Loss of Contrast

I've noticed that since I've had intralase lasik things look strange when the lighting is dim, but when I go outside in daylight things return to normal. I had it July 2, 2010 so I'm sure I've lost some contrast. I've heard that it returns to pre operative levels withing 6 months. I've read where anybody that has refractive surgery loses it but then it returns. Just wondering how true this is. I've also notice it does the same in the evening when the sun goes down. I'm hopeing it will go away.

Doctor Answers 4

Loss of contrast

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Loss of contrast sensitivity often means that you have a small amount of residual refractive error that was not fully corrected.  If that error is sufficient and bothers you, your surgeon may be able to correct it with further laser or with glasses or contact lenses if you prefer.  Refractive error that is very small or that does not bother the patient may be best to leave alone. Your surgeon can determine if this is the case with a good cycloplegic refraction.  Haze can also cause loss of contrast sensitivity and can be treated. Please see your doctor as soon as possible to make sure the cause is genuinely related to your laser surgery and not some undiagnosed eye disease.

San Diego Ophthalmologist

Loss of contrast with Intralase LASIK

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The Intralase works by making thousands of tiny explosions close to each other so that a plane of a flap is made. In inexperienced hands, it is certainly a safer way to make a flap, but it has a number of complications not seen with a microkeratome. Loss of contrast in most situations will improve with time as will most Intralase flap problems. The issue commonly has to do with the amount of laser energy used in the making of the flap. The frequent use of tear drops helps the surface of the cornea and your surgeon may put you on steroid drops if the cause is inflammation. Other causes may be from flattening of the cornea or uncorrected residual refractive error. You should discuss this with your surgeon.

Mark Golden, MD
Chicago Ophthalmologist

Most intralast LASIK patients continue to improve

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Indeed hopefully you will continue to improve like most Intralase LASIK patients.  I agree that most patients notice the improvement within 3-6 months for a variety of reasons like neuro-adaptation (the brain readjusting), first healing, and the resolution of post-operative dry eyes.  Using artificial tears, Restasis, and/or punctual plugs to improve the film often speed the recovery.  Speak to your surgeon.

Christopher Coad, MD
New York Ophthalmologist

It depends

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Sometimes this type of complaint after refractive surgery is temporary.  But sometimes there are permanent issues due to corneal scarring, reduction in the tear film, residual or recurrent refractive error (need for glasses), or issues related to loss of focusing power (accommodation) in individuals around age 40 and above.

Talk to your surgeon -- s/he wants you to be satisfied.

Benjamin Ticho, MD
Chicago Ophthalmologist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.