Laser Eye Surgery (part 8) - The aftermath
Well I can truly say the response to my last post about the results of my surgery have been completely overwhelming. Having posted it also on digg, I really didn’t anticipate the kind of response it would get. Thanks to those that offered words of advice and support!
I went to my first post-op check-up yesterday morning to see my optometrist. He said everything looks good, except for some slight marks on the cornea. He recommended continuing to take the Biox drops which should help with the healing and make the irritating go away. This may have to do with the unusual dryness I was experiencing before the procedure.
I still am not feeling any pain, and my vision seems to be increasing progressively. The optometrist noted my vision was around 20/25 when I saw him 24 hours after the operation, which is really incredible I think. He says he expects it to reach 20/20 within a short while.
The only problem I’m still having is with light sources. Looking at direct, exposed lights, they appear very foggy and still have a sort of rainbow halo around them. This is something else that I hope will go away as time passes.
I’m down to four drops a day for Maxidex (anti-swelling), Vigamox (anti-biotic), and Biox. After today I’ll be finished with the Vigamox, too. I’m also happy that last night was the last time I’ll have to wear those protective shields to bed. They can be quite the task to get adjusted properly.
It’s amazing to see the difference already, and I can’t wait until it improves more!
Laser Eye Surgery (part 7) - The conclusion
It’s done! All in a matter of maybe ten minutes, they’ve hit the reboot button on my eyes. I came out from under the machine feeling very disoriented and somewhat weak, but that was probably just the Ativan.
Forgive any typos I make, I just woke up from a brief nap and I’m typing with my eyes closed.
I arrived at the TLC building around 8:45 this morning, to be immedialy greeted and have my payment processed. Immediately following this, myself and four other hopeful patients were coralled into a small dark area with reclining chairs where one of the surgeons’ assistant went through all the post-op care, introduced us to the fab shades I’m wearing right now, and basically just set us all at ease.
At this point, the assistant also administered the freezing all around the eye, and an optional hit of Ativan, a very mild sedative which I still haven’t felt.
We were called in one by one, not more than 10 minutes for the whole procedure beginning to end. Of course, I ended up going last, so I had the opportunity to watch everyone else before me on the monitor. The most interesting part is when the flap of the eye is peeled back. At this point, the eye just looks like a peeled grape. You must wonder how that looks from the patient’s perspective..
When it came turn for me to go in, I was fairly calm about the whole thing, trying to remember that it was elective surgery, so that anything that went wrong was all my fault. I sat down between two giant machines, which I presumed were the Intralse machine, and the other was the actual operating laser.
As soon as I sat down, we got started. The doctor placed a small metal device with a loop at the end around the surface of my (now frozen) eyeball. This held my eye in the correct position I immediately couldn’t see anyting out of this eye - presumably because it was exerting force on all sides of the eye and the light was being distorted. He then moved the chair under the machine to the left, which is the Intralase machine. It would be cutting the flap.
I was pretty disoriented at this point, but I think the machine lowered to clamp on to the metal suction object on my eye to do its work. An assistant then called out “30 seconds,” and that portion was done. They bandaged up my eye for the time being, and did the same thing to my right eye.
Now, the actual laser procedure was ready to begin. He removed the bandage on one of my eyes, then used some kind of tool to keep my eyes open all the way. I could see a blinking, very HAL-like light above me, and was instructed to focus on it. Easier said than done… during this time my Surgeon was peeling back the flap of my eye, and so the light from this red dot hit my eye, the flap being moved around caused the dot to jump all over the place. It was tricky to keep an eye on it.
Once the flap was removed, the Surgeon used a small metal surgical device to move it up and out of the way (typically, this is when if you’re watching a LASIK procedure, the surface of the eye will appear as an exposed grape). This is when things went weird. My vision was just basicaily gone. I could see colors and lights, but couldn’t make anything out. They were now trying to line up the laser with my pupil. If you’re looking on the obersvation screen, you can see a crosshair trying to focus on the patient’s eye. This part is all about will power, as I tried to stay as still as possible. I thought I was fidgeting, but the surgeon assured me that the computer would lock on as needed.
Seconds later, I heard a “whish”-sound followed by the familiar sound of a cooling fan. The laser must now be powering up. An assistant announced “20 seconds of laser for this eye,” and that’s when it started going off. There was an arking-type sound, the kind you hear when high power electronics are being used. With each arc of the laser, I saw a ring of yellow light that gradually improved. This went on for the alloted 20 seconds, and then it was done. The surgeon carefully placed the flap of my eye back into position, and with a few drops, suction took care of the rest of it.
