Lasik over RK with haze and dryness

The images below are of the same eye. In the 1980’s this eye underwent 3 separate Radial Keratotomy (RK) procedures followed by 2 separate LASIK procedures about 25 years later. The photo below was taken through a bio-microscope (slit lamp). Notice the dull grey spike like figures going from the corneal periphery towards the center. These are the open, scarred RK incisions. Again, look carefully and you will see a dull, grey “smile-like” image in the lower portion of this photo. This is “epithelial ingrowth”. This is due to the cells on the surface of the cornea (epithelial cells) getting under the LASIK flap where they do not belong. It is quite possible for these cells to proliferate years later below the LASIK flap leading to vision loss. The 2nd image was taken with a technology known at “Optical Coherence Tomography” or “OCT”. This is a cross section of the cornea with a scleral lens over it. The top 2 curved lines represent the front and back surfaces of the scleral lens. The thick grey curved structure is the cornea. Look carefully and you can see a curved white haze in the center of the cornea toward the right side of the image. This is another view of the epithelial ingrowth. This patient will have to be seen at regular intervals to make sure that the cornea remains stable. This cornea is extremely irregular and has a very dry ocular surface. The scleral lens is the only technology that will allow this patient to see clearly and comfortably with this eye.