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Laser Eye Surgery

By theantix in Technology
Thu Nov 08, 2001 at 06:08:00 PM EST
Tags: etc (all tags)

Eight months ago I undertook LASIK surgery, which corrects vision problems using a procedure often referred to as Laser Eye Surgery. To date, the procedure has been a resounding success for me, and I would like to share my experiences with this technology to those who are interested or curious in the procedure.

What is commonly referred to as "laser eye surgery" actually refers to two separate procedures. Photorefractive Keratectomy (PRK) was the first procedure developed, followed by the newer Laser-assisted Intrastromal Keratoplasty (LASIK). There are other procedures as well, but they are much less common than LASIK and PRK.

PRK is an older procedure and is rapidly being replaced by LASIK for most patients. PRK involves using a specially tuned laser to burn the surface of the eye until it matches a predefined shape set out by the doctor. Since this procedure affects the cornea (the outer layer of the eye), it is often associated with a great deal of pain. However, the amount of pain varies from person to person, usually high-strength pain killers (codine) will be enough for most people. A more detailed explanation can be found here.

The procedure I undertook was LASIK. This surgery involves cutting a corneal eyeflap, and using the same method as PRK to alter the shape of the layer underneath the corneal flap directly. After the re-shaping takes place, the original flap is replaced. Since there are no nerves where the burning takes place, it does not involve any pain. A more detailed explanation can be found here.

The most realistic risk of the procedure is that you will have to undergo the procedure a second time. Sometimes the doctor will be conservative and under-correct the eyes. In other cases the procedure is successful, but the eyes will regress over time and require some fine-tuning in a second operation. Unfortunately the eyes need to heal before another procedure is done, and there can be several months of wearing interim prescription glasses that is different from the original one. This risk varies depending on your original prescription and the accuracy of the doctor performing the procedure.

The other realistic risk is a slight degradation in nighttime vision. The halo that accompanies bright lights at night will be enlarged for many people, but again it varies from person to person. For the first several months, it may be difficult to drive at night, and to read backlight signs. However this goes away for the vast majority of people after several months.

Another risk is termed "haze" and refers to a slight degradation in clarity, while still retaining good vision. I understand this sounds contradictory, but having experienced this myself, it does in fact occur. You retain 20/20 vision, but everything looks as though it is covered with a thin film, it is similar to a difficulty in focusing. Again, in most cases this usually does not last more than a few months.

With the PRK procedure, there is risk of infection because the surgery is done to the exposed eye. The clinic will provide anti-inflammatory drops that should prevent most problems. With the LASIK procedure there is a risk of shifting the eyeflap, it is critical not to rub your eyes for the first two weeks after the procedure is finished.

There are other risks though. In a small percentage of cases, patients will have to continue to require glasses, often with a different prescription. Also in very few cases the eyes will not be able to achieve 20/20 vision even with. According to my research, there have been no cases of blindness from anyone undergoing laser eye surgery as of this writing.

For a quantifiable estimation of risks, visit this page. Many clinics will tout results much better than this, so these should be considered very conservative.

The main benefit it obvious: you can see! But there are countless benefits that are difficult to quantify or predict before the surgery, so I will list some of my personal favorite post-op benefits.

  • Sunglasses. Before it was required to get prescription sunglasses made, requiring a several hundred dollar purchase, and was restricted by style and lens type.
  • Activities. Water-skiing, scuba-diving, swimming, many sports are possible with glasses, but are much better enjoyed with corrected eyes.
  • Simple Things. The pleasure of waking up in the middle of the night and reading the alarm clock without fumbling for glasses is enormous.
  • Kissing. It sounds silly, but it is really great not to poke your partner in the face with cold glasses while kissing.
  • Others. Not experiencing the panic of losing or breaking glasses or contact lenses.
  • In short, the feeling of having vision unencumbered by an external device is simply wonderful. And you can't quantify that!

    Where to go:
    If you decide to undergo the procedure, or are trying to decide if it is right for you, choosing your clinic is an important step. Before my surgery I visited three different clinics, and had a radically different experience in each one. The first clinic was The Laser Center (TLC) who actually denied me surgery on the basis that my glasses-prescription had shifted within the last three years. I appreciated that a great deal, so two years later, I visited the same clinic again. However, they were undergoing a complicated change-of-management so I stuck with the doctor instead of the clinic, and visited The Pacific Laser-Eye Center (Pacific). The price quoted to me by Pacific was $4,000 (CAD) for both eyes, much greater that others in the area.

    So I visited a local clinic (which I will leave unnamed) for the purposes of comparison. The difference was outstanding. At the local clinic, the price quoted was $1,900 (CAD), but I was appalled at the business practices. The doctor approved me for the procedure before reviewing my medical history, and when I confronted him on this he derided it as unimportant. The success rate that he predicted was much higher than predicted by TLC or Pacific, which I read as shucksterism, not a genuine prediction. So I chose the more expensive clinic with the doctor that I trusted, even though the cost was more than double the cheaper place. If you are investing laser-eye surgery, I strongly encourage you to ensure that choose a reputable clinic. Try to find other people in your area who have had the procedure done, and investigate the various clinics as much as possible.

    The surgery:
    I chose to have the LASIK procedure, because I preferred the personal risk of rubbing my eyes over the external risk of infection. I visited the clinic on a Thursday morning, and arrived bright and early, and very nervous. First the doctor did a final inspection on my eyes to ensure that nothing had changed in the past days since he last saw me. Then, the assistants took me into a separate room for eye-numbing drops, and awaited my surgery. When the room was prepared I went in the room and laid down underneath the scary-looking laser machines.