I then had the same procedure done on the other eye. Whoo! The whole procedure was entirely painless - the only uncomfortable after-effects are what I’m feeling now - a slight burning in my eyes. Thankfully I have my awesome Hasselhoff-esque shades to wear all day, and my shields at night. I’m also on a strict schedule of antibiotic eyedrops until tomorrow, with another set that will be used until next week.
My vision right now is still quite blurred. I can see distance better than up close at this point, but it’s expected to improve by tomorrow morning. I’m off to rest now!
Update: First off, welcome to all you diggers! Surely didn’t expect this story to attract so much attention - just thought I’d try to raise some awareness about this procedure.
I thought I’d also clarify a couple things.
1. First off, there was no “cutting” of the cornea by any metal object. They place a metal suction cup like device onto your eyeball, and that device is then locked into the Intralase machine which will cut the flap. This was traditionally done with a microkeratome, which I wrote about previously, and this basically is a metal blade that swings across your eye to create the flap. Intralase is both safer, and more accurate than this method.
After the flap was cut, the Surgeon used a metal rod of some sort to reach under the cut flap, and pull it away so that my eye was now exposed and they could begin using the laser on it.
2. While I didn’t type entirely with m eyes shut, I did my best to. I was advised that keeping away from staring at the TV/Computer for excessive amounts of time during the first week or so would be a good idea. I just tried to rest my eyes at any time that I could as the flap heals best while your eyes are closed.
3. I didn’t notice this before, but I have a slight amount of bruising on the tops of my eyes. It doesn’t hurt or anything, but it’s sensitive to touch. They say this is completely normal, and is caused from the suction cup like device that held my eye in spot while the procedure was being done. You can’t see it unless I lift my eyelids.
Leave a comment if you have any questions! I know I was a huge information junkie going into this procedure, so I’d be happy to help anyone else who is doing the same.
Laser Eye Surgery (part 6) - Here we go!
An hour till the procedure gets underway. Gidee-up!
Laser Eye Surgery (part 5) - the fineprint
This is the part most people hate — the waiver.
…you acknowledge that although vision-threatening complications are rare, it is possible that partial or complete loss of vision may be produced as a result of a surgical or healing complication.
Sign me up!
Laser Eye Surgery (part 4) - Post-op Sunglasses
For the past few weeks I’ve been shopping around for a new pair of sunglasses as my current ones are prescription, and will be useless to me come Friday afternoon. Having visited just about every mall in the GTA, I’ve been stopping in the Sunglass Hut stores to get their opinion on what kind of glasses I should get.
Every salesperson I spoke to said that there was no other way for me to go except with polarized lenses. They tell me my eyes will be extremely sensitive post-op, and that I need all the protection I could get. After being told this for what seemed like the fifteenth time on Saturday at Square One mall in Mississauga, I decided to check in with my TLC specialist to get their opinion on the matter. The answer?
Polarized glasses are great, but not an essential need after surgery.
Fantastic! So misinformed salespeople have been feeding me BS. Or have they? It’s fairly common for polarized lenses to fetch a premium when retailers sell glasses, often around a hundred dollars more than their regular counterparts. Maybe they were just trying to upsell me on their most expensive glasses. Interesting.
Laser Eye Surgery (part 3)
I took care of the last pre-op appointment this morning for my TLC/Lasik surgery. It seemed that some of the tests that they did before needed to be re-done to check whether the dryness in my eyes had been resolved.
I had a great little re-visit with the orange/black concentric-circle machine that I mentioned in part 2, as well as some other new machines, one of which for some reason I remember as the “pupillator,” but I’m sure I probably just made that up.
More tests…
All of the machines that TLC uses to test your eyes involved you staring at some crazy-shaped light through eyepieces. Presumably they’re taking some kind of measurements, but the whole thing just looks like a light show to me. The strangest feeling test is where they scan the back of your eyes. You can see a vertical column of light scanning over your eye, and it feels like it’s going right into the back of your brain. It’s not painful at all, but is really an interesting sensation. I have no idea how they go about actually seeing the rear portion of my eye (mirrors?), but the devices they use to do it looks out of this world.
Near the end of the appointment, they presented me with the mighty agreement, which for one, gives me a lifetime “warranty” for any corrections beyond a certain point, and two, reminds me that I’ll still needed reading glasses at 40. That doesn’t bother me whatsoever, since by then I’m sure there will be a new procedure to correct this as well. They also let me know that I may experience some glare at night due to my unusually large pupils. That’s fine… colour me a vampire for a while.
They also let me know that Diazepam, a mild sedative, will be available if I want it. Supposedly most people use it, which I think I’ll go for. I don’t want any chance of a freak-out while they’re peeling away the flap of my eye like an onion.
Complications
I made the mistake of reading up on LASIK on Wikipedia, particularly the complications section.
