An unproper laser treatment? Need for help

[xiushan]

I am very confused with my retina health. Wish to get some real professional advice from a credited source.

Two months ago, I was scheduled with an examination before ICL surgery, The doctor appointed to conduct my ICL surgery told me that there was a degeneration in my eyes and advised me to take a prophylactic laser treatment to prevent further development that may lead to retina tears or detachment. She told me there is no cons but only pros to take the laser treatment. I was not even informed what type of my degeneration is that time. I conducted the laser treatment that day because I thought it's better to follow doctor's advice. One week later, I experienced a failed ICL surgery because the ICL they chose for me is not well suited. The ICL vault is too high. So they conducted a ICL takeout surgery two days later.

From that day on, I began to focus on my eyes health and learned a lot of knowledge about what I have taken, especially the laser treatment (photocoagulation). According to several info sources and another eye doctor, it seemed that my degenerations seem to be White wWthout Pressure type. It is a very benign type and there is no need to take the laser treatment at all. I was very upset and questioned the doctor who advised me to take the laser treatment, She didn't respond to my questions directly but she also admitted there was no urgency to conduct the laser treatment that day. She once told me my degeneration type is Frost-Like degeneration which I cannot find any related information on other sources.

If the type is WWOP, does that mean I have experienced an unproper treatment? Will the treatment increase the risk of my retina health in the long term? Or, whether the treatment could really help to lower the risk of retina tears or detachement?  Left eye: -13.0D. Right eye: -9.0D. Both eyes with +2 Astigmatism.

Thank you sincerely.

[John C Hagan III, MD, FACS, FAAO]

WWOP is a normal variant and does not require treatment.  Likely you were having ICL because you are highl myopic. The 'frost like' degeneration is almost assuredly LATTICE DEGENERATION.  Read about it. It is found in about 4-6% of non-high myopic eyes (I have lattice D in both eyes) and a higher % in highly myopic (refractive error greater than -6 diopters)  There are not set rules for treating lattice. It depends or how much, where in the retina it is, wether there are holes or tractions. Do I would not distrust the surgeon.  I am not a big fan of ICL and generally do not recommend it if they ask my opinion.  Surface refractive surgery often better choice.

[xiushan]

Thanks a lot, Doctor Hagan.

From the OCT picture, I cannot see anything like lattice degeneration, only a wide "green" and "cloudy" area surrounding my peripheral retina, which looks like WWOP pictures I found on some websites. I don't know how to show these pictures to you in the forum. I don't know the exact type of degeneration yet. The surgeon who conducted the laser treatment didn't deny my question about WWOP either.

I am in deep concern with the effect of laser treatment on my retina. Will the laser treatment improve or harm my retina health? Since I have taken out the ICL, how much damage I will receive from the surgery?

[John C Hagan III, MD, FACS, FAAO]

the OCT will never show lattice.  Might show up on a wide angle dilate retina exam. I cannot quantify risks, only the eye MD ophthalmologist that has examined the eye can do that.

[xiushan]

I assume since the laser has changed the treated area, maybe I couldn’t never know whether it is a proper treatment. Is this a right assumption?

I also found the average RNFL thickness is low in my two eyes. I reads OD100/OS90(94/89 after the laser and ICL surgery), S reads OD101/OS110(103/115), T reads OD66/OS65(68/84), N reads OD51/OS51(50/62).
I learned a low RNFL thickness may be a warning of glaucoma. The eye pressure is normal 15/16 and the visor field index is 100/97. I don’t know the low RNFL thickness is caused by high myopia or anything else?

[John C Hagan III, MD, FACS, FAAO]

I am not in a position to interpret your test,  not allowed by the website.     As for the laser, remember when to treat lattice depends on many things,  and one retina surgeon might recommend treatment and another equally competent may recommend 'wait and watch'

[xiushan]

Thank you Doctor. What's the long term effect of this laser treatment would put on my retina despite whether the degeneration is lattice or WWOP, since I have taken the treatment.

[John C Hagan III, MD, FACS, FAAO]

The laser itself is not a problem,  developing more lattice or existing lattice developing holes is the highest risk. Your ophthalmologist, based on examing your eye, can give you a better prognosis

[xiushan]

Good day, Doctor. I double-checked with another ophthalmologist today. He confirmed that the degeneration is WWOP through dilated exam. So, it seems that I had an overused treatment? It really depresses me. I don’t know why the ophthalmologist who conducted the surgery would do this to me. It really puts my health on a big risk.

[John C Hagan III, MD, FACS, FAAO]

You need to discuss that with the treating ophthalmologist. I can't answer

[xiushan]

Got it. Even after the laser treatment, given that my retina and eye are healthy right now, can we say that the risk is low that I may encounter other retina or eye problemss in the future? Or the risk will be elevated by this maltreament? Really appreciate your help.

[John C Hagan III, MD, FACS, FAAO]

I have gone as far as I can go with this discussion

[Emily_MHManager]

Dr. Hagan has thoughtfully answered all of your questions, and has advised that you need to speak to your treating ophthalmologist to address any future risks.

** Thread closed. **