Complications from LASIK
Concisely and synoptically I would like to report the situation I am facing, hoping in your specialized medical opinion. My name is VK, I am 27 years old, and in 1-10-2008 I was the subject of a myopia correction operation in both eyes, which was done with the LASIK method causing to me a severe problem and reduced my vision extremely.
In particular from the second day following the surgery I was presented with severe diffuse lamellar keratitis (DLK), with a reduction of vision, severe clinical strain symptomatology , tearing and photophobia, intense pain and heavy blurring in the centre of both eyes. A situation which had as an effect the presentation of edema and striae on the flap. The medication I was treated with included topically collyriums, cortisone drops, (and after a certain stage I was treated with one cortisone drop every 10 minutes) and natural tears. This situation evolved reaching a peak on the 7th day and stage four DLK with the danger of permanent loss of my vision.
A. I am asking for your knowledge on the following subjects that concern me as my vision has not yet fully recovered.
Q. Have you ever faced such an incident like mine?
A. Before I stopped performing LASIK 5 years ago in favor of the safer LASEK procedure, which CANNOT have DLK because there is no flap underneath which debris can accumulate, I, like any high-volume refractive surgeon, also had DLK cases–probably about 100 in total.
Q. What would be your way of managing a patient with these symptoms?
A. For severe DLK they should have lifted up your flap and irrigated, first with BSS (saline), then with steroid drops, and also put you on oral steroids.
Q. Is stirae a common result of the laser lasik operation?
A . It is after DLK, as you may have some melting of the cornea caused by the inflammation, so the flap and bed don’t match up correctly. Again, this is why I switched to the no-flap LASEK procedure 5 years ago, as my striae incidence went from 1% to 0%, as it is impossible to have striae if you don’t have a flap!
Q. In your opinion I should undergo another surgical operation in order to fix this stirae?
A. You may need a lift and smooth, or a lift and irrigate with hypotonic saline, or even suturing of your flap–I have had to do all of these things to fix striae in LASIK flaps before.
Q. In case no is the answer and I am not a subject of another operation what would you approximately say is the recovery time of my vision?
A. It’s hard to say, because of individual variation; it can be weeks to months.
Q. Is this implication a threat to one’s vision if not faced in time with the correct medication?
A. Usually it doesn’t permanently degrade vision but sometimes can, unfortunately.
Q. Is cortisone dripping every 10 minutes a common and suggested DLK treatment? What is the long-term effects of cortisone? I mark that I was treated with cortisone collyriums for more than two months.
A. I would have irrigated under the flap directly is a more efficient way to get the dose of steroid you need where it is needed.
Q. I have read in foreign medical magazines that causes of this implication are inadequate sterilization of medical surgery tools, metal parts, bigger than normal thermal impact from excimer laser, improper washing of the eyes, dust. What is your opinion? Could it be caused by a combination of these parameters?
A. Yes, these or any other factors, some of them unknown.
Q. Is there a medical explanation to the intense pain I have been through during the surgical procedure?
A. Sometimes patients have pain.
I thank you in advance for your precious time and I will be eagerly and gratefully looking forward for your response based in your specialization and experience in laser operations. I am deeply concerned and hope for your help. For any clarification and confirmation contact me:
You’re welcome but I’m sorry I can’t correspond anymore as we do not have a proper physician-patient relationship over the internet, if you happen to come to NYC sometime for some other reason I would be happy to see you, but you should be able to get good care in Greece, you can John Kannelopoulis, MD, whom I trained with at Harvard, I think he’s in Athens or something like that, you can tell him I referred you, good luck!
Yours,
–
Emil William Chynn, MD FACS MBA
Dartmouth / Columbia / Harvard / Emory / NYU-trained
1st surgeon in NYC to have LASIK!
10,000 cases - 100% Legal To Drive!
Member FACS, AAO, ASCRS, MENSA