    At this point I was exceptionally nervous, so they gave me little stress balls to grip. The first step was to cover one eye, and to put a little clamp around the other eye, which felt like a little pinch. This made me unable to blink or move my eyes to any great degree. Then they instructed me to "look at the red light" and the cutting started, as they cut a little circle in my eye around the area. It was quite scary as all of a sudden the little light I was looking at went all fuzzy - the corneal flap was removed! Now the re-shaping was ready to start, and I was strongly reminded to look straight ahead at the red light. Well at this point my blood was pumping so strong and was breathing so hard that they could not continue.

    They turned off all the fancy devices, and gave me a sedative, which was great. Thankfully they stopped before I could do any damage, and felt much better after a few moments. Now, they re-attached the eye clamp, and began the re-shaping procedure. The buzzing noise of the laser, and the smell of my own eyes burning was a bit disconcerting, but it only took a few moments, and they re-attached the flap and patched me up to do the other eye. The second eye went without a glitch and I was off the operating table within perhaps 15 minutes. Afterwards, they did some tests to make sure everything was a/ok, and sent me packing. The entire procedure took only 60 minutes including prep time, my freak out, and the actual surgery.

    As I have stated throughout this article, my results were a resounding success. Right after the procedure, my eye doctor reported that I had 20/20 vision. Of course, I was patched up at the time, and was terrified of shifting my eyeflaps... but I could see like a normal person. These results were confirmed the next day, and again the following week, month, and year. I returned to work four days after the surgery, and resumed a normal schedule after a week. I'd do it again in a heartbeat.

    Note: This topic has been covered before in a different format on Kuro5hin.org, some other excellent testimonials to laser-eye surgery can be found here, here, and here.


    Voxel dot net
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    Are you considering laser-eye surgery?
    o Yes 36%
    o No, risks are too great 23%
    o No, too expensive 9%
    o No, not eligible 6%
    o I can already see without correction 17%
    o I have already got it done, silly 5%

    Votes: 73
    Results | Other Polls

    Related Links
    o Kuro5hin
    o here
    o here [2]
    o this page
    o The Laser Center
    o The Pacific Laser-Eye Center
    o before
    o here
    o here [2]
    o here [3]
    o Also by theantix

    Display: Sort:
    Laser Eye Surgery | 55 comments (53 topical, 2 editorial, 0 hidden)
    Excellent article! (4.00 / 1) (#1)
    by M0dUluS on Thu Nov 08, 2001 at 04:31:31 PM EST

    I felt my heart speeding up during your surgery description! Do I understand you to say that they actually clamped the eye-ball without sedative?

    "[...]no American spin is involved at all. Is that such a stretch?" -On Lawn
    Thanks (4.00 / 1) (#3)
    by theantix on Thu Nov 08, 2001 at 04:42:35 PM EST

    Actually, they gave me a mild pain-killer and some drops that numbed my eyes -- perhaps that could be considered some form of sedative, I don't know. But nothing that would actually calm me down in the way the sedative did. I think I reacted more nervously than most people, because they seemed vaguely annoyed with me.

    You sir, are worse than Hitler!
    [ Parent ]
    Sedatives (5.00 / 1) (#10)
    by smallstepforman on Thu Nov 08, 2001 at 08:50:05 PM EST

    First the nurse gives you a set of eye drops.
    "Do you feel anything now?"

    More eye drops.
    "Do you feel anything now?"

    Another set of eye drops.
    "Do you feel anything now?"
    "Good. That means that the anastetic works, otherwise you'd be running down the hallway screaming."

    [ Parent ]
    Drawbacks (4.00 / 2) (#5)
    by Bad Harmony on Thu Nov 08, 2001 at 05:55:30 PM EST

    The U.S. military has restrictions on this type of surgery. You may need to get your commander's approval and the surgery may disqualify you from certain jobs, such as aircraft crew member or diver. Something to consider if you are considering a military career or planning to become a pilot.

    5440' or Fight!

    I thought 20-20 (3.50 / 2) (#7)
    by Blarney on Thu Nov 08, 2001 at 07:06:31 PM EST

    I thought that people who needed glasses or contact lenses to see 20-20 wouldn't be allowed on a military aircraft crew anyway.

    [ Parent ]
    Nope (4.00 / 1) (#16)
    by wiredog on Fri Nov 09, 2001 at 09:15:46 AM EST

    IIRC, fighter pilots and combat helicopter pilots (Apache's, etc) need to be 20/20. All other crew members, and other pilots, can wear glasses.

    The idea of a global village is wrong, it's more like a gazillion pub bars.
    [ Parent ]

    Laser Surgery in the Military (5.00 / 1) (#12)
    by sse1177 on Thu Nov 08, 2001 at 10:11:21 PM EST

    Last spring the Air Force started performing PRK on active duty members. This "trial" has been so successful that they're expanding the number of locations performing surgery. At current probably only about half a dozen to a dozen fields are ineligible without Commander's approval. Everyone that I've encountered in such situations have recieved approval with only one or two people allowed to get it at a time.

    As part of the doctors speech before surgery, he'd pointed out that the military had chosen PRK over LASIK for it's reduced potential for complications during wartime conditions (flap breaking loose along the scar lines).

    On a personal note: The militaries doctors do an incredible job, especially for the number of them they do within a short time frame. I was seeing 20/15 within two months of surgery.

    [ Parent ]
    Personal Testimonials (3.00 / 1) (#6)
    by Anoymous 22666 on Thu Nov 08, 2001 at 06:00:47 PM EST

    I have to say, I really like your article. In elective surgeries, I have found that many people get very nervous, regardless of what the statistics say. It takes these personal testimonials of quality workmanship by doctors to reassure people.

