Scott's LASIK Experience

I had been wearing thick glasses since I was in second grade, and hated every second of it. Glasses limited my participation in school sports, as my number one concern was protecting my glasses from damage, and scoring points in a game were secondary. I started wearing contacts in college, and wore them pretty much exclusively for two or three years, but they were always uncomfortable. They made me extremely wind-sensitive. The slightest breeze, even from a distant air conditioner, would make my eyes burn and itch. I was also light sensitive with contacts as well. Eventually I went back to glasses, only wearing contacts for sports like scuba diving and water skiing. I'm not sure of my prescription when I first started wearing glasses, but I know it was pretty heavy. My last pair of glasses were -5.25 diopters, making my vision in the neighborhood of 20/600. This means that what I could read at 20 feet away, people with "normal" vision could see at 600 feet!

I'd always watched trends in eye surgery, hoping to one day rid myself of my dependance on glasses and contacts. I watched RK (Radial Karatotomy) come and go, but it had so-so results, lots of problems and side effects (like no scuba, ever), annoying star-burst patterns at night, significant weakening of the cornea, and it was only good for minor adjustments, and would not fix my myopia.

They then came out with PRK (Photo Refractive Keratectomy). This is a process where an Eximer Laser is used to reshape the surface of the cornea. The Eximer Laser is special, because it has the ability to vaporize a layor of tissue without damaging the surrounding tissue. In this way, it can "burn" away precisely controlled layers of the cornea to arrive at near-20/20 vision. The drawbacks of this surgery are generally several weeks of discomfort and very blurry vision, and pretty high chance of infection, as the outer protective surface of the cornea (epithelion) is removed, just like a burn or abrasion to normal skin tissue.

In 1998, I met a fellow scuba diver that had a procedure called LASIK (Laser Assisted in-SItu Keratomileusis). This is a process similar to PRK, but the healing process is much quicker and less painful, and with much less risk of infection. Recovery is normally in days instead of weeks. In LASIK surgery, a device called a microkeratome is used to make an incision creating a flap of tissue on the front of the cornea, usually about a 1/2 mm thick and 8 1/2 to 9 1/2 mm in diameter. The flap is then folded back out of the way, and the Eximer laser is then used to remove layers of tissue from the cornea. Once the laser process is complete, the eye is rinse and the flap flipped back down.

I finally decided to have my eyes fixed with LASIK. The total price of LASIK surgery in my area (Oregon) ranged from $3000 to $5000, and was still fairly new. More money that I had to spend. I talked with one local eye doctor who does LASIK and PRK, and his price was $4000. He mentioned that it was a lot cheaper in Canada, but he said "They crank people out one after another." I thought about this for a minute, and figured that was a good thing. The more surgeries a doctor has performed, the better he/she is going to be. I asked this doctor how many LASIK operations he has performed, and has answered that he'd done three. I scratched his name off my list!

The more research I did, the more I discovered that in Canada the doctors are far more experienced than in the States, and the equipment is of better quality and newer technology. For example, at this time lasers that use tracking (take account for the patient's eye movements during surgery) have been used in Canada for years, but have only recently been approved by the FDA (way to go, government!) and only a small portion of local LASIK surgeons have access to these superior machines. I discovered that the price of having LASIK done in Canada at LasikVision was $1000 US (total cost), an amount I was prepared to pay. The price is so much cheaper because they have been doing it so much longer they can afford to be cheaper. Also there is a patent issue. In the US, the clinic has to pay around $510 to the patent holder with each eye they treat. In Canada, they do not have to pay the patent fee. So I called and made an appointment to have the surgery done in March 2000. We made it a nice little family vacation to Vancouver, BC. Here is what I experienced:

Monday morning, March 6 I arrived at the LasikVision clinic for my pre-operative exam. They ran me through the usual barrage of tests to determine my uncorrected vision. They then did a test to determine the thickness of my cornea. If the cornea is too thin, then PRK is the only option. Fortunately my cornea was just fine (as is the case about 90 to 95 percent of the time), so I opted for LASIK. They then use a computer-controlled machine that analyzed the topography (shape) of my cornea. This information is later fed into the Eximer Laser's computer, which uses my eye shape and amount of desired correction to determine exactly where to laser and how much tissue to remove. The tests were painless, and the technicians and optometrists were very friendly. My only complaint was that they dilated my eyes, and did not provide dark glasses to wear on the walk back to our hotel. The day was sunny, and the light grey sidewalks glowed like the sun.

