Ask the guy who just had LASIK surgery

Miscellaneous and Personal Stuff I Must Share
1

Well, after thinking about it for years, I finally bit the bullet and had LASIK surgery yesterday. The LASIK surgery I had used all the latest technological bells and whistles - wavefront analysis, intralase for cutting the ‘flap’ with a laser.

So far, I can tell you how it went - my first appointment for an evaluation was two weeks ago. It took about four hours for tests. I went to the Gimbel Eye Center in Edmonton, and they have a phenomenal reputation for thoroughness and professionalism.

After finding out I was a good candidate, I booked an appointment. Luckily, there was a cancellation for yesterday, so I took it.

The day of surgery was no sweat. I showed up, filled out a disclaimer, took some ativan, and went into the surgical suite.

First up was the intralase to cut the LASIk flap. This was the most uncomfortable part of the whole procedure. First, they give you some freezing drops to numb the eye. Then, they put a little spring-loaded thingy in your eye to hold your lids open. Next is a little ring connected to a vacuum pump. They put the ring on your eye, and when the vacuum kicks in your vision greys out in that eye and you really can’t see anything. Then they wheel you under the Intralase, and it moves down and presses against your eye with a fair mount of pressure. Nothing intolerable, but you sure know something is pushing pretty good against the eye. Then you just wait for 60 seconds, and it’s done. You don’t feel any cutting or burning or anything.

After that, they remove the suction ring and the clip, put a patch over the eye, and repeat for the other one. I’d say the entire procedure for both eyes takes maybe 20 mnutes.

Then it’s off to the laser for shaping the eye. Again the wire spring goes in to hold your lide open. WHen they remove the patch it’s a bit disconcerting because you’re functionally blind. All you can see is shapes and light. I imagine a cataract is probably something like that. I remember thinking, “hoo boy, I hope I don’t wind up with vision like this…” Anyway, the surgeon then lifts back the flap that was cut by the intralase (you can’t really even tell what’s happening, and it’s not uncomfortable at all. Just a blurry motion in front of your eye. Then you’re asked to look at a red light (which is really just a red smear all over the front of your eye, and the laser starts doing its thing. You hear a ‘snapping’ sound as the laser works, and you can smell what smells like burned hair, but I guess is burned eye tissue. This whole process takes no more than 5 minutes or so. Then the surgeion rinses the eyes, smooths the flap down again, and re-patches the eye.

Repeat for the other eye, and you’re done. The nurse then taped what looks like a set of airtight goggles over my eyes, and told me not to take them off until I got home. The goggles protect the eyes from dust, keep you from inadvertently rubbing your eyes, and trap moisture so the eys don’t dry out.

All told, I was in the office for the day of surgery for about 2 hours, with about a half hour spent in the actual surgery suite. There was no pain to speak of at all. It was really a piece of cake.

Then I was given a prescription for four different kinds of eye drops, and sent on my way home. On the first day, you aren’t allowed to watch TV, read, or use a computer, and you’re supposed to just rest. Antibiotic drops every half hour, anti-inflammatory drops every other half hour, and wetting drops in between. For the first five days after surgery you have to sleep with the little goggles taped to your face.

As for vision quality, I started out with -6.25 diopters in each eye, which is about 20/400. By the end of yesterday, I’d guess I was seeing 20/40 or so, but it kind of looked like I was looking at everything through a fine gauze. This morning I went in for my followup, and I’m already 20/20 in both eyes, and it should get significantly better. I still see strong halos around light sources, and still have that gauzy texture to my vision, but it’s already faded quite substantially. There’s no pain at all. Today I take the anti-inflammatories once every two hours, the antibiotics once every four, and wetting drops whenever I feel like it. My eyes do feel drier than normal. Part is due to the surgery, which will improve, and part is because I’m not wearing glasses, which means more airflow around the eyes, and I’ll have to adjust to that.

I highly recommend the intralase treatment. 90% of the compllications from LASIK are due to the flap cutting, and Intralase makes this very precise. You get fewer risks of infection or flap damage, and a smoother laser cut means a better chance for higher quality vision when you’re done.

The cost of the surgery would have been $1245 per eye for the LASIK, plus another $800 for the optional intralase. I got lucky - my wife is a nurse, which got me a $400 discount on the LASIK, and I happened to book my surgery on a day when one of the top LASIK surgeons in the country was into gain her intralase certification, so I got the intralase for free. So I paid a total of $2090 for both eyes.

I’ll be happy to answer any questions anyone might have about the procedure.

2

Good grief Sam, you are allowed at least one typo after all that.