    I just farted... And I blame the fiction section. - Psycho Les

    Report from someone who had PRK 3 years ago (4.66 / 3) (#9)
    by smallstepforman on Thu Nov 08, 2001 at 08:47:09 PM EST

    I've had PRK 3 years ago, and I'll share my experience:

    During the operation, the surgeon removes protective layers of tissue from your eye with a scalpel, and then zaps your eye with a laser. During the post-operative period, you're given 2 sets of eye-drops (steroids) to help the healing process. One of the eye drops helps heal the layers of protective tissue, ie. it accelerates the growth. At the same time, the other set of eye drops slows down the healing of the lasered eye. Your body tries to 'heal' itself by regrowing the zapped area, which the 2nd set of eye drops tries to prevent.

    Since each of us react slightly differently to the steroids, I've had the problem where my right eye healed too fast, resulting in better vision than before but not 20/20. When I operated the left eye several months later, the surgeon altered my dosage of steroids and the results were 19/20 (almost perfect).

    The surgeon offered to redo the right eye (at no extra cost) but threw an extra element into the mix. I'm 31, and almost everyone in their mid 40's ends up needing reading glasses (pensioners glasses). The myopia in my right can postpone the need for reading glasses to a much later period (maybe even eliminating the need). I chose not to redo the right eye.

    So basically, I'm OK to play football and such, but I choose to wear glasses when watching TV. At work I dont wear glasses (my right eye is perfect for reading paper and PC monitor). After going through it all, I do not regret it. It has improved my lifestyle.

    thanks - great random but applicable info (3.00 / 1) (#11)
    by stego on Thu Nov 08, 2001 at 09:18:16 PM EST

    This article is a good example of why I love this format for a website, and this particluar site especially. I never know what will be here, but odds are I will learn something interesting and applicable.

    My dad had this done... (5.00 / 1) (#13)
    by blackwizard on Fri Nov 09, 2001 at 03:21:31 AM EST

    LASIK, I mean. He was legally blind, and now he has perfect vision. I don't think he has too much trouble seeing at night, but I believe he has to wear reading glasses sometimes to see up close.

    They gave him Valium before the procedure, and let me tell you -- he wasn't stressed at all. He was wearing an ear-to-ear smile the whole time. =) I watched the procedure through a window in the clinic with my girlfriend -- she was considering having it done, but decided against it because she didn't like the idea of having somebody slit open her eye like that. (What if their finger slips? I guess it's important to get a doctor who has done a lot of these procedures...)

    He also had to wear a pair of oversized goggles for awhile, and he had to be really careful about his eyes for a few weeks, i.e. I guess he had to be careful not to get water in his eyes when he was taking a shower, and a lot of other stuff... In his case, there must have been several pages of instructions to follow as far as what to do and what not to do to take care of your eyes post-operation.

    I know he's much happier with his eyes now, all things considered.

    There can be drawbacks! (4.50 / 2) (#14)
    by bgarcia on Fri Nov 09, 2001 at 06:58:44 AM EST

    I too decided to have laser-eye surgery about 3 years ago. I talked to as many people as I could find who had undergone the procedure, and everyone I had talked to said that their eyesight was perfect!

    I opted for PRK, which is a little different from LASIK. In PRK, there is no clamp on your eye, and there is no cutting - the only thing touching your eye is the laser. I found this idea more appealing than worrying about somebody taking a knife to my eyeball, but I realize that it is mostly an irrational fear.

    Unfortunately for me, it appears that the eye doctor who took the measurement of my dilated pupil before the surgery had screwed up. I used to have *excellent* night vision (with glasses or contacts, of course). I could still see things clearly in a room so dark that my wife swears she couldn't see a single thing.

    Now my pupils seem to open wider than the treated area of my eyeball, so some light passes through the untreated portion, resulting in a kind of "starburst" pattern around all bright lights at night. It makes nighttime driving pretty difficult, especially since this glare tends to screw up my depth perception to some degree.

    During the daytime, I couldn't be happier. My eyesight is actually better than normal (20/15), and I no longer have to worry about glasses or contacts. But I did pay a price, one that I have to live with the rest of my life.

    I'm going to get it (none / 0) (#15)
    by MicroBerto on Fri Nov 09, 2001 at 09:06:47 AM EST

    Eventually, I'm going to get this surgery. However, I'm almost 20, and my eyes still degrade a bit each year. Although my main spending concerns are beer and college right now, should I wait until my eye degradation slows down too?

    - GAIM: MicroBerto
    Bertoline - My comic strip
    Yes, you should probably wait (none / 0) (#22)
    by theantix on Fri Nov 09, 2001 at 12:02:39 PM EST

    should I wait until my eye degradation slows down too?
    I would certainly recommend that you wait until your prescription has been stable for a few years. Otherwise you run the risk of losing your corrected vision and having to re-purchase correction (new glasses/contacts/surgery). Some shops will not bother to ensure this before you go in... but the good ones do (in my experience anyhow). With elective surgery, you obviously want to minimize your risks as much as possible, so I wouldn't recommend getting it until your prescription settles down.

    That being said, get it done as early as possible, because your eyes will still require reading glasses at about 40-50 yrs, same as a normal person. So the earlier you get it done, the more years you will have with your corrected eyes. Cost/benefit, you know?

    You sir, are worse than Hitler!
    [ Parent ]

    Look at orthoK (none / 0) (#38)
    by Bwah on Sun Nov 11, 2001 at 10:09:08 PM EST

    Check out orthokeratology. This is a non-surgical option where you end up wearing RGP contacts that reshape the cornea. You wear the lenses at night. During the day you wear nothing, and can go for a couple of days sometimes. The big deal is that this usually slows down degradation.

    This also tends to be cheaper that getting cut on or zapped. Like $1000 in the DFW area. YMMV.

