RE post operation thread + updates + auto refractometer
Posted , 11 users are following.
1- Cornea related stuff
So last time after the LE (near IOL eye) was done my wife ended up with corneal erosion in the line of sight = very blurry vision.
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On the post OP day the normal steroid drops were stopped for 2-3 days and repair lubricating gels were given. After 3 days Dexa free steroid drops were then started. Wife had fully blurry vision for 6 days and then the cornea healed and she finally had super sharp near vision in the LE!
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Now for the RE, the surgeon used the strategy of using loads of vitamin A gel after he closed the wound and disinfected it properly. No steroid drops for the 1st day. Today was post OP check and he found 2-3 small dry dots on the cornea even though the eye was swimming in lubricant Vitamin A gel. No full erosion/patches on the cornea like last time but still enough to cause some blurriness.
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Now he is 99.99% sure as to what was happening as my wife never had dry eye issues coming into both operations.
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My wife's cornea seems to react to Betadine (the iodine containing disinfectant used for eye surgeries etc, there are no alternatives to it and it HAS to be used during surgery).
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The last time when LE was operated, Betadine must have caused some damage to the cornea. Then when the strong steroid drops were used on top, the damage was made lot worse and resulted in my wife suffering severe burning pain and longer blurry vision. So if wife had taken steroid drops like last time, the RE would again have had more pronounced corneal erosion like the LE.
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Doc has told us to take Vitamin A gel on it's own for one more day (nothing else) and then start with Dexa free Steroid drops from tomorrow. He wants the cornea to heal bit more. We have to go back on Tuesday for follow up check with one of his assistant like last time, just to be safe (he is away operating). He is sure that she will see super sharp like the left eye.
2- Current "visual quality" status of RE (far eye)-
Yesterday wife was seeing blurry post OP (normal). This morning she started seeing 90% sharp. It is improving all the time. The 2-3 dry spots on the cornea + only one day since OP + very thick layer of Vitamin A gel= 10% blurriness in the RE (last time at same post 1 day, LE was 90% blurry).
We had 1 hour walk on the way back from the surgeon today, aim was to provide more visual data to the brain so that it could kick start the software upgrade process.
Wife started crying during the walk because she was able to see everything so much brighter, clearer and colourful. With RE only she can see my eyes from 40cm away. Car number plates she could read very well 30m away. Company signs 40-70meter away. She could recognize people from far away which she has not been able to do for last 4 months.
Hope all goes well and she gets to 100% sharpness.
3- Eye measurement conundrum (RE and LE)
LE was targeted for -1.25 and RE for -0.25
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RE readings 1 day post OP are meaningless but auto refractometer says...
1 day later= +0.25
Now the confusing part! LE was operated 4 weeks ago.
3 day later = -2.75
7 days later = -1.50
4 weeks later = -2.00 wtf ???????
We checked the measurement printouts when we left the clinic, on seeing -2.00 we went back and luckily the surgeon was outside to collect the next patient, so we quickly grabbed him and asked him about it. He said don't worry as auto refractometer are not accurate specially post OP.
**Note- ** The sharpest focus point for LE has not changed since day 7. We have measured it 2-3 times daily. It has stayed exactly same since day 7 at average distance of 45-47cm. If anything it has moved away couple of cms and not closer. On day 3 it was around 30cm.
Both eyes are working together well already for my wife. So I am not sure if there is really a difference of 2.25 diopters between both eyes!
How will we get absolute accurate measurements in the future? Via Keratometer?
Conclusion
We are cautiously optimistic and happy. Wife sees super sharp near and far vision is improving 10 times faster than LE was. Combined vision is very good too!
STAY TUNED!!!! Free Cataract roller coaster ride!!!!!
3 likes, 63 replies
soks W-H
Posted
congrats on being done! i have some worrying information for you about steroid drops or lack of their use which i will save for later. ☠
W-H soks
Posted
We ARE taking the steroid drops! 3 doses already taken for today. It was started 2 days later as per Dr Zeiss's instructions.
soks W-H
Posted
thats the right thing to do. your doctor is the most qualified to recommend action.
beryl68139 soks
Posted
Hi soks please let me know about worrying information re steroid drops.I am down for me operation 22nd November and I think the drops may have caused the scar tissue that is very thick and I can't see out of my left eye. Am worried it may grow again. I was kept on the drops about 8 months and also on prednisolone for PMR.
W-H beryl68139
Posted
Hi Beryl,
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I think Soks meant because we were NOT using steroid drops for the first 2 days after operation. He has managed to scare quiet a few people because of his post 😃
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You can get infection etc if you don't use steroid drops.
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Our surgeon told us to postpone start of steroid drops by 2 days so that cornea could heal as it had reacted badly to the disinfectant that is used during ALL surgeries.
