Blurry Vision after Epi-Lasek

Question

I had Epi-Lasek about 10 weeks ago. The doctor says I have roughly 20/20 vision in both eyes. However long distance viewing is blurry and not crisp/sharp. I have a .50 prescription left in the left eye. When I put the artifical tears I get 1 second of sharpness, but I don't believe I have dry eyes. I got two other opioions and 1 doctor said I have dry eyes and trace haze (which the first doctor said the same thing) and the third doctor said my haze was a 1 (between 1 and 100) and that I have allergies and not dry eyes. Not sure what to make of all this - from all Ive read at this point 10 weeks in, I doubt my vision will improve. Im also taking strong steroids to relieve the haze but I see no improvement after 10 days. Thoughts?

Christopher Coad, MD · Answer

In my experience, visual recovery after Epi-LASEK (and PRK) takes longer than LASIK (flap) and 3-6 months is not uncommon. Unlike LASIK, where the epithelium is not removed, LASEK (or Epi-LASEK) and PRK require the corneal epithelium to be removed. This can contribute to longer healing, haze (scarring) and visual fluctuation. The fact that the vision improves, even momentarily, after instilling artificial tears is a good thing. Remember you may not “feel” dry, as the corneal nerves need to re innervate or sensitize the corneal tissue after laser vision surgery of all types. Dry eye treatments such as punctual plugs, Restasis eye drops, omega 3 (fish oil or flaxseed) supplements and other treatments such as IPL (Intense Pulse Light) may be beneficial. Also remember that dry eye and haze can vary from day to day and throughout the day and vary from minimal to marked. Patience and trust in your surgeon is important. Most likely you will do well. Hang in there.

Sandy Feldman, MD · Answer

Blurriness and fluctuating vision may occur after all laser vision correcting procedures. Healing and dryness may cause the symptoms you describe. The important consideration is to treat the dryness in a systematic way. I would seek the care of one doctor with whom you feel most comfortable and try to establish a schedule of visits that makes you feel more comfortable and allows a stepwise treatment of the dryness. Surface procedures do take longer to heal, and 10 weeks is still early. The results often improve slowly over time. One year after surgery the results are better than six month and six months are better than three months so patience is needed as well.

William Trattler, MD · Answer

Hi,

	      There are many options to further improve your vision before surgery, and typically the most important step is to treat dry eyes with more advanced treatment options, including Restasis, punctal plugs and occasionally lubricating gels at bed time.  You should discuss these options with your doctor - as improving dry eye (even if mild) can result in improved crispness of vision.

	      I hope this helps

	 

	William Trattler, MD

Blurry Vision after Epi-Lasek

Answers (3)