On Tuesday March 7, 2000, I arrived at the clinic at 1:00 pm, an hour prior to my scheduled surgery. I was quite nervous, to say the least. I took a couple of Tylenol with Codeine (over the counter in Canada). Soon I was taken to a separate office, where a technician/nurse told me all about what was going to happen in the surgery, gave me a pack of post-operative stuff, and also a couple of Ativan tablets (similar to Valium), to help relax me. The pack contained antibiotic eyedrops to fight infection, steroid drops to reduce scarring, some pain-killer drops if things got too uncomfortable, and re-wetting drops (artificial tears) to keep my eyes lubricated. I was also given a pair of dark sunglasses (wish I had them the day before!), and some clear plastic eye shields that tape over the eyes during sleep for the first few days for protection.

I then went to another waiting room for a while. A technician/nurse named Linda helped me to relax by just being friendly and funny, which helped quite a bit. I found out my surgeon would be Dr. George, who had performed over 8000 LASIK surgeries before me. I felt I was in good hands!

In the small waiting room was a patient who had just had his eyes lasered minutes before. He was instructed to keep his eyes closed for 20 minutes. We lightly chatted, and he said he wasn't in any pain. I was relieved.

I said that I didn't want to see the equipment just prior to surgery, so when they finally came to get me around 2:30 pm, they had me take my glasses off and they led me into the operating room. The lights were very dim, thankfully. They laid me down on the machine, put in numbing eye drops, and let me lay there for a few minutes. I think the Adivan and Codeine were kicking in, because I was surprised that I was almost able to fall asleep. I think I was actually a lot less nervous just before surgery than I was a couple of hours before.

One of my fears was that they would put the wrong person's information into the computer, and adjust my eyes per someone else's prescription. But the doctor asked me to spell my last name while I laid there, which put that fear to rest.

After about five minutes, they surrounded me, and placed a cover over my right eye. I was relieved to discover that I could not see anything they were doing. My biggest fear was that I'd see them "come at me with a scalpel," and I'd freak. But the room was dark, and there were small, bright lights shining in my eyes, so I couldn't see a thing. Then they positioned my left eye under the machine, and installed a device to hold my eyelids open so it was impossible to blink. I had heard that this is uncomfortable, but I didn't mind it at all. Actually I could hardly tell it was on me. They then applied the suction ring on my eyeball... They applied a lot of pressure, my vision went black, and it was quite uncomfortable for about five seconds, then the pressure was relieved and my vision returned. This was the only pain that I experienced throughout the entire procedure.

Once the suction ring was in place, I heard a soft buzzing from the microkeratome, and they informed me they were going to make the flap. I held rock-still as they created the flap, which was completely painless. They then lifted the flap. I could still see the two white lights shining on me, as well as the blurry red dot I was instructed to stare at during the laser procedure. Imagine sitting in a car during a heavy rainstorm, at a stoplight, with the wipers off. My vision was exactly like that. Everything was watery-looking and blurry.

They positioned the laser, told me to stare at the red blur, then told me they would be lasering for (I think) 49 seconds. They warned me just before it started, then I heard the machine "zap zap zap" and smelled the faint smell of ozone as layers were painlessly removed from my cornea. After about 20 seconds, they took a break for a few seconds, then continued. They kept me informed of how many seconds remained, which was nice. When the lasering was done, they rinsed my eye, then replaced the flap and removed the equipment. The whole process took around five minutes.