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Using normal steroid drops on it would have made it worse.
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Our surgeon does not like using the Dexa free version of steroid drops on freshly operated eyes. Hence the 2 day delay. Plus because he checked one day after OP that there was no sign of infection.
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What is your basis for thinking that your scar was caused by steroid drops? Each and every person has used steroid drops post surgery here.
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In general I would say a surgeon's knowledge trumps our forum knowledge (there are exception though as some surgeons are bad).
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Was your scar tissue not capsule related? I thought it was due to the capsule opening closing due to fibres reconnecting and closing the front opening? If yes then it has nothing to do with your steroid drops. Correct me if I remember wrong.
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Or was your scar on the cornea? Cornea = outermost part of your eye. The part that you can physically touch (please don't touch though).
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Capsule you can't touch as it is inside the eye.
W-H
Posted
Yeah using steroid drops for 8 months is not ideal but maybe the surgeon had no other alternative.
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Not using it could have potentially caused even more serious issues.
beryl68139 W-H
Posted
Please see my other thread. Scar tissue operation or YAG. for reply. Beryl
ara21947 W-H
Posted
My drops are nonsteroidal . Do you mean that or do you -( ie your wife who never writes )mean you got actual steroids?
Sue.An ara21947
Posted
Ara I was prescribed Prednisolone drops. Yes has steriods - helps with inflammation
W-H ara21947
Posted
My wife's drops DO have steroids in them. She started taking them just 2 days later than she did with the first eye, on surgeon's advice as her cornea was not happy with the disinfectant that is used during ALL kind of surgeries.
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So surgeon wanted cornea to heal a bit before subjecting it to more abuse via multiple types of steroid drops and gels.
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For the second eye she is taking 2 main drops, Dexafree steroid and Yellox. Rest are just lubrication and repair related.
W-H
Posted
4 days post OP
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Ok so we had another post OP checkup on both eyes. The 2-3 spots on the cornea are fully healed along with the surgery related cuts. Both IOLs are sitting very well.
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Latest Autoreftractor readings-
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(1 month post OP) LE -1.75 ( changed from previous -2.00) Original target was -1.25
I think this IOL has not changed much since day 7, the autorefractor probably just gives different readings each time we visit.
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(4 days post OP)RE-0.25 (changed from previous +.25) Original target -.25
Early days.
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Eye pressure around 12 in both eyes.
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Both eyes are working well together. For near eye final reading of anything between -1.25 and -2.0 will make us happy. As long as the difference does not get larger than 2 diopter.
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Far eye anything from plano to -.5 we will gladly take.
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Now we go back in a month for final accurate measurements. Might go in between to normal glasses shop to get autorefractor readings just out of curiosity.
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The female doc said that autorefractors are not super accurate but not completely inaccurate either. They are like when you visit a shoe shop and tell the shopkeeper your shoe size. He still gets you few larger and smaller sizes to try to find the best fit. Autorefractor is bit like that lol
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So today was an excellent day.
Guest W-H
Posted
Perfect result! 😃
Try to forget those measurements now, no matter if it ends up 0.25 one way or the other, you would never mess with a good result like that.
Take your wife out to dinner and celebrate the good outcome, instead of taking her to the glasses shop for autorefractor readings 😃
Sue.An W-H
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This a good outcome !!! Time to stop worrying and start living life to the fullest again. Celebration time. Congrats to your wife. Long process is finally over with.
W-H Sue.An
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Is it normal for sharpnesss to fluctuate? The near eye after 1 month is sharp all the time.
The far eye is on the 5th day and today is less sharp. I guess it is part of healing and patience is required?
Guest W-H
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Yes, it is very normal, my vision fluctuated for at least one month.
Sue.An W-H
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Yes totally normal. TBH it fluctuates all the time: morning vs evening / sunny day vs cloudy / type of lighting / good night's sleep vs not.
I take a flaxseed capsule every day - find it helps or Omega 3 capsule.
W-H Sue.An
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Yeah we take actual flaxseeds with food and smoothies. We also have omega 3 capsules BUT for last few months we have been slacking. Will restart again. Is that for dry eyes or eye health in general?
Sue.An W-H
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Both. Some say evidence isn't conclusive but I slacked off over the summer and didn't replenish my supplements. Went last week to buy the flaxseed and find it does help. Particularly in evenings when eyes more tired.
As there ate other benefits to these doesn't hurt to take them.
soks W-H
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does rapid blinking help with the sharpness? if yes, then dry eyes.
W-H soks
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Sharpens temporarily she said, I am talking milliseconds. Actually while doing it, it sharpens,
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With left eye it was similar during the early days but it had cleared up by day 6-7. And today is day 6 for right eye and right eye...hmmm.