A patient travels across the world for Dr. Chynn
Sakiko W: I am shortly visiting New York City and would like to have a consultation and evaluation of my eyesight. I recently underwent LASIK surgery in Singapore (my eyesight was previously very poor; -11). The doctor assured me I would obtain eyesight to around -0.5. Recently (six months post surgery) my eyesight has begun to deteriorate and is now at -1.5 in the both eyes. The doctor at the LASIK center tells me this is normal and that it will probably settle around -2. I am worried that it will deteriorate further. Would you be able to productively consult on this matter?
My husband and I arrive on October 2nd and would be able to see you from the 3rd onwards. Kindly advise.
Thank you very much.
Dr. Chynn: You should not have received a LASIK, first of all, for a -11 Rx, as that is neither safe nor recommended. You should have had an advanced surface ablation, either LASEK or epiLASEK, as that would save tissue and leave your cornea stronger, which is much safer. I am concerned that you might have Iatrogenic Keratoconus or Keratoectasia secondary to your LASIK. Please bring your records with you as these will be helpful in assessing your problem. The charge for this initial visit/2nd opinion is $300 USD.
Thanks and see you then!
Sakiko W: I must now confess my ignorance and admit that I actually don’t know what procedure I had; LASEK or LASIK or epiLASEK; they shaved off a bit of the surface of the cornea. The second Singapore doctor I went to see with this concern (the doctor doing the actual procedure was too brusque and non-communicative for my liking and thus I went for a second opinion) explained that my deteriorating eyesight was due to the fact that cornea grows back a bit after the procedure and also that there was plenty of cornea left. He also said that if HE had done the procedure he would have ‘over’ done it (to plus one) so that it would grow back to zero as it were. I don’t know if this is helpful or not but there you have it.
Nils W:
Thank you for this note; we have requested the records from SNEC in Singapore and insh’Allah they will be with you by the time you meet Sakiko on Friday. I do realize that you prefer your treatment (LASEK etc) method to the one my wife had in Singapore (LASIK). You Americans are more cautious and a good thing that is too. Our Singapore doctor (however) assures us that the cornea was thick enough to perform the LASIK and that she (post-procedure) does not have Iatrogenic Keratoconus or Keratoectasia. I am writing with you to plea with you to kindly take into account that my wife is rather sensitive and easily frightened by potential medical complications. As you may imagine your initial email put her in a state of near panic. I hope that you will find her cornea and eyesight in good condition; if so I will be grateful for your calming reassurances. If further treatment (against all odds) is needed I rely on you to be as positive as humanly possible and to not make her more distressed than she already is.
Thank you so much for your kind attention. This may all seem rather silly and infantile to you but I assure you that the fear and worry is all to real to my beloved wife.
Dr. Chynn:
Thanks for the information, it seems like the doctor performed a LASIK and that he thinks there was enough tissue to do so. We will perform an Orbscan to confirm this if she needs an enhancement, we can do a LASEK on her prior LASIK flap. This will not further weaken her eye as the flap adds almost 0 structural integrity to the eye (you can think of it as a hat on top of someone’s head.) So the eye after will be as strong as possible. I will be sure to communicate everything carefully.
Thanks for your concern and support, she is in good hands with us:)
Emil William Chynn, MD FACS MBA
