Corneal topographies are regularly taken before and after refractive surgery. From the colors of these maps, the relative steepness and flatness of the cornea may be determined. Ideally, the central cornea would be a single color, indicating a smooth surface. In the RS victim, the surface of the cornea is not smooth, but instead irregular, with numerous penninsulas and islands of tissue. These refract light in complex and abnormal ways, accounting for much of the ghosting, halos, and other aberrations that refractive surgery victims report.
9-27-99 Taken just minutes before surgery. This was the only pre-op set taken, and it's evident that I had dry eyes and some irregular astigmatism (corneal warpage from contacts) prior to having LASIK, which was a contraindication to having surgery so soon after discontinuing use of RGPs.
10/5/99 On the 1st day post-op, I developed a blinding white haze in my right eye. My OD did not see it, and finally on the 8th day postop, I was finally diagnosed with DLK (which is an inflammation under the flap due to a contaminant being deposited there during surgery). Note that ablation appears to be decentered on my right eye. The black circles are my pupils.
10-08-99
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11-15-99
11-29-99 One day before the hyperopic enhancement for a shift to +6 from Grade 4 DLK.
1/19/00 Nearly two months after the hyperopic enhancement. Immediately after the 2nd surgery, I began seeing multiple images. The enhancement was done while I was still on Dexamethasone 4x daily, and did not have stable refraction yet, so now I'm back at -2.5.
11-02-00 A paracentral island of approximately five diopters in the right eye. I also have a ridge in the stromal bed because the Hansatome microkeratome (Bausch & Lomb) jammed in my right eye. My surgeon restarted it and went ahead and applied the laser rather than aborting the procedure like he should have. The laser was applied evenly to both of the planes created in my cornea and the ridge is within my pupil. I have 360 microns of total corneal thickness left which leaves me at risk of developing ectasia, which is a bulging forward of the cornea requiring a full corneal transplant.
1/17/02 I had PTK (Photo-Therapeutic Keratotomy) on the right eye in October, 2001. This topography shows the now regular bowtie astigmatism. During the procedure, which is a surface lasering to remove irregularities, Dr. Feinerman was able to see the large vertical wrinkle in my cornea as he lasered it off. By January 2002, my BCVA had improved to 20/20. I wanted to be able to switch to glasses when the contacts get to be too much at the end of the day, but with the difference in power between my two eyes, I am not able to tolerate glasses at all.