It is also possible that the patient has a genetic condition that causes the cornea to thin out following surgery. While this is screened for in the pre-op exam, it is possible in rare cases (about 1 in 5,000) for the condition to remain dormant until later in life (the mid-40s). If this occurs, the patient will require a corneal transplant.
They quoted this 1 in 5000 chance today, but didn’t specify the possibility of having to have a corneal transplant shoud this occur. That makes me slightly uneasy, and I’d almost rather go into it being ignorant of some of the more “unfortunate” consequences. I like the odds though, either way. It puts me at ease that the doctor who will be performing the surgery has already done 20,000 procedures just like this.
Dryness
With regards to the dryness of my eyes, it’s not going to cause any complications for the surgery, but if it keeps up, my eyes may irritate me following the procedure for a while until they get back to normal.
This is due to the underlying problem of me still not being able to find a balance between work/home/sleep. I’m spending far too much time in front of an LCD screen every day, and far too little time sleeping. I’ve been on about six hours of sleep a night for the past 2-3 months, and I know it’s not healthy, but I can’t seem to get out of the cycle. As of Monday, I’m going to start going to start coming into work later, and going to bed earlier. I’m sticking to a strict regimen of eye drops as well. More than anything, I’m going to try and reduce the amount of time I’m in front of a computer at home.
I’m still really looking forward to having this done, and can’t wait to be able to see well again. Those of you who don’t have the need for glasses/contacts truly don’t appreciate how lucky you are. Two weeks to go!
Laser Eye Surgery (part 2)
I had my first appointment with TLC today, the initial consultation. Had a few more tests done on my eyes. The first was a 3D map of the eye and cornea. It consisted of a really trippy looking concave plate with concentric circles in orange and black on it. When they activated it, a strobe light went off that I could see passing from one edge of the eye to the other. For some reason I couldn’t stop blinking during this so they had to redo it about three times.
I then spoke to the optometrist on site who told me that my eyes were unusually dry - I can totally attribute this to spending way too much time on the computer without breaks and a lack of sleep. Probably not good for the rest of my body either - I’ll make this my new year’s resolution. She gave me drops which I’m supposed to use every 2-3 hours for a couple weeks until my second appointment, where they’ll do a few more tests. She also let me know that my pupils are larger than average (0.7 mm versus the typical < 0.6 mm) which was interesting. She said in older forms of Lasik this might have caused starbursts at night after the surgery, but not with this new process.
New process, you ask? I was surprised to hear this as well. Traditionally, in the first step of the surgery where the corneal flap needs to be lifted, this was done with a microkeratome; This is a blade that oscillates over the eye to cut the flap. At the TLC center where I’ll be having the surgery, they’re now using a process called Intralase in which a computer-guided laser does the corneal flap. This is apparently a safer, and more precise procedure, which is all the better for easing my one and only concern about this whole thing. There was always something about a metal blade cutting my eye open that I wasn’t too thrilled with. For some reason, hearing that a laser will be involved eases that concern.
Another aspect of the new process is rather than reshaping the surface of the eye with the laser to basically mimic my prescription in my glasses, they now take up to 200 points on my eye and individually reshape those. This results in less chance of complications after the surgery, as well as minimizing the glare experienced at night.
I’m really excited to have this done. I can’t wait to be free of glasses and be able to see without having a dependency on something. Simple things like being able to see my clock from across the room at night will make all the difference in the world. If anyone has any questions about the process or what I’m having done, I’d be happy to answer them in the comments.
Laser Eye Surgery (part 1)
I’ve decided to bite the bullet and be rid of my eye glasses forever. Before the end of the year, I won’t have a need for them anymore and will have better vision than I’ve ever had.
Today was the first step towards that goal, as I had my pre-operation consultation with my Optometrist. I had just seen him a few weeks ago to check my prescription and was delighted to find out that it had finally stabilized after several years of degradation.
Today, he performed a number of crazy tests that I’ve never had done before. The first step was to dilate my pupils, which I’m still experiencing as I type this. I must say I look like quite the lunatic with my pupils dilated to their full size.
After that, I waited about 20 minutes in the waiting room and then proceeded to get the actual tests done. My doctor checked a number of things, including measuring the thickness of my cornea and mounting some Ghostbuster-like headpiece on himself and using it with some funky mirror to check out the back of my eyes.
Everything seems to be in order - apparently I have “thick” corneas. I guess that’s good. I’ll be making an appointment within a few days with TLC/Lasik to have a consultation with them, and then have the procedure done.
I absolutely can’t wait until I get this done. It’s surely going to be a liberating feeling not to have to worry about putting on my glasses when I want to see something more than six feet away.
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Adam lives in Toronto, Canada and likes to make cool stuff. He sometimes even gets paid to make things for the Web.
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