I told them that it was so much fun, I'd like them to do it again to my other eye. Must have been the Adivan talking! Anyway, then shifted me over, covered my newly-zapped eye, and started working on my other eye. This was an exact repeat of the first eye, but this time I think I was lasered for 52 seconds. It's hard to be sure, the whole process is a bit hazy for me, as were the next two or three hours until the drugs wore off.

So after about ten or fifteen minutes in the operating room, I was led back to the small waiting room. On the way there, I noticed that I could see distant things much better than I could have before without my glasses, although everything was extremely foggy. I sat down in a chair, instructed to keep my eyes shut for twenty minutes. There was another patient there with me, who was just about to go in. It was a bit weird to be in the opposite situation as a half hour before, with me telling the next person how I felt, putting their mind at ease. I like how they have that set up, where the patients can encourage one another.

After my 20 minute wait, they came and got me, and let me open my eyes and walk out into the waiting room. Everything was pretty blurry, but nothing hurt at all. I didn't even feel like I'd had surgery at all, except I could see distant objects. We walked back to the hotel, where I taped on my eye shields and slept for a couple of hours. I felt great, with absolutely no pain. My eyes felt a bit like I was wearing contacts. Not painful or uncomfortable, just a slight feeling like something was different. I made a few phone calls and listened to the TV for a while, while Becky took the kids down to the hot tub to play and leave me in peace. My vision was still blurry, but much better than I had been without glasses on.

Day 2 - Wednesday, the morning after surgery, I awoke at 5:00 am, feeling great! I took a shower, dressed, then headed out to walk the streets of Vancouver, and see how my new eyes worked. My vision was still somewhat blurry, but it was equally blurry for close objects as it was for distant ones. For example, I could not see the little hairs on the back of my fingers, but I could see details and read some of the business signs blocks away.

Around noon, we were back at the LasikVision clinic for my post-operative exam. In the waiting room, I recognized several people I'd seen the previous two days, but now none of us were wearing glasses. Some did however wear sunglasses. One young couple were there that we'd met at the hotel on Monday. He had his eyes LASIK'd a month before, and was in for his one-month followup exam. His wife had her eyes done the same day as I did, about an hour later, but her corneas were too thin for LASIK so she had PRK done. She was still in a lot of pain, so I gave her my pain-killer eyedrops in case hers ran out. I also met the person that was in the waiting room with me just after my eyes were lasered, but I didn't recognize her until she spoke, as I had my eyes closed when we met.

They checked my eyes with a microscope, and said my flaps were doing great. They mentioned that there was a raised area where the "hinge" was, but that was normal, only visible under magnification, and would flatten out in a few weeks. They checked my vision with an eye chart. My right eye showed I was seeing 20/20, but my left eye was only seeing a very blurry 20/30. Together my eyes could read the 20/20 chart. Not completely perfect, but acceptible, especially for less than 24 hours post-op. Vision is supposed to improve over the next few weeks as the eye heals and swelling goes down. I'm crossing my fingers, hoping to fall into the 20/15 to 20/25 range. But coming from 20/600, even 20/30 is really nice!

Day 3 - Thursday, March 9. I drove the car for the first time today post-op. During the day, everything was perfect. I drove to my scuba club meeting this evening, and was surprised at the glow around headlights and street lights. They looked the way lights do in a light fog. I'm pretty sure this is due to my blurred vision. I am not experiencing "Halos" around lights, as some LASIK patients have seen. I think that they are a thing of the past now. When they first started doing LASIK, they made a relatively small flap and lasered area. At night, when the eyes would dilate, the pupil would get larger than the treated area, causing reflections on the "seam." Now they make a larger diameter flap and lasered area, larger than a dilated pupil. In my case, my flap was 9.5 mm in diameter.