Is there any reason they do both eyes at once? I knew nothing of the surgery until your explanation but am a little surprised they don’t break it in two, allowing you one good eye at each juncture.

3

You can opt to do one eye at a time, if you want. I guess the only reason you might want to is if you can’t tolerate the 3-4 days of recovery time you’re supposed to have before going back to work. Some people choose one eye at a time in case something goes wrong, and in the early days of LASIK it was done that way fairly routinely. Also, some other forms of surgery like PRK have longer recovery times until your vision returns. If I were going to have poor vision for a week or two, I’d certainly consider doing one eye at a time.

But today, with the amount of experience they have in LASIK, they prefer to just do both eyes at once. With Intralase especially, your vision recovers extremely quickly. One day after surgery I’m already seeing better than I ever did with my glasses. And now I don’t have to take the time off to go and do the other eye and go through it all again. Also, the way they do LASIK allows them to back out of the procedure if one eye goes badly. Since almost all the surgery-ending complications come from making a mistake with the flap, if they make a mistake with one eye they can just stop and leave the other eye untouched. There aren’t really any complications that would affect both eyes.

4

How many fingers am I holding up?

5

Dear Sam–

which model of 1920’s Style Death Ray did they use to zap your eyes–the neon glass coil or the gimbled copper busbar model?

6

I’ve often been tempted by LASIK, ever since it was first introduced about 13 years ago. I decided to wait because being an “early adopter” with something as important as my eyesight could be a bad thing. I’m still tempted on occasion because of the advances and the personal reports of a couple friends who have had the procedure. My vision isn’t bad(about 20/40 in one eye 20/50 in the other). My glasses are lightweight and inexpensive and about the only thing I need them for is driving(although I wear them most of the time to reduce eyestrain). Every time I end up weighing the pros and cons I come up with “my eye’s aren’t that bad” and “vision can degrade as your eyes change” which tend to stop the process.

I’m glad to see you’re happy with yours and the detailed description along with the fact that the “World’s most experienced LASIK surgeon” is within a couple miles is a temptation.

Enjoy,
Steven

7

Eleventeen.

8

One close call - just before they pushed the foot trigger, I noticed the laser was set to ‘kill’. I had them move the dial to ‘Lasik’. Whew.

9

To be honest, I don’t know if I’d do it if my eyes were only 20/40. That’s only barely outside the range of expected outcomes in the first place (they don’t guarantee 20/20). I’ll bet if you went in for an evaluation they’d tell you you’re not a good candidate for that reason.

I was so blind that without my glasses I was pretty much useless. Couldn’t read the bed clock, etc. I used to wear contacts, but lost the tolerance for them a few years ago. That put an extreme cramp in my lifestyle. I like to ski, SCUBA dive, play pool, and fly airplanes, and all of those are significantly more difficult with glasses. I had to stop jogging and doing Karate, because my prescription was so strong that when my glasses would jiggle on my face it would make the whole world spin. So for me, this is a major improvement in quality of life. If my eyes were 20/40, I’d just live with it.

10

Sounds very expensive even with the discounts. I looked into it a little it sounded like it should run around $1200 for both eyes in the NJ/NY area. Maybe someone else from this area could chime it. What is US to Canadian dollars these days? I thought the gap had closed a lot.

I got 1,000.00 CAD = 860.309 USD
1 CAD = 0.860309 USD 1 USD = 1.16237 CAD
from http://www.xe.com/ucc/convert.cgi

11

You can find it cheaper - I’ve seen ads for $800 for both eyes. But as I’ve said many times before, in this case, price should not be your primary concern. If you’re interested, find the best doctor around, and then see if you’re willing to pay what that doctor charges. You don’t want Jim Bob’s Discount Mufflers ‘n’ Lazer Surgery.

Mine was the best $2500 I ever spent.

12

What did they say about glare and halos, Sam? Did you have glare/halos when you wore contacts? I wear contacts and have major glare issues, particuarly at might. I’m afraid Lasik will wind up with me having them permanently, since they said that could be a side effect.

13

How did you go about choosing a doctor? I’ve seen ads for as little as $299 per eye, but obviously you didn’t go the super-cheap route (I wouldn’t either). In fact, if I could figure out who’s the best in the area I might do it.

My sister went to Canada to do hers, because the procedure got approved something like ten years earlier there - hence there were more experienced people available.

14

You can get LASIK around here for as little as $350/eye. But the Gimbel is the gold standard for LASIK. They’ve been around longer than anyone, they have pioneered many of the techniques, and I know they’ll be around for a long time if there are complications. My doctor in particular is one of the best LASIK surgeons in the country. She’s done thousands of them, written several books on the subject, and is the editor of one of the major peer-reviewed journals in the field.

