Lasik over RK Equals Disaster

The images below are of the left eye of the same patient. This eye underwent 2 separate RK surgeries over 30 years ago followed by 4 separate LASIK surgeries. As you might expect the results of these surgeries was nothing less than disastrous. The first photo (taken 4 years ago) shows the RK cuts with blood vessels growing along the inside track of the cuts. The white “hatchet-like image is epithelial ingrowth. 4 years ago I referred this patient to a world renown eye institution where corneal transplant surgery was recommended. This patient declined to accept this advice. The 2nd image was taken today. 12 months ago the corneal specialists at this institution diagnosed the crystalline appearance in this cornea as “Crystalline Keratopathy” (extremely rare complication) and was placed on fortified antibiotics for the last 12 months. The 2nd photo looks exactly like a photo that I took of this eye last year. The 3rd image was taken with a technology known as “optical coherence tomography”. This images shows a cross section of this cornea with a scleral lens over it. In this image you can see the crystalline deposits deep inside the cornea. Over the last year this patient visited 8 corneal specialists from around the U.S. Many of them blamed the scleral lens as the cause of her corneal condition. In addition, a variety of therapies and treatments were recommended to her. With the scleral lens the visual acuity in this eye is clear (20/30). In addition, the cornea is clear with the exception of the crystalline deposits and the patient has no comfort issues while wearing her scleral lens. Since this eye has been stable for the last 12 months I recommended that no action should be taken and that this patient return periodically for evaluations including ocular photography and imaging.