original LASIK surgery because the laser hung right in the middle of doing my right eye that it didn’t get to correct my grade completely. Thus I had to go back the next day for them to re-open the flap and continue the laser correction. Yes it was a hassle, but I didn’t blame them for the technical problem because it was beyond their control. Little did I know it would lead to another complication during healing. I was a statistic then, when the laser hung during my operation. I continue to be a statistic now, with the epithelial ingrowth inducing astigmatism.

Since the ingrowth had already affected my vision, they decided to have it removed. They told me it was a simple procedure to open the flap and wash away the growing epithelial cells. My operation was scheduled the following Friday.

I came back March 30. I went through the routine check-ups and vision test. Only when I asked what was with my right eye did I learn that I had an astigmatism of 100 on my right eye. Obviously this was new, because I only had myopia (nearsightedness) before my LASIK surgery – I never had astigmatism. I now had an explanation for my degraded right eye vision. Though my procedure was supposedly quick, I had to wait a long time since there were a lot of patients in line for LASIK.

While on the O.R. waiting area, two interns who were observing wanted to see my eye, since I was obviously a rare case for them. I didn’t mind – whatever I could do to aid their learning. They only had one question which I had the perfect answer for – did it affect my vision? When I was finally brought to the operating room and lay down on the bed, I was asked if a picture was already taken since they wanted to submit it somewhere since I was an isolated special case for them. Since we were not sure a recent pic was taken, I said I was ok if they wanted to take a pic first, so they put me out of the surgical attire and I waited to have a pic of my right eye taken. Since they operated on someone else while I was out, I had to wait another 20 minutes before it was my turn again.

Back on the operating table, I was prepared for the pain/pressure that I remember associated with the speculum prying and keeping my eye open. I was pleasantly surprised when it didn’t hurt as much this time. I saw the vision changes when the opened the flap, wash away the cells, and close the flap. There was only slight pain when an assistant was asked to press down on the lower right side of my right eye during the wash. After the procedure my right eye became blurry, which was normal post-op. After the doctor checked my eye under slit lamp, I was cleared to go.

The assistant wanted to give me a transparent cover for my right eye for protection; I asked for the transparent goggles instead so I could wear them as soon as I walked out of the O.R. and through the mall without looking too weird. She agreed and kept the transparent eye cover in a pouch (for use that night), together with the prescription for eye drops, and handed over to me. My eye wasn’t also as sensitive to light as it used to be after the original LASIK procedure. Also didn’t feel any pain afterwards, just like after my LASIK. We bought the prescribed eye drops which turned out to be two-in-one antibacterial and anti-inflammatory drops called Vigadexa. I remember being given two separate eye drops for antibacterial and anti-inflammatory after LASIK for free.

The following day I came back for a post-op check-up (I would have complained this time if I was asked to pay a fee again, luckily I wasn’t). During the computer tests I asked how my right eye was and was informed that the structure was ok but my vision was still to be checked. Under the slit-lamp eye check they asked how my vision was and I honestly replied it was still a bit blurry. I was told it was normal to still be hazy since my eye was still swelling a bit from the procedure. I remember not being able to read the smaller letters, but when asked to read through a small hole I was able to read the letters, I just don’t know if it was up to the 20/20 line. They usually don’t share the results unless you ask. I would also learn later that my records would reflect I already had 20/20 vision, but my actual experience was actually not that clear of a vision on my right eye so I don’t know how they came up with the diagnosis of 20/20.

So they following week I came back for what was supposed to be 1-week post-op but since it was holy week that weekend I was asked to come earlier on Tuesday instead so just a few days after my first post-op check-up. I went through the usual computer checks and asked if I still had the astigmatism and was told not anymore. They said the induced astigmatism was gone, because it was artificially caused by the epithelial ingrowth. I remember making a mistake with one letter on the 20/20 with my good left eye (I mentioned C instead of S). And on my right eye it was still blurry though I still made an effort to read – I think I had to squint. I probably got two or three letters with much effort, obviously that wouldn’t be the case for a normal 20/20 vision. I experienced that for a period of time after my LASIK surgery so I should know – my vision was much better then. The optometrist tried to put a grade of -0.25 on both eyes (including my supposedly good left eye because I made a mistake while reading with the left) and the letters became clear and crisp, significantly so for my right eye that used to have induced astigatism. When the opthalmologist checked up on my eye under slit-lamp, I asked if it was expected for my 20/20 vision to be restored on my right eye and was told that it already was 20/20. But I knew deep inside that my vision was still blurry on my right eye. Plus during the vision test a -0.25 grade was tested and only then was my vision clear. So next time I go for a check-up I will not try to exert much effort in reading the small letters anymore if they were unclear, because a 20/20 vision shouldn’t have difficulties reading the letters and shouldn’t have the blurry vision. Hopefully this time they won’t insist my vision was perfect when it wasn’t. I would accept it if they told me it was still going to get better in time, I just wanted to know the real case with my eyes and not be told it was 20/20 when my actual experience says otherwise. I’m coming back for another routine post-op check-up in a few weeks. Will keep you updated how the succeeding check-ups go.

Don’t get me wrong – I’m thankful that American Eye took care of checking up on my eyes regularly after my LASIK surgery and addressed the epithelial ingrowth complication that followed. It’s reassuring to have these regular post-op check-ups so they could detect if anything was wrong early on and I’m glad regular post-op check-ups are part of the package. I’m thankful that they closely monitored the ingrowth complication during these check-ups. I’m still happy that I don’t have to use eyeglasses or contacts anymore. I just want sort of a full disclosure on the state of my eyes. And it’s not just me, a friend also experienced the same thing when after LASIK his left eye was blurry even with the bigger letters even after trying to put (+) or (-) grade and only after being asked to read through a small hole did it became clearer. He was told everything still looked good. Eventually after probing he was told he had a bit of farsightedness. He used to be nearsighted before LASIK. I hope mine and my friend’s eyes get better in time. Good luck to us!

Anyway, for a full account of my previous LASIK operation please check out http://www.watimbox.com/2011/lasik-experience-at-the-american-eye-center/

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Added: May 23, 2012

I went back for a check-up last April 28, around a month since the ingrowth was washed away. This time the follow-up consultation was not free anymore, it cost me Php250 for the routine vision checks by American Eye staff, and Php550 for the specialist’s professional fee. I still had to exert effort to read with my right eye, but I was able to read the 20/20 line this time with effort, and they concluded my vision was OK. The specialist then took a quick look at my eyes under the light, took her less than a minute to conclude it was OK. Again, that less-than-a-minute check cost me Php550 but I’m just relieved it was fine, didn’t get worse. I’m due to another check-up in two months, that will be around July, and I’m expecting to pay another Php800. But hey, if it’s for my eyes, good eyesight is priceless.


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One Response to Lasik – 8 months later

  1. Dona says:

    Hi. How’s your vision now? Is it still 20/20?

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