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Just a note before you begin: This tells about my experience with Lasik laser eye surgery. It is my experience, nobody else's, and it would not necessarily be yours. The things I saw, did, chose to do and not to do, and that were done for me are unique to me. Don't take anything I write as a recommendation based on anything except my experience. What worked for me might not work for you. You can cut right to the Bottom Line.
Some HistoryI have worn glasses since I was 6 years old; 43 years of specs, scratches, goo, dust, bent frames, chips, and general hassle. I remember vividly a day in 1st grade, in Huber Heights, a section of Dayton, Ohio. After school I was playing with friends in a snow pile. When I was done, I had lost my glasses. My mother went ballistic - justifiably, of course! So, glasses have been a pain in the tuchas forever. My knowledge of lasik eye surgery began in about 1995. I met a young woman, Jennifer Bass, who had been part of early trials. She went, as I recall, from 20/600 to 20/20. Pretty impressive. I looked into laser eye surgery back in 1997. My ophthalmologist recommended that I wait for a while as I had astigmatism and was far sighted. He said he was not comfortable with the work done up to that time for people like me. I agreed to wait. Then, in 1998, things started getting much livelier with Canadian LASIK surgery. I heard more and more about it. Seemed that it was less costly and of the best quality. Then, the son of a co-worker went to Vancouver, British Columbia and was very happy with the results. My co-worker, a very no-nonsense guy named Wynn Dance, was also happy with it. I got information on the specific place they had gone, Lexington Eye Institute, in Surrey, a suburb of Vancouver. I also did a web-search on laser eye surgery, on other places that offered the surgery, and asked around with friends and colleagues. Go back The ChoiceI decided on Lexington because I knew people who had used them, I liked their deal (more on that later), and because they were very professional over the phone. Other surgery centers in the Vancouver area may well be absolutely wonderful; I just went with Lexington. Since that time, the Lexington Eye Institute has closed. A very brief toll-free call set up the exam and surgery. I got numbers for the shuttle and Ramada Inn, Surrey B.C. All very quick and clean. They have a great system set up. I made arrangements with work, with dog sitters, with the money, and with the Institute. It was pretty simple, and on Monday, 20 March, 2000, I went for my pre-operative eye exam at Focus EyeCare, in Bellevue, Washington, a suburb of Seattle. Focus EyeCare is also closed. Go back The Eye ExamFocus was in an office park. Unlike most office parks, this one is park first, office later. The people were prompt, focussed (no pun), professional, and personable. A technician took pictures, did the dilation, ran me through various tests, and did an ultrasound to get the thickness of my cornea. Seems the normal range is 400 - 600 microns, with most folks in the 500 to 550 range. I was close to 600. I was also 20/40 in my left eye, and 20/30 in my right. Not bad, compared to others. The ophthalmologist rechecked everything, answered questions, and I was out of there. Driving in the late afternoon, heading west back into Seattle, was not difficult, but I was pretty alert and had good sunglasses. Go back The Van TripOn the very rainy morning of Wednesday, 22 March (why wait?), my wife, Kipling, and I went back to Focus for the shuttle. It was late coming up from Sea-Tac, the regional airport, but we all got underway quickly. The driver, a Canadian fellow named Dave, got us to the border in about 2 hours. I asked him if these border crossing were pretty routine. He said yes. He asked us the questions he would be asked - our nationalities, where we lived, what our business was, whether we were staying more than one night, if we were carrying more than $US10,000, if we had any weapons like guns, knives, mace, or pepper spray. I had been to Canada many times over the last few years, and this is normal. The wave-through is a given. But not today! The Canadian border official read the driver the riot act about not knowing who these people (us) were, not using the bus lane in spite of what the driver had been told, and to pull over and talk to the immigration people. Things went pretty well, except that Kip does not drive, and had only a Washington State identification card. This is a fully valid ID, just like a driver's license, but it gives people fits, and did the same to the Canadians. Seems you can be denied entry into Canada for DUI/DWI (good for Canadians; what about George W?), and not having a driver's license is suspicious. After some delay, some computer work, and some sideways glances, we were given our IDs and told to have a nice stay in Canada. Lesson: bring a passport for identification. Go back The HotelThe Ramada Inn in Surrey is a nice place - not too hot, not too cold. Very nice rooms, good room service, a nice attached restaurant, and easy to get around in, including ramps as well as stairs. Nothing really fancy. And full of eye surgery patients! The hotel is often fully booked, and a large part of the business is from Lexington. A shuttle runs from the hotel to a nearby mall and to the Eye Institute, at no cost. The driver leaves a cell number and you can call him to come get you when you need a ride. Convenience galore! Go back The Lexington Eye InstituteThe first time I went into the Institute was the evening of my surgery. Again, professional and personable. After a brief wait, I went into a cubicle with a technician to go over the "informed consent" stuff and the items in the After-Care Kit. It was all pretty routine as I had read up on all of it already. The tech took an eye scan (a topographical image) of my eyes. She said my corneas were very thick and that they would have plenty to work with if any adjustments were needed later. She said they call my sort of corneas "nice thick juicy ones." Hmmm. I went into an exam room and got a final eye exam. After that, they took me to a pre-operative lounge and took my blood pressure and did a scrub-up around my eyes. They offered me a sedative. I had been told by other patients to "Take the pill!" It is 1 mg of Ativan. Pop it under the tongue, let it dissolve, drink a bit of water, and you is relaxed. I was pretty relaxed anyhow, so I did not notice much difference. I heard they would give you 2 if you seem really agitated, but don't take my word for it. But, take the pill! Go back The SurgeryJust before the surgery, I met the surgeon. He asked if I had any questions. I got the impression he would take all the time I needed. I asked a few to which I figured I knew the answers, and he ushered me into the care of the nurses. No hospital gowns, no bright lights. Just a rather dim room, mellow music, and a well-orchestrated team of pros. I laid down on a simple bed-table with a pillow roll under my knees. A hollowed out pillow held my head in place. The surgeon, technicians and nurses were excited about the job. It was after 6 PM, and they were still turned on about the work! Comforting to see. They put some numbing drops in my eyes (get at least 2 per eye), and taped one eye closed, then taped my lids open on the other eye. Then they put a gizmo in to hold my eyelids open for sure. This was a bit uncomfortable. They moved a machine over my eye, and I saw a red light surrounded by red haze directly in front of me, and a green one to the lower area of my vision. The surgeon explained that the red one positions the laser horizontally, and the green one does so vertically. Everything is very precise. The next thing I knew, another device pressed in on my eye. The visual sensation was similar to gently pressing onto the side of your eye - lights get blurred and distorted, and even disappear. Physically, this was also uncomfortable, but not sharply painful. There was a sideways pushing sensation and my sight went completely blurred. This was the cut into the cornea. The flap of cornea was lifted, and a tech began calling out numbers of seconds, and there was a tick-tick-ticking sound and a slight burning smell. This was it! Zapped! In a moment, a light blue glowing thing was rubbed over my eye. I think this was antibiotic solution. It was very wet. Come on antibiotics! In a moment, the flap was returned into position. The surgeon said it was perfect. Then, on to the other eye. This one had not gotten as many numbing drops, and there was a bit of pain, but it was over in no time. They put more drops into my eyes and helped me sit up. I could see, but it was very watery. They took me into a darkened room for a few moments of rest in a big overstuffed leather chair. There was nice music and a large, colorful still-life painting of flowers in a vase. For some whose eyesight was pretty bad, I'd bet that painting was a miraculous sight, even that soon after surgery. After a quick check with a refracting device (a VERY bright light that is NOT welcome, but is necessary) they pronounced the surgery a success and gave me some big, blocky sunglasses. They are like the ones Roy Orbison used to wear. There was not much pain at all. We went out into the late afternoon sun and got into the shuttle. I could see pretty well, and was not especially light sensitive. Then, as we drove back, the hurtin' began. Everyone said it was like getting dirty contacts. But, as I had never worn contacts, that did not mean anything to me. I'd say it was like getting eyelashes and grit in your eye. Only, you can't rub it away. Yowsa, that's nasty! Back at the hotel room, I took the Tylenol Extra Strength, but it was not effective for sleep inducing. Tylenol PM is not sold in Canada. They have an item called "222s" (two twenty-twos), but they have caffeine in them. Go figure. Take Tylenol PM with you and use them! I put on the eye shields, and got some sleep. After some light room service, it was back to Morpheus. Go back The next morningI got up about 8 am. The room was still dark, but outside I could see…everything! A smidge blurred, but the detail was there. In the bathroom I could read the labels on the small hotel size bottles of shampoo, mouthwash, and lotion. I did not put mouthwash on my hair, gargle with lotion, or rub shampoo on my skin. In the lobby I met some of the others with whom I had come up from Seattle. They were equally psyched! One woman was freaked at how clear everything was. She could barely read the Ramada Inn sign before, and now she could read everything. At the Institute I got a post-operative exam. They said they could not even tell I'd had surgery. I was 20/30 in my left eye, and 20/20-15 in my right. Success. Go back Since thenThe trip back on Thursday was great. The day was brilliant and sunny. The Cascade Mountain Range runs close to the coast in northern Southern BC/Washington, and it was snow capped and gorgeous. The farm fields were wet and just showing greenery. The sky was deep blue, the air clear, and the van was full of gawkers! I could drive home from Focus EyeCare with no problem. A bit early to bed, and the next day, I started to read all sorts of stuff. Kip says I read all the fine print I could find. Well, maybe. Go back Post-Operative LogFriday, 24 March, 2000 Took it easy. Read a bit, did some computer stuff, played with the dogs, took a walk. No strain. Saturday, 25 March, 2000 Went to the gym. I could check in on the computer (no i.d. cards) without guessing which keys I was punching. My photo has me wearing specs. Keeps me humble. Got a sweatband to keep sweat out of my eyes. Not bad lifting weights, but I did not bust a hump on it. Maybe I should have held off; you have to wash your hair after a workout, and I have discovered that eyelids do not really shut out all water. Felt the layoff time, too. Sunday, 26 March, 2000 Worked around the house. Began a new book, and am amazed still that I can read without specs. Distance is still fuzzy. Monday, 27 March, 2000 Went to work. Did some instructor-led computer-based training, but I could not see the projected screen in the front of the class as I moved around among the students. They asked a lot of questions about LASIK, though. This distance blurring is a bit troublesome to me as an instructor in front of a class-full of people, but it will settle down. Did a good workout at the gym, and it felt much better. Talked to my Krav Maga (self-defense) instructor and told him I'd be in the next class session next week. He promised to start out with heavy-duty head punches. Great. Tuesday, 28 March, 2000 More of the same. Doing training is okay, I just have to look at students’ screens rather than the projected screen up front. Good gym time, but aerobics only. Weights do not put much strain on my eyes. Wednesday, 29 March, 2000 First follow-up eye exam (1 week). Quick and easy. 20/25 in my left eye, 20/20 of a bit better in my right. The eye guy said he could barely see any incision. Recommended I use the eye drops much longer than the After-Care literature says. He gave me a different kind, Tears Naturale Free. It has no preservatives and comes in small plastic ampoules. Feels great. Second week I love to read, and may be over-straining my eyes a bit. Still blurred, and it gets worse as the day goes on. Should take a long hike in the mountains or on an island in the Puget Sound so I won’t have to focus on anything too closely. I want to get a magnifying glass, as this will make some reading easier until my eyes settle down. I find that I get minor headaches that are relived with an application of the tears. Krav Maga class began. I think I’ll get some eye protection. Too much banging around (not head punching). Got a bit of a finger in the eye during escape-from-a-headlock practice. Not good. One month later I have done 2 weeks of stand-up training. A bit of a strain on the eyes, but I handled it. Did my 1 month follow-up. Things are still a bit blurred, but better. I can read in bright sunlight just fine, but in dimmer light things are fuzzy. The doctor showed me that this had to do with how much more light is pouring in so I can see more clearly. Remember the cones and rods and day versus night vision? That's it. Two months later I got a good poke in the eye in my Krav Maga class last week, and went to the Clinic to have it checked out. No harm done and everything is preceding normally. 20/20 in my left eye, 20/25 in my right. The doctor suggested that I could get reading glasses (Lasik doesn't correct presbyopia) of 1 to 1.5 diopters. I got two 1.25 diopter specs at a local drugstore - $22. They really do help for close up reading and computer work, but are useless for anything more than 3 feet away. They seem to be magnifiers, actually. Very helpful. Nine Months Later After nine months I can say without qualification that I am glad I got this surgery. No regrets, but more things I did not expect and have to adjust to. The biggest is that I now putz around with glasses more than I ever did before. Previously, I would put my specs on in the morning and take them off at the end of the day, more or less. Now, since I do not need specs for seeing clearly beyond 2 or so feet, I do not need to wear them much. However, for reading I do need them. This can be a challenge in some situations. This summer we went to Arizona to visit friends and tour around. As my friend drove, I navigated. I ended up putting the specs on to see the map and taking them off to look out the window. Over and over and over again. When I go to the store, I carry the specs most of the time, but need to put them on to read. In the evening, I often read and watch TV. I put the specs low on my nose to look down to read and to look up to see the tube. I did read that some women who had the surgery in March were suing the Lexington Clinic over injuries. Seems they claim lots of problems with light at night, lack of clarity at the periphery, and infection. I have no insight or information into the issue, so you might want to check that out. April, 2003 It has been just over 3 years since the surgery and I am still happy with it. I went to an ophthalmologist a year ago and he was very happy with the technical results. He gave me a full exam and recommended drug store glasses - one set for reading (1.5 diopters) and one for computer work (1.75 diopters). The distances for each are slightly different, but enough to make two sets needed. I just leave the computer one at my computer. Juggling glasses has become pretty routine. Go back Things I was not expecting
The Bottom Line
DefinitionsAstigmatism - the cornea has an irregular shape. Objects both near and far are out of focus. Farsighted - distant objects are clearer than nearby objects. The eye is too short for the cornea to accurately focus images on the back of the eye. LASIK - (Laser in-Situ Keratomileusis) is done by cutting a flap on the cornea. The flap is folded aside, and the cool-light laser zaps part of the inner cornea. The flap is returned to position, and held in place without stitches or protective contacts. Informed consent - you know what they are doing, you understand the risks, you agree to have the surgery, and accept that there are no guarantees - in writing and signed. You get the form before you go, so you should know the drill well ahead of time. After-Care Kit - TobraDex antibiotic drops, GenTeal Artificial Tears, plastic eye protectors and low-tack tape, 1 Tylenol Extra Strength, printed post-operative instructions, big blocky sunglasses like Roy Orbison used to wear. |
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