Comments on: Daily Mail Laser Eye Surgery Article, 30-11-10. The truth?

By: RS

RS — Wed, 24 Aug 2011 21:06:33 +0000

p.s. i am 34 years old (female) and my eyesight was -5 in both eyes prior to surgery. my refractions are still 0′s in both eyes as of todays examination (9 weeks later).

By: RS

RS — Wed, 24 Aug 2011 21:04:33 +0000

Hello again Dave,
So I saw my surgeon today, a few technical details about my surgery (which i hadn’t asked for before): flap diameter was 9.5mm, flap thickness 100 microns. the laser used was a wavelight eye Q, with wavefront guidance.

now about the floater(s) he did extensive examinations and assured me my retina is safe and intact, there is some separation of vitreous from retina, which he says is normal for all myopes as well as comes with age. he did however see the one floater that i am complaining about in my left eye, and assures me that it will liquify and gravitate towards the bottom in time. does this sound right?

you say that PVDs are presumed to occur at time of lasik or soon after, i think its too much of a coincidence for it not to be related. could it be that it was smaller at first and got bigger? could it be that this is a process that elapses over time and that it will get even bigger or that I will even get more of them?

(freaking out a little bit)
thanks for all your responses,
rs

By: Dave Allamby

Dave Allamby — Tue, 23 Aug 2011 13:21:26 +0000

Hi RS, Its an interesting area. The clinical research on LASIK and vitreous changes shows that some movement of the vitreous, with posterior separation from the retina, is not uncommon. Posterior vitreous detachment (PVD) is correlated quite well with degree of short sight. The higher the myopia, the more likely to get a PVD, either partial of full.
In an Argetinian study clinically, 8% (4 eyes) had positive perception of postoperative vitreous floaters in their low myopia group (up to -4.00D), and 32% (16 eyes) in the high myopia group (more than -7 dioptres).
Using ultrasound to assess occurrence of PVD after LASIK, measured at 1 week postop, it was found in between 4% and 10% for lower degrees of myopia, and up to 20-30% for high myopia. So a significant number of patients are having vitreous detachment associated with the suction applied during flap creation. However, there is no statistically increased occurrence of retinal detachment associated with this vitreous movement in two large studies on the topic.
These PVDs are presumed to occur at the time of LASIK or very soon after. I can find no studies tracking occurrence of PVD in the following weeks, nor any data on size of floaters post LASIK, so I think you can disregard that aspect.
Regards, Dave

By: RS

RS — Mon, 22 Aug 2011 17:23:50 +0000

Dear Dave,
I saw a retina specialist today who confirmed that in fact, floaters caused by LASIK can appear weeks after the procedure. he did a dilated examination and saw the floater. said that there’s a chance it will settle down, and a chance that it won’t. i read elsewhere, though, that the floaters caused by LASIK are too miniscule to drop down or move from their place. i’ve also read the reports of many disgruntled LASIK patients who got their floaters weeks later and who kept getting more of them- so now I am doubly worried about getting more. i can maybe learn to deal with the one i’ve got now, but the prospect of getting more of them is very frightening.

regarding my night vision: i had no problems pre op with my contact lenses, whatsoever. my night vision right now is a whole new world to me. i’m not sure which laser my surgeon used, but i will find out. although SO many people i know had their procedures done with him and none of them have complained from any of my side-effects. he’s revered as the best surgeon in town.

please shed some light if possible.

thanks,
RS

By: Dave Allamby

Dave Allamby — Mon, 22 Aug 2011 06:48:36 +0000

RS thanks for your kind words. Everyone experiences floaters to some degree, and they are more common in shortsighted people, who go on to have LASIK, so sometimes hard to tease out cause and effects. But a floater occurring weeks later may or may not connected to the LASIK itself. for the starbursts etc most patients at six months say they are happy with their night vision, so please hang in there and it should improve. most people find the symptoms end up the same as they had preop, so if you had night vision probs pre you will likely also have them lost LASIK. May also depend on which laser you were treated on. Best, Dave

By: rs

rs — Sun, 21 Aug 2011 22:00:40 +0000

first of all thank you for keeping this up to date informative blog. it’s very easy to become disheartened by all the information online, whether it is credible or not.

I had wavefront LASIK two months ago, and presented with a dlk inflammation the following day. it was treated promptly and my vision was retained at 20/15. I am still experiencing starburts and halos and like others am sometimes doubtful that they will ever subside but try to remain hopeful.

my question is about floaters though, I started to notice a very annoying floater only in the last two weeks or so, not before. is it possible that the floaters would show up months after the procedure? (if caused by the pressure of the flap making step)?

thanks,
rs

By: Dave Allamby

Dave Allamby — Sun, 21 Aug 2011 15:25:38 +0000

Hi Granny M. Floaters after LASIK is, in our experience, an uncommon event. I might hear that only once or twice a year. Plus these patients do seem to get used to them. However, appearance of floaters is common in the general population, and even more so in those who have short-sight, so it is hard to say definitively that it was the LASIK that caused it. But we do know that the flap creation process will cause pulling on the gel within the eye, so it is possible and conceivable that LASIK is the trigger in some cases. They get less prominent, either because the brain gets better at ignoring them, or that the gel moves downwards, taking the floaters with it. Or a combination of both factors.
I expect your symptoms will improve over time, and I hope it becomes less of an issue for you.
Regards, Dave

By: Granny M

Granny M — Sun, 21 Aug 2011 15:03:30 +0000

Thanks Dave.

I am somewhat disappointed that this was not listed as possible side effect from the US clinic.

When you say that floaters become less noticeable, do you mean that they are permanent but over time once the eyes get used to them, then they become less noticeable?

In your experience, how often do you see patients having floaters after Z-Lasik and what are the chances that they become less noticeable with time?

Sorry lots of questions.

Thanks,
Granny

By: Dave Allamby

Dave Allamby — Thu, 18 Aug 2011 13:06:45 +0000

hi
It is possible for LASIK to cause floaters, as the pressure applied during flap creation can cause movement of the gel inside the eye. Also, sometimes the floaters were there previously and the patient notices them or becomes more aware of them after treatment. Floaters often become less noticeable with time, so I would suggest waiting and see how things change over the next 3-6 months.
Regards, Dave

By: Granny M

Granny M — Tue, 16 Aug 2011 23:33:28 +0000

I recently had Z Lasik in the US about 2 weeks ago and realised thereafter that there are floaters in my treated eyes.

Would lasik result in floaters and will they ever go away?

They are really annoying and I never had them before surgery. Please advise.