Complications After LASIK Surgery: A Patient's Journey

Complications and sequelae of myopia laser surgery..?

Hello, Doctor Hu.
I underwent LASIK surgery at a hospital in southern Taiwan on August 11.
During my follow-up appointment the next day, I informed the doctor that my vision appeared white (later I learned this is DLK).
He told me that taking medication and using eye drops would resolve the issue.
However, during my follow-up on August 16, it was discovered that I had corneal scarring, and I underwent a washout procedure.
I later consulted another clinic, and they assured me that my eyes would not worsen, but my uncorrected vision is now only 0.5.
There are severe folds in the membrane, and both eyes have 0.1 cm round white spots at the pupil location.
I am currently unable to see clearly at both near and far distances.
I am being treated with steroid eye ointment and 0.1% eye drops.
I would like to know why the surgeon did not wash my eyes immediately after the surgery, especially since I had intensive follow-ups for 14 consecutive days.
Also, will my vision recover? Thank you.

Qiao, 20~29 year old female. Ask Date: 2006/09/26

Dr. Hu Yusheng reply Ophthalmology

Dear Mr.
Chiao,
After your LASIK procedure, you experienced diffuse lamellar keratitis (DLK) on the fifth postoperative day, for which you underwent irrigation treatment.
DLK is a rare complication, and its management varies based on severity.
Milder cases can often be controlled with medication, while your need for irrigation treatment indicates a more severe situation.
Now that it has been over a month since your surgery, with proper cooperation and treatment from your physician, there is still a chance for improvement.
Wishing you good health and safety.
Thank you for your letter.
Sincerely,
Dr.
Hu Yu-Sheng
Ophthalmology

Reply Date: 2006/09/26

More Info

After undergoing LASIK surgery, it is not uncommon for patients to experience complications, and your journey highlights some of the potential issues that can arise. Let's break down your concerns and provide some insights based on medical knowledge.

Understanding DLK and Its Management
You mentioned experiencing a condition known as Diffuse Lamellar Keratitis (DLK), which is an inflammatory response that can occur after LASIK surgery. It is often characterized by a white, cloudy appearance in the cornea and can lead to vision problems if not addressed promptly. The fact that your surgeon suggested medication and eye drops indicates that they were attempting to manage the inflammation conservatively. However, the delay in performing a thorough examination or intervention, such as washing out the eye, can be concerning, especially given the persistence of your symptoms.

The Importance of Timely Intervention
In cases of DLK, timely intervention is crucial. If the condition is not treated promptly, it can lead to scarring of the cornea, which may explain the findings of corneal scarring during your follow-up visits. The presence of scarring can significantly impact visual acuity, as you have experienced with your current vision being reduced to 0.5. The fact that you had to seek a second opinion suggests that your initial care may not have met the standard expected in such situations.

Recovery and Prognosis
Regarding your question about whether your eyes will recover, it is essential to understand that recovery from LASIK can vary significantly from person to person. Factors such as the extent of the initial damage, the presence of scarring, and the effectiveness of ongoing treatment all play a role in determining the outcome. The use of steroid eye ointments and drops is a common treatment for inflammation and can help reduce scarring if used appropriately. However, the presence of significant folds in the cornea and white spots can indicate that the healing process may be complicated.

Future Steps and Considerations
1. Follow-Up Care: It is crucial to maintain regular follow-up appointments with your eye care provider. They can monitor your healing process and adjust your treatment plan as necessary.

2. Second Opinions: If you feel that your concerns are not being adequately addressed, seeking a second opinion from a corneal specialist or a different LASIK surgeon may provide you with additional insights and treatment options.

3. Understanding Risks: LASIK surgery, while generally safe and effective, does carry risks. It is essential to have a thorough discussion with your surgeon about potential complications before undergoing the procedure. Understanding these risks can help you make informed decisions about your eye health.

4. Long-Term Outlook: While some patients experience complete recovery after LASIK, others may have lasting effects from complications. It is essential to have realistic expectations and to understand that some visual disturbances may persist.

In conclusion, your experience underscores the importance of timely intervention and thorough follow-up care after LASIK surgery. While complications can arise, proactive management and open communication with your healthcare providers can help navigate these challenges. If you have ongoing concerns about your vision or the effectiveness of your treatment, do not hesitate to advocate for yourself and seek further evaluations. Your eye health is paramount, and you deserve comprehensive care.

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