    To redesign an infinite ensemble of universes: what terrible responsibility, what arrogance ... It sounds just like the type of thing your average Homo sap would do for a dare. -- Stephen Baxter
    [ Parent ]

    Wouldn't work for me, darnit. (2.50 / 2) (#17)
    by wiredog on Fri Nov 09, 2001 at 09:28:05 AM EST

    My vision problem is uncorrectable. When I was 11 I got hit in the left eye with a 2X4 as a result of a playground disagreement. It resulted in a scar on the retina. How did an impact on the front of the eye damage the back of it, you ask? The shockwave propagated through the eye and tore the retina. The end result is a scar on the retina that left me with no central vision in my left eye. So while the right eye is 20/15, the left is 20/100. Peripheral vision is good in the left eye, however.

    No central vision in one eye has interesting effects. I have trouble seeing in stereo. Those cool 3-d pictures from the Mars Pathfinder? Some I can resolve in stereo, some I can't. Anything that requires seeing in stereo is very difficult for me. I have trouble hammering nails and drilling straight holes, can't hit a baseball, tennis ball, or golf ball. Either the object I'm swinging moves through the blind spot, or the object I'm swinging at does.

    How bad is the blind spot? Well, holding my copy of the Camel Book at arms length, the 'e' in "Perl" is mostly hidden. The "Progr" and part of the "a" in "Programming" is hidden, as is most of the "O'Reilly".

    Despite that, I was able to enlist in the Army, which only requires one good eye, and am a fairly good shot most weapons.

    The idea of a global village is wrong, it's more like a gazillion pub bars.

    Good shot? (none / 0) (#19)
    by CrazyJub on Fri Nov 09, 2001 at 10:33:57 AM EST

    "Despite that, I was able to enlist in the Army, which only requires one good eye, and am a fairly good shot most weapons."

    Am I the only one troubles by the fact that this guy owns guns? Guns, note that he said most weapons.

    [ Parent ]
    Weapons I'm good with... (none / 0) (#21)
    by wiredog on Fri Nov 09, 2001 at 11:00:43 AM EST

    First, note that firearms only need one good eye for aiming.

    I am (well, was, it's been a few years) very good with the M-16 and M-14 rifles. The .45 cal pistol (given its accuracy) and the 9mm are good weapons, if the enemy is within 20 meters or so. But, having been with infantry units, if they bad guys are that close it's time to move, or fix bayonets. The M-203 grenade launcher is a very easy weapon to use. The stinger AA missile is self guiding and it's a lot of fun. Damn near orgasmic when it lights off. Couldn't shoot the LAW worth a damn.

    The idea of a global village is wrong, it's more like a gazillion pub bars.
    [ Parent ]

    firearms with one eye (none / 0) (#31)
    by kurgan on Sat Nov 10, 2001 at 03:01:36 AM EST

    His left eye was fscked, right eye was actually better than most. Most weapons are designed to be aimed with right eye (and fired right handed, sorry lefties). Colt 1911/1911A1 can be quite accurate. My father once shot better at 80 yards with a 1911A1 (in .38 super) than the local game warden did with a 1894 Winchester rifle. He then cussed the game warden for incompetence, because even a not particularly accurate rifle like the 1894 winchester (typically 3" at 100 yds) a decent shot should be able to beat an expert pistol shot at 80yds. I like the colt1911. Throw it in the mud, drive a truck over it, then pick it up, shake the mud out of the barrel, and shoot it.

    [ Parent ]
    m1911a1 (none / 0) (#33)
    by wiredog on Sat Nov 10, 2001 at 07:00:48 PM EST

    Robust as all hell. But no accuracy unless you've modified it, which makes it less robust. We once clamped a .45 to a sawn off telephone pole, and pulled the trigger three times. The target was about 50 feet away, and the rounds hit in a 3" radius circle. Fun to shoot, though.

    The 9 mil is very accurate, but it jams if you look at it funny.

    The idea of a global village is wrong, it's more like a gazillion pub bars.
    [ Parent ]

    Re: Good shot? (none / 0) (#30)
    by John Miles on Fri Nov 09, 2001 at 07:32:10 PM EST

    Am I the only one troubles by the fact that this guy owns guns?

    Pretty much.

    For so long as men do as they are told, there will be war.
    [ Parent ]

    Best thing I did.. (2.50 / 2) (#18)
    by jspectre on Fri Nov 09, 2001 at 10:24:48 AM EST

    I had LASIK done this past May. Have to say I'm one of their success cases, no more glasses and loving it. I had halos/starring around lights at night (very common) but they gradually faded with time, just be patient. The procedure was quick, simple and painless for me (sorry to hear you got nervous, but that's common, it is a little scary).

    My biggest bit of advice, DO YOUR RESEARCH! Be very thorough and look around. Get statistics on the doctor who is performing the surgery. How long has he been doing it? Make sure the place you choose is using the latest equipment and research the equipment on the web (you can find most of it, try google). It's worth paying a little more for the latest EQ, price will vary by doctor and location, big cities have a lot of competition and lower prices but you are talking about your vision, is it worth saving $500 for less-than-perfect results?

    Since my success 5 friends have gotten it done (at the same chain, Lasik Plus) and all are very happy with the results. YMMV but as I said be sure to do your research into the doctor and equipment being used.

    15% of the populace will never steal. 15% of the populace will steal most anything not nailed down.

    Price not an issue (none / 0) (#20)
    by CrazyJub on Fri Nov 09, 2001 at 10:38:22 AM EST


    $1,500 or $4,000....I'll have to go with the $4,000 one. Why? They are shooting lasers in my eyes, I don't want discount surgery. Hey, if I found a guy charging $5,000 I'd probably pick him, assuming all the credentials are the same.