I didn’t want to skimp when it came to my eyes.

Glare and halos are definitely a risk. One of the prime reasons is having a pupil that is larger than average - larger than the ablation area of the laser. You want to make sure that you get LASIK with a laser capable of completely covering your pupil and then a little more, because it’s the interface between the treated and untreated areas that cause the halos. You want that to be outside your pupil. Glare is another side-effect, but it usually fades away in a few weeks to a few months. So far, even a day after surgery the glare hasn’t been too bad. I’ll let you know in a few weeks.

I had a worry about halos until I realized that I was always seeing halos with my glasses anyway since they were rarely perfectly clean.

Another risk is reduced contrast sensitivity, which can make it harder to see at night. This particularly worried me, so I had them do a contrast sensitivity test before I had the procedure. Mine was pretty much perfect, so I decided that losing a tiny bit would be acceptable if it happened. It’s not a really common side-effect, but it can happen.

I just picked the place with the best reputation, and which had been around the longest. Then I asked them how many procedures the doctor had done, and how long she had been doing it. The more experienced the doctor, the better the chance of a good outcome. Don’t skimp on your eyes and just go to the cheapest place you could find. We had a whole bunch of LASIK clinics open up in Alberta offering all kinds of really cheap specials. Almost all of them are out of business now.

15

I think I’m within the bump limit for this thread. I’m considering LASIK and would like to know how Sam’s vision has done in the last 2 months.

16

Good Bump, I meant to bump it last month and I forgot. I really want to look into this early next year.

17

For what it’s worth, I’m about 2 years out from my surgery, and I’m still fine.

18

My eyes are pretty bad, and I’m pretty sure I’m up for bifocals when I go for my appt in Jan.

I’m terrible when it comes to someone, even me, touching my eyes. Just putting drops in make me squirm like a …something. I can’t do contacts because I can’t touch my eyes. Pschycological I’m sure, not physical, but I just can’t let anyone get near my eyes without closing them. Will those drugs and drops they give you, make a guy like me sit still for all that, in your humble opinion??

19

Sorry for not updating the thread sooner.

I went through a bit of a bad time about 2 weeks after the surgery - for the next couple of weeks my eyes were always dry, sometimes felt like they had sand in them, and my vision was changing constantly (i.e. I’d blink, and one eye would be a little blurry. Blink again, it goes away. Then it gets blurry again). I was taking eye drops every 15 minutes or so. When my one-month evaluation came up, I told the doctor about it, and he said it was slightly above normal dry eyes, that all my symptoms were due to that, and should go away. He told me to use a more viscous eye drop at night to protect my eyes while sleeping, since I was waking up with very dry eyes in the mornings.

Also, one month after surgery I was still seeing pretty dramatic halos and starbursts around anything that emitted light, and it didn’t seem to be improving much. That really worried me. So if you had asked me what I thought about LASIK a month ago, I would have been lukewarm on the subject.

But the doctor was right. Within a week of that appointment, I noticed that my eyes were bothering me less, and the halos seems to be getting a little better. The improvement in the second month was rapid. Within 2 weeks of that appointment (6 weeks after surgery), I was only taking eye drops a couple of times a day, plus once before bed and on getting up in the morning.

As of now, my eyes are fine. I rarely take drops at all during the day, because I just don’t need to. My vision is stable, and the halos are almost gone - faint enough that I almost never notice them. The doc says they’ll improve even more over the next six months, so I’m happy.

As for my vision, it’s awesome. At my one-month checkup, I was 20/15 in my left eye, 20/20 in my right, and 20/15 with both eyes. Better than 20/20. And even then, I could tell that the difficulty I was having in resolving the 20/15 line was due more to the halos around the letters than to a lack of acuity. So I’m guessing that the next time I get my vision tested I’ll be 20/15 in each eye, and maybe even better with both eyes open. This from someone who started out at around 20/400 uncorrected, and only 20/20 with correction, clean glasses, and a fresh prescription. So my vision today is unquestionably better than it has ever been.

As long as I don’t relapse or suffer some long-term complication, I’m extremely happy with the outcome.

20

I’m a brand new member & I stumbled accross this very enlightening thread. I had Cateract Removal, Lens Replacement followed by Lasik just after my wife had the same - both 6 months ago. Hers worked perfect. Mine ended with the Cloudiness, Halos and Evening Contrast Problems I read about in these threads. The Cloudiness is gone, Halos & Contrast problems are better but still remain - daytime vision is 20/20. Bottom Line - this stuff is not the slam dunk that some providers make it out to be. Thanks for the enlightenment!