Laser Eye Surgery

So those of you who know me would say I tend to be quite verbose, i’ll try to shorten this as best I can.  If you want to know more, just email me at derek@hatfield.on.ca.

LasikMD is giving away free consults right now so I decided to go check it out. I inquired for more info on April 13th and finally emailed about an appointment on April 21st and received one on May 29th.

On May 29th the appointment was at 1pm and I was told it would be two hours. By 3pm I was just leaving the clinic, but be prepared to have some waiting in between tests. They were pretty thorough in my tests, having me tested with machines I’ve never seen before. They took pictures of my corneas and even did some neat topographic mapping of my eyeballs. Some neat things, no pain and no dilation the first time.

I read that there was a clinical trial going on at this particular clinic and inquired to the optometrist and the other techs that saw me. After my tests I was told that I was an ideal candidate and could ask further after seeing the last consultant who would tell me about the cost. I was told Lasik would be about $2800 for both eyes and Zyoptix (Waveform) would be $3500. I’ll explain those two shortly. As well, if I was interested in the trial, it would be $2000, much cheaper, but the risk of it being a trial, plus I would need to come back more often as I was being tested and observed for the study.

So I went home and did research on the Aspherical Laser and found out it has been around in Europe and Asia for a while and the States just finished their study but no results have been released yet. I opted for the trial after reading what I could.

Ok, so you’ve read lots so far, but let me get a bit more detailed.

Lasik is explained good here:  http://en.wikipedia.org/wiki/LASIK

Essentially they take your eyeball and cut open a flap, lift it, and use a laser to blow away microns of cornea, put the flap back and you are left with a slightly flattened cornea. Which you can now see through.

With Zyoptix (waveform): Zyoptix, the laser is faster, with shorter pulses, works over a larger area and removes 20%-30% less cornea. It is more customizable to each eye and has less complications. It is more money but a much better procedure and if you didn’t qualify for Lasik, you may with this one.

The Aperture Laser is essentially (as explained to me) the same as Waveform, uses the same laser but new software. It works more at keeping the shape of your eyeball spherical and does this by doing more laser pulses in the outer area. This is what I got done.

One more word on the procedures. Lasik works on a smaller area, and removes more cornea so the flattening is more pronounced. If you have a weaker prescription, small pupils and/or thick corneas, this will work for you. The higher the prescription the more cornea they have to remove. So if you have high prescription, or thin corneas, you should opt for Waveform and Lasik probably previously disqualified you. With larger pupils, because your eyes open so much more at nght, they tend to go beyond the area that was treated, so you get the “halo effect”. This is where lights have this soft glow around them. With Waveform, as it works over a larger area, it helps make this halo effect less pronounced. I didn’t think I had the halo effect until it was described to me, heck I’ve had it all my life and never noticed. After the surgery it is much more noticeable, but even a week later, has subsided alot.

Got all that? My prescription was -3.00 in the right eye and -3.75 in the left. Average pupil size is 6mm, above average is like 6.5mm-7mm, mine were 8mm, everyone there kept noting how big mine were! haha. BUT I have nice thick, healthy corneas.

So because I opted for the trial, they asked if I could come back the next week for the surgery, I would get in sooner being part of the trial, but they noticed I had worn my contacts six days previous and I needed to be contact free for seven. So I had to wait and come back to do all the tests again.

My next appointment was June 15th and I did all the tests again. My eyes barely moved and I was good to go for my June 18th surgery date. I was up late the night before, so I notice when tired, my eyes slip a bit, so I was actually closer to -4.00 in the left, and almost -3.25 in the right.

On June 18th I went in, got tested all over again and I was back to -3.75 and -3.00, eyes were stable and good to go. Jennifer with whom was leading the study sat me down and explained the importance of the next week, my eye drop regime and NO TOUCHING THE EYES!! VERY BAD. I paid the fee, and had the option of getting the drops prescribed to save money, but just landed up paying the $60 for them. She also asked me if I wanted something for my nerves and I said heck ya. I got an atavan, but didn’t know what the hell it was until I researched it later.

There were other people getting the surgery done at the same time, we were lining up like cows to the slaughter. One guy was there with his wife, he had the surgery the day before but was back for his checkup and found out he had an inflammation in his eye and they wanted him back next day to check it. Nothing serious, but it happens to half the patients. He told me what to expect and one guy that was in front of me also told me about it after he came out. The first guy told me you will see two lights, but focus on the top one, as they are both red. Later I found out he is red/green colour blind and only one is red, the top one and the green smaller dot like one below is the surgeon’s.

So I’m sitting there, and people know I get nervous. Heck, I needed nitrous oxide to let the dentist clean my teeth a few years ago. I’m told over and over it’s painless, but things go wrong right? So here goes my experience

The Surgery:

I sit there, Haley (self proclaimed “drop lady”, cute and younger) puts the numbing drops in my eye. I wait for a while and she puts in some more, they only last 15min or so. I get a lovely medical hair cap, the latest fashion she claims. The one lady patient comes out and I know its my turn shortly.