Day 6 - Monday, March 13. Well it has been six days now since my surgery. My eyes feel great. I'm done with my five-day regimen of eyedrops, though I'll still be using rewetting drops to keep them lubricated for several more weeks, as the doctors recommend. My vision is still somewhat blurry, but not too bad. It seems much more pronounced in dim light, like in my computer room. When I go outside, things seem almost perfectly clear. I was surprised, because I expected to be light sensitive after the surgery, but I am not. I used to be very light sensitive when wearing contacts, but I'm fine now that I've had LASIK. As a matter of fact, I'm prefering brighter light than before. I guess this is common after eye surgery. Wednesday is my one-week followup exam with a local eye doctor, and I'm anxious to see where my vision will be.

Day 8 - Wednesday, March 15. I just had my one-week post-op exam today. My right eye is right at 20/25, showing signs of mild astigmatism. My left eye tested out to be a bit worse than 20/30, with a little more astigmatism. I was hoping for a bit better, but the doctor tells me that my eyes still show quite a bit of swelling, and my vision will likely change day by day, even hour by hour, for a few more weeks. He said my vision should be pretty well stablized after a month post-op. We'll see...

Fast Forward... Now it is April 24. I just checked my eyes. My left eye is checking at 20/30, and my right is at 20/25. I'm mostly happy with the surgery. I mean, going from 20/600, it's really, really nice. But one thing I have difficulty with is seeing stars at night. Of course this could be corrected with glasses, or an "enhancement" operation. I'm on the fence about whether I will get an enhancement. I think I've still got some astigmatism going. During the day, in bright light, my vision is pretty darn close to perfect. At night, no starbursts and very little if any halos, and my night vision is much better than it was at first. I still need lots of artificial tears, particularly in my left eye. All in all, I'm happy with the procedure.

July 25... My vision is stabilized, still 20/30 w/ mild astigmatism in my left eye, 20/25 in my right. I'm still having to use lubricating drops. Some days just a couple drops, other days I'll need it often. I always need drops first thing in the morning.

August 24: I had my eyes checked. The doc verified my vision at 20/30 and 20/25, with some astigmatism. I bought new lenses for my old glasses frames, and wear them sometimes. During the day, it is almost impossible to tell a different when wearing glasses or not. But at night the difference is very noticeable. Lights in the distance without my glasses look misshapen. Instead of being round, they appear shaped like the Playboy bunny logo... with two ears up above, a bow tie below and a nose off to the left. The astigmatism causes the round light to be focused on multiple locations on the retina, causing the blurring effect. With my glasses on, lights in the distance look normal. Without my glasses, bright stars appear dim, and dim stars are not visible. With my glasses, I see twice as many stars, and they are much sharper.

With my glasses, using my computer is much easier as the small text is more easily readable. I am still using lubricating eye drops, but not as often. I always use them in the morning when I first wake up, then I usually need them a couple times in the evening, and again when I go to bed.

I asked the doctor how the healing is coming. He said that my eyes still have a lot of healing to do, especially the left eye. He explained that when they make the flap, burn the surface tissue and then put the flap back down, the area under the flap takes up to a year to heal back completely. Right now, I've got a pocket of tissue between the inner and outer layer of my cornea that is still healing, which is what is likely causing my astigmatism. When it fully heals, the pocket will be gone, and my cornea will again be one. Hopefully my vision will be improved at that point.

November 12, 2002. Well it's been more than two years since my last post. My eyes have healed up completely, and my vision is probably between 20/20 and 20/25. My right eye healed up very quickly, but my left eye took about a year before I could put away the lubricating eye drops. My right eye seems perfect, while my left eye still has some mild astygmatism. It has really been nice to not need glasses anymore. I'm free! :) The only drawback I have is that very dim pinpoint lights, like tail-lights and stars, are somewhat smudged. I might eventually get some glasses just for reading or driving at night or looking at the stars, but would not be a necessity, just a luxury. Conclusion: I am very happy that I has LASIK surgery, and would recommend it to anyone who hates wearing glasses or contacts, particularly if their eyesight is so bad that they can't function without them.