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Old 11-18-2012, 08:56 PM   #1
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Epi-lasik done one eye at a time

There is so little posted on epi-lasik that I thought I would post some thoughts from my surgery. Last Friday I did epi on my left eye only. From what I have read the biggest problem people have with epi or prk is that they have crappy vision for weeks and it is debilitating. I decided that it would be far easier to do one eye at a time so that I can keep functioning more normally. I am also really cautious since there are the occasional horror stories about lasik. I chose epi because the risk profile seems better than lasik and doing one eye (not my dominant) is about the safest way to do it. I also think it will be very interesting to compare my new eye to my current vision.

So Friday I did the surgery. Like everyone else it was quick and painless. A little distressing to smell skin burning . Doc put me on neurontin for a few days and the usual sets of drops. My wife ran my glasses over to LensCrafters and had new lenses made that are planos with the same reading bifocals I have today. We then put the left lens in and kept the right for later. I think they will be handy for sitting at my desk where I am used to looking down with bifocals and up at my tv or out the window. I am also considering getting a single reading contact to experiment with when surgery is done. I really didn't mind contacts at all and mono vision contacts seemed to work fine for me but I just couldn't get contacts to work overall. I have astigmatism and they just would not stay upright so focus came and went. Later with my astigmatism corrected i might find that a reading lens on one eye is useful. We will see.

Anyway, day one, two and three (fri, sat and sun) have gone extremely well. Surprisingly I have had no pain. I little ache sometimes but nothing much. I attribute part of that to the regimen that the surgery nurse gave me. She gave me 6 cases of individual sterile eye drops. Told me every 15 min to put an entire one in my eye. Seemed like overkill but strangely it made all the burning sensation the first day go away. I can only guess that it is either because it cools our eye or because it rinses out something made by your eye. Like the enzymes that build up on contacts that make your eyes burn. Maybe the healing process creates some kind of chemical waste that the eye drops rinse out. An entire dropper in one eye is basically irrigating it. It is sun night and I can barely tell I had surgery in terms of pain. I have just about quit irrigating my eye.

Vision of course is terrible in that eye. Went way downhill today. But it is really no biggie because my right eye is still fine I just wear my glasses as normal with the left Plano and I can see. My left eye is good enough for depth perception and all the detail comes from my right. Unless I close my right eye, I hardly notice. I assume the vision going downhill is a good thing since my surgeon removes and discards the epithelium (transparent eyeball skin) that he removes with the epikeritome (deli slicer) and bad vision probably means I am growing a new one now. I also suspect this is the reason for all the fluctuating vision that people report. If your eyes are just wet enough the roughness of the new surface is filled in with liquid. Over 3 months your blinking eventually polishes this new skin surface to be as smooth as it once was.

Finally an observation. If I hadn't done one eye I would think I had a lot of symptoms now. I notice halos and dryness then I think about it and realize that it is in both eyes. My point is that I am now paying really close attention to this stuff So i am noticing it. I wonder how much of the post surgery symptoms people notice were there all along. I just never paid really close attention. For instance I was looking at a light on my black ceiling tonight to see how much glare and halos I saw. It was pretty bad. Then I thought to try my good eye and it was better but it turns out staring into a halogen spotlight against a black ceiling just causes some halos . Anyway, it is really interesting to have a real "control" as they call it that I can compare too.

I will try to post other observations.

Greg

Last edited by Indygreg; 11-21-2012 at 01:20 PM.

 
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Old 11-19-2012, 10:05 AM   #2
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Re: Epi-lasik done one eye at a time

Day 4 - doctor visit

Visited the doc today and all,is great. I have no idea why I am doing so well but I am not complaining. Nurse feels strongly that the constant irrigation with tears is a big factor. Doc seemed surprised that my epithelium was 95% healed already. He removed the bandage contact and told me to come back in a week. I tested 20/40 but you know how that is. I couldn't even see the chart when we started but I worked to find a spot where I could see and blinked until i found focus. And they tested me before he removed the contact.

Vision is a little worse without the contact. Strange that I seem to be able to focus best at about 2 feet where it is harder to focus across the room. I hope this adjusts over time. I didn't sign up for mono vision.

The nurse encouraged me to step it back up on the drops. Even if I don't feel like I need them they feel that keeping it wet helps it heal. So I am eliminating the neurontin and doubling down on the preservative free tears.

Greg

 
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Old 11-20-2012, 01:55 PM   #3
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Re: Epi-lasik done one eye at a time

Day 5 - blurry but feels fine

Stopped neurontin yesterday and was more aware of my eye but still no pain. More like a dry spot early in the day that has mostly gone away by evening. My vision in that eye is still blurry and a little double vision from time to time. Again, I have to close my right eye to notice it. With my good eye open I am just mildly aware that my left is blurry. I am a little concerned still that when my vision is best in that eye (it comes and goes) i can read from about 2' away which is something I can't do with my good eye. With my right eye I can read from that distance only through the bifocal part of my glasses. So I seem to be optimized for mono vision right now which I did not want. Hopefully this changes over time. I am using drops every hour or so as needed.

As background I did epi-lasik with the epithelium removed and discarded on an algerhetto eye-q laser. I believe he used alcohol but I did not verify that. I just remember he said he did when I first interviewed him.

As a side note I have been reading a lot of blogs and I am surprised how many people do prk or epi and dont really understand what they signed up for. Seems like a lot of people agree to have a doc perform one of these procedures without reading about it first then are really unhappy when they find that it will take months to fully heal. It is odd how many panic posts there are around the 1-2 week mark then the person never follows up to say how it came out. I can only guess that many of these resolve themselves but it seems strange that people wouldn't report on their final outcome so that others will know how it came put. I will try my best to remember to come back to this thread after I get to a stable state and report.