I get called in and the heart jumps out a bit, not sure if that atavan helped, but I’m not super nervous, but a bit. The doc doing the survery is Dr. Avi Wallerstein, one of the two founding doctors for LasikMD and one of the two qualified in Canada for this new procedure. He sits me on the table and goes over my chart with me. Says (again) I have really big pupils, so good I’m going the Waveform path, moderate to high prescription, but really nice thick, healthy corneas, plus this will also fix the very slight astigmatism I have. Whoa, back up, I have that? I ask him about it, and he says no eyeball is perfect and usually people have some slight form of it. Mine is barely there, but the laser accounts for it, ok, cool, another plus I didn’t even know about.

So he asks me to lay down, ugh, it’s starting. There is a nice form fitting head sponge there, your head doesn’t move. They also give you these stress balls, which believe it or not, help, mine were crunched pretty good until half way through my second eye when I knew it was almost over.

I ask them to keep my eyes wet as I have dry eyes and to talk to me, ALOT, its what I learned from the dentish that helps my mind. If mentally I’m kept distracted, physically I do much better. Plus I really am interested in technology, I find it really cool.

They tape my left eye shut. He brings over a piece of tape, scotch or masking, not sure in front of my right eye. He does it so deftly that it raises my top eyelid, then he does the bottom. All the while he is telling me EXACTLY what he is doing, where he will touch me, everything, and I have to admit it was very comforting.

Then he puts in the speculum. If I spelt that wrong, shoot me, but he says ok, you’ll feel some pressure on the left side of your eye (remember it’s numb, so you can poke it all day and not feel much). When it goes into the tear duct area, it does feel a bit wierd, almost uncomfortable, but it’s not for long. He winds it open and I said I like to blink alot, but with this thing, you can try to blink, your other eye will, but not this one, hehe. They are always putting drops or water on your eye, ala Clockwork Orange, I was waiting for Beethoven’s 5th.

At this point I black out and wake up in an alley with a missing kidney. Oh wait that was a movie the other night. No, no, at this point he puts another device on the speculum and I see for a while, but it gets darker and darker. He says I’ll feel some suction and I hear him winding something again. It feels like my eye wants to pull out of the socket, again, no pain, just a bit wierd. Eventually it does go all dark, I swear he was turning something. The device comes off and he is also talking to the room of people. Great flap Derek, he says, they put more water on it, then says to look at the red laser and four short blasts of the laser will happen.

I see the laser, well a starburst red light easily, then he lifts my flap and he says it may smell a bit. It goes a bit fuzzy. The laser makes a loud electrical snapping sound and I do smell some burning flesh, but it is very slight. It happens four times, and he counts it down, almost congratulating me each time. The flap may have been open for hmm, a minute in total?

He closes the flap, it is kind of milky, underwater looking. Then he says usually the left eye is more sensitive and I ask why, but don’t remember an answer. The speculum going in felt wierder, almost uncomfortable, but again, not too bad. The cranking that I guess was slicing my flap though was wierd because I knew what was coming this time. My eye looked up, or I thought it did and I thought I was going to get sliced below my pupil, but no, it was in the proper spot. At this time any discomfort I knew was behind me and I started to relax. The laser part really is nothing. You hear a sound, it fires, you smell it a bit, but that’s it. He puts the flap back down, waters it and untapes me. That’s it.

The whole thing might have been 10 minutes. I was in the room for less then 15. I do get my eyes examined to check out the flap and surgery. He really likes the result and asks if a visiting optometrist can see, go nuts I say. The other guy looks and smiles and nods, he seems happy. About five people were in the room. I go out and Haley is there waiting.

I have four types of drops, an anti bacterial, anti inflammatory, and two types of lubrication (one regular tears and one heavy duty gel like tears). Haley does my anti bacterial and 10min later the anti inflammatory. As it drains in the tear duct you do taste it a bit, I think it is almost metallic, like buckleys or something.

An hour passes with you wearing your dark sunglasses, you can’t take them off inside or out for 2 days. They check me out and say I’m good to go. I came in for 10:20am got the surgery at 12:30 and was out the door by 1:45 or so.

I went to the hotel, grabbed a sandwich, still not able to see clearly, still kind of milky underwater vision. I kept my eyes closed all day except for maybe two hours and listened to audiobooks. The Road by Cormac McCarthy and thought I would relisten to the Potter one coming out in theatres. I ate dinner in the room, but did leave to get it, things were a bit clearer.

Slept a lot, lots of eyedrops, taped the eye shields to my face while I slept and spoke to the parents and Aziel for a bit. No shower either, blah.

Ate breakfast the next morning, and got my eye exam at 8:15am, I’m 20/20, but slightly off on my right eye. They attributed it (as did I) to my eye still healing as I found my left clear but right still slightly milky/fuzzy. They did note my left eye had a slight inflammation and wanted me to come back a couple days later to check up on it. So it being Friday they would have wanted me Sunday, but we pushed it till Monday.

All weekend my eyes itched, but I never touched them, even using the shields the first couple nights to be safe. I had my anti inflammatory drops increased to every two hours, but I religiously used them all. Each day they are less itchy. I did notice the light and computers were hard to use very long at first.

I went in for a 5min checkup Monday, they said my left eye was still inflammed and were not overly concerned as it was much less so then the previous checkup. I am to go in for my week later check up soon to test my vision and make sure my left eye is good!

That’s it, did you get all that?

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