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LASIK already done..Again myopic..worried..Please advise
prateek207 posted:
Dear Sir Alan Kozarsky,

I had undergone LASIK operation around 6 years ago (Jan 2008). Prior to surgery, I was highly myopic (-8.5 dioptres, both eyes). I could see well after the surgery and they said then the power was zero. After a month of the surgery, I felt my distant vision started going blurred again. When I got my checkup done, my eyes were weak by -2.25 dioptres. The surgeon advised to go for LASIK again and we did go for it. Again corrected to zero (?) and then followed the same nightmare.. After 2 weeks I could not see far objects clear. Finally I was prescribed to use -2.25 dioptres glasses and was advised that whatever best could be done has been done.

Few months ago I got my checkup done again to find that vision had further degraded and it is now -3.5 D in both eyes. I am so worried doctor. What's the best that can be done now so that I could see clear without glasses? Is it advisable to go for a surgery again? Please suggest.

Thanks a ton.
Alan M Kozarsky, MD responded:
Sounds like you don't need any more LASIK.

Your doctor needs to check for cataracts and your corneal shape. Early cataract formation results in progressive nearsightedness which should not be "chased" with LASIK. Rarely, increasing nearsightedness and especially astigmatism after LASIK can indicate a decrease in corneal strength/shape.
prateek207 replied to Alan M Kozarsky, MD's response:
1. Just curious as I had gone through this:
What Are the Advantages of LASIK Eye Surgery?Adjustments can be made years after LASIK to further correct vision if vision changes while you age.
Isn't this quite a possibility with my case?

2. I feel like I have astigmatism because my near vision is also blurry. Can corneal shape be brought back to normal (prk or something)? Kindly suggest the way it can be cured.
Alan M Kozarsky, MD replied to prateek207's response:
Under ordinary circumstances LASIK can be easily "enhanced" by secondary procedures. An example of this might be a 4 diopter LASIK treatment enhanced by another 0.75 diopters. You situation is far different with over 10 diopters already performed and over 3 diopters still "needing" treatment. Your situation is not that of simple under-correction or postoperative drift; something very different than the usual is occurring and needs diagnosis but does not need further are already at the maximum permissible level of treatment with an unstable refractive situation - you don't want more treatment.
prateek207 replied to Alan M Kozarsky, MD's response:
But then can my Corneal/Cataract imperfection be cured if diagnosed?
prateek207 replied to prateek207's response:

Please advise. Would I able to get a treatment by some other way, if not by surgery?
Alan M Kozarsky, MD replied to prateek207's response:
As previously stated, you need a comprehensive eye examination by an ophthalmologist specifically checking for corneal weakness (ectasia) and cataract formation. There are many treatment possibilities including glasses, contacts lenses, cataract surgery, etc but the treatment will completely depend on what is actually occurring with your eye.

Thus, one cannot make a specific treatment recommendation until a competent ophthalmologist determines what actually underlies your very unusual postoperative course after LASIK.

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