Greg

Last edited by Indygreg; 11-21-2012 at 11:02 AM.

 
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Old 11-24-2012, 03:48 PM   #4
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Re: Epi-lasik done one eye at a time

Day 8 - clearing up but no distance vision yet

Eyes feel totally normal. I can see fairly clearly with my left eye from about 2 ft. I can easily read with it. I just can't focus across the room. I am hoping that changes over time but I am not seeing any change yet. My distance vision has cleared up in the sense that I don't have any double vision or other noise. It is just beyond my focal range. My new eye is now better than my uncorrected right eye in all situations but certainly not as good as my corrected vision was yet.

I am SO GLAD that I did one eye. If both eyes were like my left right now I would be pretty tired of it. I have gotten totally used to depending 70% on my right eye and using the left mostly for depth perception. With my glasses that have the left plano lense I am completely functional, driving comfortably, using the computer and ipad, reading, etc. sometimes I close my right eye and realize how thankful I am that I am not dependent on my left.

Greg

Last edited by Indygreg; 11-24-2012 at 03:50 PM.

 
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Old 11-26-2012, 06:21 PM   #5
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Day 10 - doctor visit

Did a follow up today. He said it looks very good. Epithelium is completely grown back. I have some astigmatism still but he said it is way to early to say where I will end up. He said that he could see inflammation which is pretty normal for 10 days and that is what the steroid drops are for. He checked my inter ocular pressure (IOP) which normally runs a touch high. I was several points higher than usual in that eye which is a common side effect of the steroid drops. He wants me to use travatan drops once per day until I finish the steroid in three weeks. This should lower my IOP.

Vision in the left eye is not much different. He felt I was healing faster than average and suspected i would be stable before the 2 month mark which is the expectation I have been setting for myself. I asked if he had a prediction for where I would end up and he laughed and said NO. .

G

Last edited by Indygreg; 11-26-2012 at 06:25 PM.

 
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Old 11-27-2012, 07:40 PM   #6
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Day 11 - I think it is improving

Maybe it is the drops to lower my IOP but I feel like distance vision in my left eye is a little better today. While driving tonight I closed my right eye and for the first time felt like I would be ok driving with the quality vision I have in my left.

Greg

 
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Old 12-02-2012, 07:57 AM   #7
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2 week checkup

My two week checkup went well. My epi lasik eye is clear of any haze and the epithelium has completely healed. My vision at 10 days was -2.0 with +1 astigmatism and at 14 days it had dropped to -1.25 with +.75 astigmatism. Tested 20/30 on the eye chart. Vision in that eye is very usable at this level but certainly not where it needs to end up. Doc continues to say that it is nowhere close to being done healing. Said that with epi I could come back in a week and the numbers could be back to my earlier results. I go back in two weeks. Healing is very gradual at this point but given where my eye is now it is easy to be patient.

Greg

 
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Old 12-04-2012, 03:16 PM   #8
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Re: 2 week checkup

Keep posting - although my Lasik wasn't 100% I do like to hear success stories.
Brian

 
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Old 12-11-2012, 06:08 PM   #9
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3 1/2 week checkup

Did another checkup today. My doctor called it right at the last visit. My prescription was back to the -2 spherical +1 astigmatism numbers from a few weeks ago. He said that he would have liked to have seen me improve every week but was to surprised and if he had to bet he would still bet that I will end up ok without a touch up. Said he sees people with epi float all over the place before they stabilize. I have another week and a half on drops then I will go back and see where I am.

Greg

 
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Old 02-17-2013, 03:34 PM   #10
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Re: 3 1/2 week checkup

Been a while but here is an update. Some interesting developments:

- at 8 weeks I was 20:20 in my left eye and at 12 weeks I was 20:15. I ended up about a half diopter near sighted in that eye which I am pleased with. At my age a little near sighted ness in one eye is kind of handy and anything withing a room I am standing in is very clear. Maybe if I were a bird watcher I would do a touch up but I decided to move on to my right eye.

- I did my right eye 2 days ago and it is having a similar experience in terms of discomfort. As long as I drenched it with an entire dropper full of opt ice refresh drops every 15-20 minutes I had no pain. When itis wet thus letting the contact work as a good epithelium my vision I'd razor sharp in that eye. I am very hopeful.

- I may have figured out why my epithelium healed so fast. I have rosacea and was on doxycycline when I had the surgery. I have recently read that studies show that doxy accelerates epithelial healing. Not sure why they don't prescribe it but I have to wonder if that is why I was 95% healed in three days and had no haze.

Greg

 
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Old 02-17-2013, 03:36 PM   #11
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2nd eye

Been a while but here is an update. Some interesting developments:

- at 8 weeks I was 20:20 in my left eye and at 12 weeks I was 20:15. I ended up about a half diopter near sighted in that eye which I am pleased with. At my age a little near sighted ness in one eye is kind of handy and anything withing a room I am standing in is very clear. Maybe if I were a bird watcher I would do a touch up but I decided to move on to my right eye.

- I did my right eye 2 days ago and it is having a similar experience in terms of discomfort. As long as I drenched it with an entire dropper full of opt ice refresh drops every 15-20 minutes I had no pain. When itis wet thus letting the contact work as a good epithelium my vision I'd razor sharp in that eye. I am very hopeful.

- I may have figured out why my epithelium healed so fast. I have rosacea and was on doxycycline when I had the surgery. I have recently read that studies show that doxy accelerates epithelial healing. Not sure why they don't prescribe it but I have to wonder if that is why I was 95% healed in three days and had no haze.

Greg

 
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