    Price was an issue (none / 0) (#37)
    by badturtle on Sun Nov 11, 2001 at 09:47:18 PM EST

    I had it done at a place that charged $1000 when I could have gone to a place that charged $5000. Why? Experience. The doctor who charges $1000 does it more often than the doctor who charges $5000. He knows what he is doing better because he has more experience. I had it done 5 months ago and have had no problems.

    [ Parent ]
    Had PRK, wish I had LASIK (none / 0) (#23)
    by tarpy on Fri Nov 09, 2001 at 12:05:17 PM EST

    I had PRK done back in June of 1998 (where it was, suprsingly covered by my father's insurance plan...so I had it done before I lost his insurance after graduating from college). I was the guinea pig for my entire family. Back then there weren't the "have your surgery done in a mall" places, and I went to a real hospital (Mount Carmel, in Cols. Ohio) with "real" doctors doing the work. What theantix says about the pain factor of PRK is correct. I had a great deal of pain, where my sister had none. It's all about the eye, I guess.

    The only other discomfort was the having to wear the temporary "band-aid" contact lens. Since I have the condition where my eyes produce too much "gunk", I couldn't wear normal contacts, and having to wear contacts for three straight days without being to take them out really started to chafe. I've had no problems, the nighttime halos went away after a couple months, and life is wonderful without those thick glasses anymore!

    Sir, this is old skool. Old skool. I salute you! - Knot In The Face

    My very, very negative experience (4.25 / 4) (#24)
    by dmd on Fri Nov 09, 2001 at 12:32:04 PM EST

    Here's my experience-log.

    My experience:
    January 25, 1999:
    Two days ago I was:
    OD -11.75, -1.5
    OS -12.00, -1.5

    Yesterday I had lasik at TLC Manhattan with Dr. Fox...
    Today I'm around 20/30 or so, and 20/20 if I douse my eyes with eye drops... the vision is there, just not the crispness. (I still have some surface irritation, so that's clouding things a bit.)
    But ... I can see! Two days ago, I literally could not make out distinct objects beyond about 18 inches, today I walked around Manhattan without glasses and could see street signs from blocks away...
    This is way more than I expected... I had been expecting at least a week or so to go by before I felt comfortable driving, and while due to the post-op glare I'm not going to try night driving yet, I'm certainly fine to drive during the day. (Two days ago, sitting in the car without glasses I couldn't see the steering wheel, much less the road.)

    February 9, 1999:
    My screen is back to 1024x768 and normal fonts, though it's a bit blurry still. Significant ghosting at night -- night driving is not pleasant on unfamiliar roads as signs are unreadable until 2-3 seconds away at 55mph.
    Eye chart test says I'm 20/40 left, 20/80 right -- but that fluctuates every day. I am using Bion Tears every hour, and everything clears up quite a bit for a few minutes after putting those in. My Dr says that the surface of my cornea is extremely dry and not smooth and that is causing the blurriness. I'd have to say he's right, considering I can see nearly 20/20 for a few minutes after using eye drops. He says that as long as I keep using the drops for a few more weeks, the roughness will go away. My flaps were completely invisible by 1-week postop, with no wrinkles.

    June 26, 1999:
    OD plano, -0.50
    OS plano, -1.00

    Post-correction (same MD, 30 June 1999):
    OD plano, 0
    OS plano, 0

    I've had serious problems with healing due to dry eye and my vision has been consistently cloudy. My co-manage eye doctor says my eyes are gunked up with sloughed-off epithelial cells. Dry-eye is made worse by my eyelids not closing all the way at night.

    Although my eyes are technically zero sph/cyl, I get about 20/40 OD and 20/80 OS on the Snellen. Problems with photophobia since the June correction -- I need to wear sunglasses outside even in very overcast weather.

    At no time since the original procedure in January has my vision been better than 20/40 for more than a day or two.

    The dry-eye is treated with lots of drops (celluvisc) during the day, and Refresh PM at night with eyes taped shut. I've had significant improvement in the past week or so since I've started taping my eyes shut at night, but still no better than 20/40 or so.

    My night vision is worse than 20/100.

    December 28, 2000:
    I wear glasses again. Thin ones, granted, and I don't always have to wear them -- in fact, sometimes I forget to put them on, and don't realize so until hours later...

    ... but wasn't the point of LASIK to not have to wear glasses?

    I think the technology still has a ways to go before it's ready for primetime.

    I still have NO night vision. Imagine driving at night with a sheet of crinkly plastic wrap in front of you. Every point source of light is a muddy starburst that spreads to cover half my field of vision; bright lights completely blind me, even if they're in my peripheral vision.

    April 2001:
    If I could go back in time and undo my LASIK, I would.

    That really sucks! (none / 0) (#27)
    by theantix on Fri Nov 09, 2001 at 01:03:27 PM EST

    If I could go back in time and undo my LASIK, I would.
    That's awful... it's horrific how different our experiences have been. Have they told you what went wrong, why it didn't work? Are they optimistic about future treatments that can help your night vision? Is your photophobia and night driving still as bad as in dec/2000, or has it improved some?

    You sir, are worse than Hitler!
    [ Parent ]
    bad interface (none / 0) (#36)
    by dmd on Sun Nov 11, 2001 at 12:49:11 AM EST

    Essentially, the interface between the replaced flap and the rest of my cornea is not as smooth as it should be; additionally, the corrected area was not large enough. There is some hope that newer technologies will allow repair, but I'm going to give it at least a decade or so before I try.

    [ Parent ]
    What was your pupil size in dim light? (none / 0) (#29)
    by John Miles on Fri Nov 09, 2001 at 07:30:26 PM EST

    I've shied away from LASIK because my pupils expand to nearly 8mm in dim light, which seems to be one of the more common predictors of problems like the ones you describe. Did your surgeon or optometrist screen you for pupil size before the operation?

    For so long as men do as they are told, there will be war.
    [ Parent ]
    9mm (none / 0) (#35)
    by dmd on Sun Nov 11, 2001 at 12:47:24 AM EST

    Yes, I was screened for pupil size (9mm), but they (Drs Speaker and Fox, arguably two of the top ten LASIK surgeons in the country) decided it wouldn't be a problem.

    [ Parent ]
    Damn! (4.00 / 1) (#39)
    by John Miles on Sun Nov 11, 2001 at 11:10:50 PM EST

    That is unconscionable. I can't imagine why they wouldn't have sent you packing with pupils that large. Almost all the LASIK horror stories seem to be associated with either dry eyes (which can't always be predicted reliably), unusually-large pupils, or both.

    I'm still thinking I'll probably do the LASIK thing someday, if and when I can no longer tolerate contacts as well as I do now, but I'm under no illusions about the tradeoff I'll be making. If I don't lose most of my night vision, I'll consider it a pleasant surprise.

    Are you able to use pupil-constricting drops at night to drive? I've heard that some drugs (pilocarpine?) can help.

    For so long as men do as they are told, there will be war.
    [ Parent ]

    pupil-constricting drops (none / 0) (#40)
    by dmd on Mon Nov 12, 2001 at 09:20:34 AM EST

    Yes, I've tried the drops; they help somewhat, but not enough to make it worth the effort. I've actually trained myself to keep my pupils somewhat constricted by fixing on bright lights now and then, and I've gotten really, really good at the blurry video game that night driving has become for me. I've always been a good driver anyway (800,000+ miles (I'm 23 years old) and I've never had an accident of any kind or even been pulled over).

    [ Parent ]
    since when is 1 in 100 'good odds'? (1.50 / 2) (#25)
    by turmeric on Fri Nov 09, 2001 at 12:37:26 PM EST

    " This means that after the procedure, even with glasses or contact lenses, you may not be able to see as clearly as you did prior to the procedure. Incidence: 1 in 100" this is from the page you link to. i am apalled that people think this is acceptable odds. would you worry about anthrax? 300 million people in the US, 3 or 4 got anthrax, and everyone is scared. thats like 1 out of 100 million. ok, now this 'hazy vision' thing is 1 out of 100. A MILLION TIMES MORE LIKELY. this proves how insane people can be , and how ignorant of statistics. is 'less than 1%' is some kind of demented phrase thought up by medical marketers? How frigging much less than 1%? 1% of the US population is 3 million people, or the entire state of oklahoma! 1% of the world population is 60 million people, roughly california + texas! more people than died in the second world war! Imagine this: "Global warfare involving genocide, nuclear weaopns, and massive bombing raids of civilian occupied cities has a less than 2% chance of having serious side effects. However its great for the economy!"

    settle down there... (none / 0) (#26)
    by theantix on Fri Nov 09, 2001 at 12:54:35 PM EST

    " This means that after the procedure, even with glasses or contact lenses, you may not be able to see as clearly as you did prior to the procedure. Incidence: 1 in 100" this is from the page you link to.
    Okay, you make a good point about the misuse of statistics, but you are overlooking three things:
  • This risk is about losing better than 20/25 vision. Some people with glasses or contacts get better than this, while many do not. Infact, very many people that do not wear glasses have 20/25 vision already and do not notice any problems.
  • The risk is overstated in the TLC page, as I noted the risks are overstated. The other clinics I visited quoted a significantly better rate that this one: approx 1/5000. The 1/100 statistic includes people that will eventually regain their crisp vision after 6-12 months.
  • The risk of serious damage (not reaching less than 20/25 vision) is less than the risk of wearing contact lenses for 30 years. This was actually the kicker for me, what helped me overcome the fear of the risks.

    You sir, are worse than Hitler!
    [ Parent ]
  • safer than contact lenses,but what about glasses? (none / 0) (#28)
    by turmeric on Fri Nov 09, 2001 at 01:18:48 PM EST

    It is interesting that contacts are so likely
    to cause damage.

    1/5000 is better, but it still sucks.
    If 50,000 people go to work every day in a sky
    scraper and the elevator has a 1/5000 chance
    of screwing your eyes up, then 10 people a day
    are going to have their eyes screwed up!
    What is the risk for glasses?
    Wtf causes myopia in the first place? Could
    it be that paying more attention to user
    interface ideas in computer screens could have prevented this myopia? Is it something in books?
    Who knows? Who cares! Lets all get risky
    surgery and then let the insurance
    take care of the people it hurts!

    [ Parent ]
    Bates method (none / 0) (#34)
    by frabcus on Sat Nov 10, 2001 at 07:38:42 PM EST

    You can also improve your eyesight by exercises, such as the Bates method.

    The eyes work the same way as every other part of your body - their ability varies over time. e.g. Late at night, your sight deteriorates as you get tired. If you exercise (which for Bates is really a kind of resting), you can improve the performance of your eyes.

    Of course, this won't make you able to see perfectly if you have very bad eyesight. If you just have an irritating loss of vision, it can help though. I used to be hyper-sensitive that everything in the distance was a bit blurry, but now I rest my eyes more my vision is much more comfortable. And computer use doesn't irriate me as much any more.

    [ Parent ]

    Myopia (none / 0) (#48)
    by Robert Uhl on Fri Nov 16, 2001 at 04:55:43 PM EST

    Could it be that paying more attention to user interface ideas in computer screens could have prevented this myopia? Is it something in books?

    It's due to the fact that man did not evolve to see things up close, but rather further out. Books are horrible for one's vision. So are computers. It involves staring at things which are far too close for us. C'est la vie.

    [ Parent ]

    Why should that trouble me? (3.00 / 2) (#32)
    by locke baron on Sat Nov 10, 2001 at 04:23:31 AM EST

    I've fired an M-16 also. Although I currently have no guns (plan on getting a .30-06 rifle for target shooting, just to keep my hand in), I have several swords (battle-ready blades, kodachi and katana).
    My point: not everyone who has, or has used, weapons is a violent, irrational, dangerous brute.

    Micro$oft uses Quake clannies to wage war on Iraq! - explodingheadboy
    Something LASIK can't do (3.50 / 2) (#41)
    by morcheeba on Tue Nov 13, 2001 at 01:01:21 AM EST

    About 4 months ago I got colored contacts. Deep, surreal green. They look great and I'm loving them! If you're considering colored contacts, here's my advice. I went through a lot of trouble to learn this.. the doctor was nice, but didn't tell the whole story.

    There are two types of colored contacts.

    The first type is transparent and has a solid color in a circle. This usually works better with light-colored eyes and lighter colors. This tints your vision (Don't worry, you'll get used to it) so it might not be good if you need to accurately use color (photographer, illustrator, etc.)

    The second type is opaque one the outside and clear (non-colored) in the middle. The opacity allows lighter colors to be put on darker eyes. Usually the opaque pattern is printed with a screen (dot-matrixish) to let it better blend in with the eye. Also, the pattern attempts to replicate the look of the iris. This type can limit your peripherial vision! (That was something I refused to do, so I don't know how well you'd get used to it). Also, the dots of the screen were visible on my eye, and it didn't look natural to me.

    I got a couple free samples to try and decided on the clear ones. My optomitrist wasn't too good, and when the clear ones weren't available in an astigmatic prescription, she got the opaque ones with consulting me. I couldn't stand them (the "blinders" effect -- these things were supposed to help my vision, not hurt!), and eventually got custom-tinted lenses.

    It seems like the lenses are moving towards the opaque versions, which is a shame. I think a transparent version with a non-tinted center would be perfect, but noone makes these.

    My pair of astigmatic lenses cost $200 each, which is a bit pricy, but well worth it. I'm pretty sure that the store ate a good deal of the custom-tinting costs to fix their mistake. Normal non-astigmatic lenses should be much cheaper.

    And, if you feel crazy, you can get some scary designs: white-out (a la Marilyn Manson), cat-eye (oval-shaped), alien, reptile, 8-ball, and there are even places that will copy your drawing onto the lenses!

    Why don't people do one eye at a time? (2.00 / 2) (#42)
    by morcheeba on Tue Nov 13, 2001 at 01:11:06 AM EST

    My sight's too precious to risk hurting both eyes at the same time! Even if it was double or triple the cost and inconvenience, I'd want to do only one eye at a time.

    Sure, I could have problems with uneven eyes (possibly causing headaches) should I decide not to risk the second eye, but at least I'd have my vision. I'd rather have to put drops in the bad eye and see out the good eye than put drops in both bad eyes... well, you get my point... Worst comes to worse, I can always wear an eyepatch/totally opaque cosmetic contact and have monocular vision.

    So, what are the arguments against one-eye-at-a-time? I'm curious about the medical aspects and the financial (surgeon's) aspects.

    Recovery time (none / 0) (#46)
    by Merc on Thu Nov 15, 2001 at 05:32:11 PM EST

    You spend a week with your eyes itching like crazy, but unable to do anything about it. You can't see anything, and (sometimes at least) they water like crazy, I guess they think something is stuck in them.

    If you get both eyes done at once, you go through that one time, otherwise you go through it twice. I think it's better to stay home for a week or two and tough it out with both eyes giving you trouble, rather than go through it twice.

    [ Parent ]
    Quick question for the poster|some comments (3.00 / 3) (#43)
    by dasunt on Thu Nov 15, 2001 at 10:04:16 AM EST

    What was your eyesite before the laser surgery?

    What is it now?

    Is there any computer specific problems you've noticed (such as with LCD|CRT screens being harder to read?)

    I'm something like 20/800 vision, and I've been considering such surgery myself, since it doesn't seem like I have much to lose. :) But I know my eyesite is very bad, and most people who have this surgery probably has better eyesite then me, thus my results may very.

    answers... (1.00 / 1) (#45)
    by theantix on Thu Nov 15, 2001 at 11:38:51 AM EST

    What was your eyesite before the laser surgery?

    Well, I was -2.5 in one eye, and -2 in the other eye, with heavy astigmatism. I am not certain of the 20/? rating of my eyes previously to my surgery... certainly not as bad as yours. Now, it's 20/20. =) You make a good point about your having not much to lose with 20/800 vision (is that legally blind?), but it will complicate the surgery. The more correction required, the bigger the chance of undercorrection, and regression. That means you are more likely to have to redo the procedure in a few months.

    I know one person that I work with, his wife had similar vision to yours (I think). She had it done, had it corrected the first time to 20/40 vision, but it regressed after a few months to 20/80 vision and had to get it done a second time. Then, it was 20/25, and last I heard it was sticking.

    Is there any computer specific problems you've noticed (such as with LCD|CRT screens being harder to read?)

    Nope. I use a PC 10+ hours a day at work, at usually several hours at home too... and I wouldn't say there are any problems at all. At first it was a bit blurry, but after about 2-3 months the crispness was back 90%. Now I would venture 100%. But that being said, I went to work with few problems only 3 days after my surgery.

    You sir, are worse than Hitler!
    [ Parent ]

    Answer to your question (5.00 / 1) (#47)
    by dasunt on Fri Nov 16, 2001 at 01:12:35 PM EST

    Yep, 20/800 is legally blind.


