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Suggest Treatment For Post Lasik Ectasia

Posted on Mon, 23 Feb 2015

Question: i got a pentacam and corneal topography test done and i have been diagonosed with post lasik ectasia
doctor told me that my cornea thickness is 460 in right and 470 in left eye also i am attaching pictures of my reports
i had lasik laser in 2003 and my number came back in 2009 and since then i am wearing contact lens and spectacles but i cannot see very clearly with my right eye even with specks or contacts rather is i press my eye from below my vision gets very clear..!!!
should i opt for hard lens as told by my doctor or they can damage my cornea further?
i m just 34 and want to know will i be able to see when i get old i mean will this cornea getting cone shaped and getting thin continue or stop?
what treatment should i take according to my reports?
also is my left eye affected as i can see very clearly from my left eye?

the first image is of right eye and second image is of left eye

Answered by Dr. N K Mishra (10 hours later)

Brief Answer:
If progressive then try to stabilized with corneal cross linkage and gas permeable lenses.

Detailed Answer:
Dear XXXXXXX

Thanks for sending your query to us. I have gone through the reports.

In such cases, we go ahead with periodic corneal topography to assess if the defects are progressive or stabilized. I did not see the date mentioned of topography report but would expect it to be recent.

If the defect is progressive then we try to get it stabilized with corneal cross linkage and use Gas permeable lenses.

If this does not work then we have the option of keratoplasty as a last resort.

Do get back to me in case of any further query in this regard.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. N K Mishra (20 minutes later)

my first question is

!) is my left eye also affected ? as the report says0.00 % keratoconus pattern not detected and 16.1 % severty keratoconus suspect interpreted also i can see perfectly from my left eye

2) this report is very recent but does ectasia problem alsways progress or sometimes it becomes stabilized?

3) if i wear gas permeable lenses will it help stop the progression ?

Answered by Dr. N K Mishra (39 minutes later)

Brief Answer:
RGP lenses always help

Detailed Answer:
My Dear,

Thanks for getting back to us.

since you have problem in only right eye with 16% keratoconus left eye is ok for now.
2) ectasia can always progress or may stabilize at some stage, , that's the reason for keeping a watch over this and having regular follow up.

RGP lenses always help and at some stage cross linkage is to be considered.

Please do get back to me in case of any further query in this regard.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. N K Mishra (18 minutes later)

thanks doctor,

i am going for my rgp lens trial today and hope for the best

secondly if i get cross linkage or c3r what are the chances of procedure going bad
i mean is there a chance that if i get c3r and it goes wrong i loose the vision of my eye?
or in other words what is the worst side effect of c3r procedure?

Answered by Dr. N K Mishra (27 minutes later)

Brief Answer:
lasik

Detailed Answer:
My Dear,
Thanks for getting back to us.
RPG lens is always a good primary option.
Cross linkage is a safe procedure and may lead to a temporary oedema leading to hazy vision for a while.
Anyfurther query in this regard, please do get back to us.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. N K Mishra (4 hours later)

since cross linkage can lead to hazy vision , how much time the vision remains hazy ?
can cross linkage go wrong sometimes?

Answered by Dr. N K Mishra (2 hours later)

Brief Answer:
lasik

Detailed Answer:
My dear,
Thanks for getting back to us.
Haziness after cross linkage may occur in a small number of cases and this may remain there for a short period of time. This usually does not last for long.
We have to give you these facts to alley your fears and since this may occur, you have to know this before you contemplate this step.
Any further query in this regard you are welcome.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. N K Mishra (18 days later)

Hello again,

i got my eyes tested again and i can see very clearly from my both eyes but my right eye number is −0.75 spherical and −5.5 cylendrical which i think is v high.
also i got my topography done again after 2 weeks of last topography as i did not wear contact lens for 2 weeks.
my corneal thickness has gone down by 10 to 20 microns in both eyes otherwise the results are better.
Could this difference in thickness be because of two different scans and results always vary or my cornea is thinning at very high rate ?
should i get the topography done after two weeks again?
also i think i have anxiety about ectasia now....:(

Answered by Dr. N K Mishra (4 hours later)

Brief Answer:
lasik

Detailed Answer:
My Dear,
Thanks for getting back to us.
This assessement of corneal thickness may also be due to mechanical difference still iit will be advisable to keep track of corneal thickness.A pachymetery can be repeated after at least six weeks.In the meanwhile you should use RPG lenses.
Do get back to me in case of further query in this regard.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. N K Mishra (5 hours later)

Can I use glasses instead of rpg lens ?

Or a soft contact lens ?

Answered by Dr. N K Mishra (21 hours later)

Brief Answer:
lasik

Detailed Answer:
Dear XXXXXXX
welcome back.
Using glasses or soft contact lenses helps you to see and nothing further is gained.
While using RPG lenses is reported to help in cotolling the progression of problem.
Do get back to me in case of any further query in this regard.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju