Friday, May 11, 2007

For Those Who Are Considering LASIK

About 48 hours ago I had LASIK done on both eyes. For those of you who have ever considered the procedure, I thought I'd give you a play-by-play and my post-op thoughts. It might help you make a decision for or against it.

First of all, I chose to use my opthalmologist that I've been seeing for a decade. She's one of the best doctors in the city and she's been doing the procedure for as long as I can remember. Also she has always invested in top-of-the-line equipment. She's not the cheapest in town by a long shot, but I trust her and I trust her equipment. It pains me to write this in print, but I paid $2400 per eye, which covers all the pre-op and post-op care for an entire year.

I met with my doctor a couple weeks ago for the pre-surgery consultation. She needed to run some tests to see if I was still a candidate for Lasik. She said she could do Lasik on my left eye but wasn't confident that it was safe for my right eye. She said the cornea might be too thin to cut the flap of cornea. She said we would re-check using a different scanner on the day of my surgery. She also recommended PRK as an option. PRK corrects the vision by using a laser through the surface of cornea. However, after reading all the materials I decided against PRK. It has a higher risk for scar tissue forming, plus the pain level and recovery time are greatly increased. I wouldn't be able to drive for at least three days after PRK, and that just isn't an option for a mom of three kids.

So PRK was out, but I was still willing to just have my left eye corrected if I could. The vision in my left eye is -4.00, but the vision in my right eye is only -1.00. Since I'm right eye dominant, I've been using my right eye to see distance for the last 20 years anyway.

My doctor also gave me a large packet of papers that I needed to read through and sign. I had to initials a couple dozen times and write out statements such as, "I understand that I may need to wear corrective lenses even after the Lasik procedure" and "I understand that Lasik can cause partial and full blindness." I'm sure all doctors need to protect themselves from lawsuits since this is a voluntary, partially cosmetic procedure. Lasik is FDA approved and is much safer now that they don't use blades to cut the cornea, but it's hardly risk-free. The greatest risk is from infection, but I'd be getting antibiotic drops to prevent that.

On the morning of the procedure I arrived at the LASIK facility, which is actually on the 12th floor of a bank building. There were warning signs on the front door that people with any form of cologne or perfume could not enter. In addition, I was not allowed to have on any makeup, hairspray, or anything else "scented." I couldn't wear makeup for two days prior and I can't wear makeup for another four days after the procedure. A whole week without under-eye concealer is not a pretty sight.

The assistant took me back and performed an OrbScan, which measures the thickness of the cornea. Thankfully, the OrbScan confirmed that I could safely have the procedure. The machine provides a colorfully cool printout that shows the detailed view of any astigmatism and the overall shape of your eye.

Then the assistant used a different machine to measure my level of myopia. This took a while but basically it confirmed that yes, I can't see well. All that information was put onto a memory stick.

My doctor met with me and double-checked the computer's suggestion for my level of refraction. She did the old-fashioned, "Which is better, one or two?" with the refractive lenses. In the end, she confirmed that the computer was accurate and she would just do what it had suggested. She numbed my eyes and drew on the whites with a blue pen. She said this would help the laser line up the eye perfectly.

My doctor gave me some Valium (bless her!) and verbally explained what would happen during the procedure. I wish she'd told me a little bit more, because a few things surprised me. However, here's what happened.

With my hair in a lovely blue hairnet, I laid down on a dentist's type chair. The nice doctor gave me a teddy bear to hold and reminded me for the 20th time that I just needed to relax and think about relaxing thoughts. Yeah, that didn't really work for me in labor, either. Anyway, first they put a whole bunch of numbing drops in my eye. Then they shoved this plastic speculum in my eye to hold it open, and then they placed a suction ring on the cornea to hold it in place. They turned on the suction and I felt a ton of pressure on my eye. My vision quickly blacked out due to the pressure. My doctor counted down as the laser cut the flap of the cornea. They released the suction, which was actually a little painful and startling, and then they repeated the procedure on my other eye. They had some trouble getting that enormous plastic speculum in my left eye, and that didn't exactly help me relax. And the suction ring broke blood vessels in my left eye, so now I have a bright red arc across my cornea. My doctor calls it an eye hickey and says it will go away.

After they cut the flaps, they swung the chair around so I'd be under the second laser. They used tape (somewhere between a surgical tape and duct tape based on how much it hurt when they pulled it off) to keep my upper and lower lids WIDE open. The doctor told me to keep focusing on the blinking light above me, which was a little difficult since it moved aorund a bit. She lifted up the flap of cornea and everything got fuzzy. I kept staring at that blinking light and the laser zap zap zapped my eye. I didn't really feel anything but I could smell something burning. Uh huh, that would be the smell of my own eyeball on fire. OK, not that bad. But definitely a slight burning smell.

When the laser finished doing its thing, the next five minutes were highly uncomfortable. They irrigated my eye incessantly with saline. That is an extremely frustrating sensation when your instinct is to blink but you can't. They put in a half-dozen other drops that were antibiotics and anti-inflammatories. Then the doctor gently put the flap back down and used some kind of spatula to smooth it back into place. That part reminded me of smoothing the bubbles out of wallpaper. She did this for a minute and I could see that spatula keep coming toward my eye. It was a little disconcerting but it didn't hurt. What did hurt was when they finally removed the tape. I imagined all my lashes coming off with the tape, but I still have some left. I happily closed my eye and tried to mentally prepare myself for the next eye.

In all, the entire office visit took just over an hour. I donned some dark sunglasses and Kevin drove me home. I put on the obligatory protective goggles and slept for nearly four hours, thanks to the Valium which had finally kicked in. My eyes stung when I went to sleep but they didn't hurt at all when I woke up. My eyes felt itchy the first day and the next day, but today they feel normal.

After my nap, I had to put a series of drops in my eye every hour on the hour. One was just a lubricant, and one was a steroid to help reduce inflammation and promote healing of the cornea. I also had a prescription antibiotic and another prescription for a steroid that supposedly helps me make more tears. I faithfully put those drops in every hour and then slept again that night with the goggles on.

Yesterday I went back to the doctor for a follow-up. She tested my vision and said that I could see 20/20 out of my right eye and about 20/25 out of my left. It doesn't feel like I can see 20/20, though. My distance vision is amazingly better, but I can't read my computer screen. (So if there are tons of typos, I'll correct them later. I'm typing this with my eyes closed because I have a headache.) I drove yesterday afternoon and today with no problems. I am seeing well but not as clearly as I had hoped. My doctor says it will improve a little bit every day, so I'll report back in a couple weeks and let you know what I think. Right now, I'm wondering a little if this was worth it. If I have to wear reading glasses, then I didn't reach my goal.

My left eye is also extremely tired today. For the last 20 years I've depended mainly on my right eye to see when I didn't have my contacts or glasses on. Now I'm having to use both eyes together and I'm realizing how weak my left eye is.

I haven't been able to wear contacts very often for the last couple years because of chronic dry eye and frequent infections. That was the major reason I wanted Lasik. Wearing glasses is not extremely convenient, especially during the summer months when I'm in and out of the pool all the time. I also wanted to be able to swim laps without hitting the wall. I'm hoping that the frequent flare-ups in my left eye, which looked like pink eye but wasn't, will stop. Time will tell whether that condition continues.

I'll let you know how my vision improves over the next week. But right now, the jury's out on whether I think I made the right decision.


Stephanie said...

You are so brave. I think I'm even more chicken after hearing your report. I've given birth twice with absolutely no drugs, but for some reason that's just different. I'm not big on my contacts, but I don't think I could muster up the courage that you have. ANd I can't believe you can blog iwth your eyes closed, and only miss one letter!

Stephanie's dad (Mr. Z) said...

Thank you so much, Chelsea, for the play-by-play. I'm signed up for Lasik on both eyes on May 24 w/ Dr. Alan Baribeau in San Antonio. I had an FAA flight medical exam scheduled for the week after; after reading your stuff, I'm going to make the flight medical exam for TWO weeks after, instead.

I will be eagerly reading your updates!

I had a Radial Keratotomy on only my left eye about 25 years ago (didn't want to bet the farm and end up totally blind if it didn't work). I'm right eye dominant and so the RK worked great for a few years but gradually my left eye started going along for the ride. It's now a flabby puppy; can't see well at any distance.

I'm not sure what that says about corrective kerato-surgery; in retrospect it would have worked better (I think) had I done both eyes. Well, here we go.

I'm learning to fly a trike; an open-air flex-wing affair, not unlike a rogallo-wing hang-glider with an engine. If you wear glasses and happen to turn around to see the pretty scene behind you, likely as not your glasses end up going through the propeller and you get to land the aircraft rather literally "in the blind". So I can wear goggles over my glasses, but then have to deal with changing light conditions as well as bifocal prescription. Just too much hassle. So it's under the knife...and tape...and laser for me.

I'm blessed to have a young pioneer fumbling along a few weeks in front of me, and blogging her findings as she goes. Again, thanks.