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Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
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Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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how can a topography determine if you have decentered ablation

Resolved Question:

how can a topography determine if you have decentered ablation following lasik?
can a doctor run a topography of the cornea and determine it just based off it or would they need other information, like pre-lasik?
Submitted: 2 years ago.
Category: Eye
Expert:  Dr. Dan B. replied 2 years ago.

Doctor DanB :

Hello and thanks for your question. Are you available to chat?

Doctor DanB :

Unfortunately an analysis of the post-operative topography alone cannot accurately determine if the ablation was on axis. This does require pre-operative measurements done before the LASIK to determine how accurate the ablation was.

Doctor DanB :

 


Does this information help address your concerns? Does this make sense? Do you have any other concerns that I haven't addressed?


 


I see that you are offline right now. I am happy to be able to help you today. I will also be happy to answer any other questions until you have the information you need. If you would like to ask further questions or clarification regarding anything I've said, please let me know and I will be happy to address your concerns as I see them on my screen.


 


If not, Please help me get credit for my efforts in answering your questions and press the ACCEPT button for this encounter; this allows part of the funds that you have deposited to the website to be released for my efforts to assist you. This does not end our conversation, however-we can continue to discuss any of your concerns without further charges until you are satisfied.


 


Any positive feedback and/or bonus you may feel prompted to provide would be welcomed and is appreciated. Thanks for your inquiry!


 


My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor.

Customer: replied 2 years ago.
yup, im available.
Expert:  Dr. Dan B. replied 2 years ago.
Do you have any questions about what I've written?
Customer: replied 2 years ago.
what are the symptoms of having it off centered?
would there be more issues then just ghosting.
Expert:  Dr. Dan B. replied 2 years ago.
Ghosting can certainly be a symptom, although just a residual refractive error (need for glasses) is the most likely result.
Customer: replied 2 years ago.
the thing is on my last exam last week, they could not correct the ghosting with glasses.
Expert:  Dr. Dan B. replied 2 years ago.
Unfortunately there are some refractive errors, namely higher order aberrations that cannot be corrected with glasses (or in other words glasses may not provide the degree of correction needed to counteract higher order aberrations that are likely causing ghosting). In this case, sometimes an enhancement procedure is needed.
Customer: replied 2 years ago.
so an enhancement can correct higher order aberrations? can the healing process help with these higher order aberrations since i am just 6 weeks out. what scans can detect higher order aberrations?
Expert:  Dr. Dan B. replied 2 years ago.
You are right on both accounts. By seeing the healing process out, some of this ghosting tends to resolve itself. However, if it doesn't then, yes, enhancements can be helpful in getting rid of these. The wavefront scans can detect these higher order aberrations.
Customer: replied 2 years ago.
I am just glad i see pretty good at close ranges to use the computer, it is the distance that i see the ghosting. This ghosting seems like a smeer type of ghosting. it seems to always connect to the main image and smeers up. and i actually can see like the ghosting image is bouncing up and down. This tells me it may be swelling or something. what do you think? would a permanent high order aberration, have the ghosting without movement or bouncing?
Expert:  Dr. Dan B. replied 2 years ago.
I think the ghosting that moves or bounces can be related to either swelling or to higher order aberrations because the movement can be directly related to the tear film. What you may consider doing if you haven't done so already, is to hydrate the eye very well using preservative free artificial tears several (at least 4, better more) times per day for several weeks (3-4 weeks). This can help augment the tear film which can often times (and may very well be likely to) be disrupted because of the surgery. This may be all that needs to be done (perhaps).
Customer: replied 2 years ago.
ok, one more question, i am getting a 2nd opinion from another doctor. what tests can be done to see these high order aberrations. I believe the regular topologies just scan for low order ones? is that correct?
Expert:  Dr. Dan B. replied 2 years ago.
Yes, you are correct. A wavefront scan is a test that can be fine to identify these higher order aberrations. If your 2nd opinion is coming from someone who doesn't do LASIK, then they will be unlikely to provide this test for you.

I hope that helps. Please help me get credit for my efforts in answering your questions and press the ACCEPT button for this encounter; this allows part of the funds that you have deposited to the website to be released for my efforts to assist you. This does not end our conversation, however-we can continue to discuss any of your concerns without further charges until you are satisfied.
 
Any positive feedback and/or bonus you may feel prompted to provide would be welcomed and is appreciated. Thanks for your inquiry!
 
My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3150
Experience: Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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