Doctors especially, and those that have experienced haze,

I had prk done about 7 weeks ago on my eyes with MMC tx due to thin corneas. My prescription was around -9 bilateral. Used contact lens bandage for approx 2-3 days, terribly painful/with dryness when removed for several days. Used steroids/methylcellulose drops since procedure. I developed some moderate haze unilaterally only that was visible grossly at about 14-17 days out, after what appeared to be a period of delayed re-epithealization in the right eye. I've been using topical prednisolone steroids with some gross regression in the haze, using ocuvite high dose antioxidants vitamins, and now it must be virtually illuminated to see, but I have not noticed significant visual improvements from 20/50 or so. Other eye is perfect 20/20. Is there a timetable for the typical resolution of haze that will resolve. I have read articles that practically all haze resolves, but it can take as long as five years. I hope and pray this will disappear. I also am having difficulty with dry eye only at night and am hoping this will resolve in time.. I would appreciate any comments from experts in the field experienced with this complication on prognosis and potential possibilities.

I'll tell you this, you're lucky you are 20/50 in only one eye (the other eye being an incredible 20/20!). From where you're coming from ie -9.00 OU this is a good result. Haze is very common for strong prescriptions. I would recommend you consider a soft silicone or a reverse geometry soft lens to hold you over in this eye and I would definitely recommend against enhancements. When you get to be over 40 you can then remove the contact and have a built in ability to see at all distances pretty well.

I'm now about 3 months postop remaining fairly stable with only slight improvement. I have had a collagen plug placed in the right eye recently. A small amount of haze remains grossly visible slightly offcenter such that I can pinhole my vision down to about 20/25 when I look around the hazy area. Strangely enough have developed vitreous floaters in this eye that I never had before that have been driving me nuts. I am still hoping for some resolution to the haze, and for the several floaters to "settle." I am still having issues related to night time dryness, aggressively treating with the collagen plug and dwelle/dakrina/nutratear but hope that this will resolve within the typical period. I am curious about the suggestions of a reverse geometry or silicone lens as being helpful. Refraction has not appeared to help to any significant extent.

JHC,

(I responded about the floaters following your similar post on another thread.)

Corneal surface irregularities can be corrected with rigid contact lenses. Whenever vision is reduced following refractive surgery, it is always a good idea to place a rigid lens on the eye to see how much your vision is improved. The fact that you pinhole down to 20/25 while glasses are ineffective suggests that a significant measure of your reduced acuity is due to the surgically-altered corneal surface. Whatever a rigid lens fails to correct can then be attributed to the stromal haze.

As Dr. Tirado mentioned, with a prescription as high as you had, a reverse geometry lens will be needed. An optometrist who does a lot of ortho-keratology (OK, also referred to as corneal refractive therapy, or CRT) should have trial lenses that are more likely to give a better indication of how much your vision can be improved. Even if you decide not to wear a rigid lens, it is important to differentiate the corneal surface issue from the stromal haze issue.

Thanks for the replies.. I will check into this. I know that the haze is offcenter with sort of a wedge (/) shape. I am able to see around it by pinholing the area, I can see clearly on each side of it. The haze is also very much thin and surface level as described by the resident physician. I can look down my nasal bridge with my right eye and a small area of my vision is excellent without any pinhole. Anyway, I just thought I would describe it a little bit more. I will ask about the RGP in the future.

I have excellent news to report and appreciate all the advice I have received. I went to see a contact lens fitting specialist today. I was able to read several of the letters on the 20/20 chart after the use of a trial RGP lens combined with a -2.5 refraction in the right eye. I was able to read 20/20 OU The doctor believes the majority of my problem is being caused by an irregular surface epithelium and is not being caused by stromal haze. Thanks very much for all your comments.

I am curious. Reading your exchanges with the doctors and now having to wear a rigid contact lens to achieve acceptable acuity in the one eye......were you wearing contact lenses prior to the refractive surgical procedure? You obviously have spent an additional outlay of money, suffered some considerable discomfort, now you have dryness issues and haze that may be permanent and we do not know what your post operative corneal thickness has become. You have a lot to hope for: resolution of haze, ability to wear a rigid contact lens with symptoms of dry eye and a cornea that could have been thinned significantly. Would you go through this again and was this experience worth the above mentioned issues and yet to be determined outcome when you likely could have been wearing a rigid contact lens with excellent resultant acuity in the first place?

Knowing what I know now, I would not have gone through with the procedure. I wore soft contact lenses comfortably, experiencing minor wear intolerance at times. I had known several prominent physicians and others to have the procedure done. It was an unfortunate experience for me to be talked into believing that complications were extremely rare and prk was best for my corneal thickness. I am greatful that my dominant eye has excellent vision, and I can wear an RGP in the other to achieve acceptable vision if I want, but its very uncomfortable. I hope that answers your question.

"I can wear an RGP in the other to achieve acceptable vision if I want, but its very uncomfortable."

In an earlier post, you mentioned needing a -2.5 refraction in the right eye over the trial RGP. What is your refraction WITHOUT an RGP tht the right eye and what is the power of your present RGP?