Hyperopic shift post blepheroplasty

[timotea]

I had RK surgery to correct myopia 12 years ago and had 20/20 vision with +1.75D hyperopia in the morning which corrected within 2 hrs. In Jan 2013 I had double bleph since when my vision has deteriorated by a further +1D and does not correct during the day. I am 4 months post bleph and Professor of Opthalmology at Moorfields thinks that this will resolve spontaneously when all scars mature at around 9 months, saw another consultant who thought it was permanent and I should get contacts, and another Consultant who recommended IOL's.
Is is possible that eyelid repositioning could cause this trauma to my corneas and is there any chance that I will regain my perfect vision that I had before?

[Timothy D McGarity, M.D.]

Trauma? You needed the double bleph, so how is this now trauma? If the eyelids are now tight (appropriately) from a blepharoplasty, then their may be some natural flattening of the RK incisions. This would cause a subsequent hyperopic shift. Anytime there is a change like this in an eye which has had RK surgery, then you need to wait at least 6 mos for stabilization. Obviously you are approaching the 6 month time frame, but I would wait even longer 7 or 9 months for further stabilization. If no improvement occurs, then a contact lens would be the most appropriate first option, followed by an IOL (possibly with a touch up lasik/prk). Do not use a multifocal IOL in your eyes.
Sincerely,
Timothy D. McGarity, M.D.

[timotea]

A related discussion, My RK Eyes was started.

[timotea]

Thank you for your very helpful post. Have you every seen this syndrome with RK Patients after Bleph before as none of the occuloplastic surgeons I have consulted have every experienced this nor have the two opthalmologists and refractive opthalmology specialist? Two said they were going to look through research papers to see if they could locate anything and were intrigued by my condition. Is there anything I can do to stabilise the corneas? I am worried about contacts because I gather there is a high incidence of infection in post RK patients (acanthamoeba)  and not sure I will be tolerant as I found them difficult to wear 12 years ago as my eyes were a bit dry.
Nice to have cross atlantic access by the way, especially to top specialist in the USA.