    OTOH, its not the same as being blind. I can identify blurry objects at a good distance (people, etc), but my eyesite is so bad that I don't try to read without glasses.

    [ Parent ]

    My decision (1.00 / 1) (#44)
    by dze27 on Thu Nov 15, 2001 at 11:27:26 AM EST

    I have fairly bad vision, -10.5 in both eyes, but no astigmatism. I've considered getting the surgery but for me, wearing contacts corrects my vision just fine, to better than 20/20, and it's barely an inconvenience. The downside just seems too serious compared with 30 seconds a day to pop contacts in and out. The only thing I can think of where contacts suck is for water sports, and I can't swim anyway, so that's a non-issue for me.

    As for the benefits theantix suggests, obviously "kissing" (not that I'm getting any of that, anyways) and "sunglasses" are not problems with contact lenses. I understand the point of "simple things" but I'm kind of used to fumbling around for my glasses in the night by now. Actually, every so often I fall asleep with my contacts in (don't do this!) and then when I wake up I think I'm cured! I'm also not particularly worried about losing a contact lens since they're inexpensive and I have several old backup ones that would do in a pinch (and I haven't lost one yet in 11 years, knock on wood).

    Just my 2 cents... it's a personal decision and I've made mine.

    "Luck is the residue of design" -- Branch Rickey

    Mine too (none / 0) (#51)
    by smarfoo on Sun Nov 18, 2001 at 01:33:44 AM EST

    I agree with you dze27 - I started wearing contacts about 5 months ago and I love them. All the benefits of 20/20 vision without the hassle of glasses. And considering the risks involved in laser surgery, I certainly think contact lenses are the way to go.

    Why risk your night vision, get that haze effect, possibly have to go back for a second procedure and maybe still require glasses/contacts in some situations, when it takes 30 seconds to pop in a contact lens? The disposable lenses these days are 66% water so the majority of people don't suffer from dry eyes. And I can't feel them when I'm wearing them (except when I accidentally trap an eyelash behind them *ouch*!). As far as I'm concerned, the only time I am short-sighted is 1 minute at night before I go to bed and 1 minute in the morning.

    Sure, in the long term the laser surgery could be cheaper (c. $200 US for 3 month supply of contacts), but I'm happy to pay the extra to keep that laser away from my eye! And until I stop seeing optometrists wearing glasses, I'm reluctant to even consider the surgery option.

    I respect everyone who has gone through LASIK or PRK - you've got more guts than me!!

    I have not lost my mind - it's backed up on disk somewhere.
    [ Parent ]

    oops - my mathematics career in trouble (none / 0) (#52)
    by smarfoo on Sun Nov 18, 2001 at 01:41:20 AM EST

    Correction - $50 US for 3 month supply of contacts :)

    I have not lost my mind - it's backed up on disk somewhere.
    [ Parent ]

    Another option to laser surgery ... (2.00 / 1) (#49)
    by Bwah on Sat Nov 17, 2001 at 09:37:15 PM EST

    would be Intacs.

    <DISCLAIMER>I haven't done this because I don't qualify (vision is too good. Don't qualify for laser either. I suppose this is actually a GOOD thing :-)</DISCLAIMER>

    However, since any kind of surgery that removed tissue always made me nervous, Intacs looked like a good alternative since they can be removed. The company that makes these is called Keravision. They used to have a web site, but I can't seem to punch through right now.

    Anyway, something else for people to think about.

    To redesign an infinite ensemble of universes: what terrible responsibility, what arrogance ... It sounds just like the type of thing your average Homo sap would do for a dare. -- Stephen Baxter

    Pick your surgeon with care (1.00 / 1) (#50)
    by pmacko on Sun Nov 18, 2001 at 01:23:20 AM EST

    I used to work with Tammy (the first person mentioned in the linked story).

    Foundation helps people deal with laser eye surgery mishaps

    Please consider getting informations about the Bat (none / 0) (#53)
    by nicolas on Mon Nov 19, 2001 at 08:17:30 AM EST

    I know eye surgery is attractive. it's a quick fix. However, as many people have pointed out, this is far from being risk free. Also, it doesn't adress the root cause of bad vision, and you can't go back once you've done it. Luckily, there is an other, natural ways to cure eye defects.

    I've already written an article about this here (which could have been written in a better way, but english is not my main language).

    You definitively have to check this page too. In fact you should check it first, it is much more complete and clearer than my article.

    Time has passed, and I can confirm that this method has worked for me, and that I am still improving my vision. However, I am now also aware that this is not for everyone. This method implies a major change in consciousness, and most people will probably need the aid of a psychotherapist to go back to normal vision (I'm considering it, but I'm damn proud :). It is also pretty long, but your efforts are paid back a thousands time, and clear vision is far from being the only benefit.

    To me corrective eye surgery is an abomination, and I'm sick at the idea. Please, please, take a little time to inform yourself about the Bates method, and if it somehow ring a bell, give it a fair try before attempting eye surgery.

    By the way, I want to thanks the guy on kuro5hin who had the neat idea of flooding my mailbox with interesting spam, about healing AIDS with crystals from outer space, and the like, just after my article was posted. This was so 31337 and open minded from you.

    A good site (2.00 / 2) (#54)
    by NoShadow on Mon Nov 19, 2001 at 03:32:39 PM EST

    If you are seriously considering Lasik, please do yourself a favor and look at this site and read through the true stories that people have posted there.

    Personally, I can not justify taking the risk of messing up my vision for the rest of my life just so I don't have to wear glasses. Granted, there may be a lot of sucess stories, but there are also a lot of stories like those listed on surgicaleyes.com , and I have no intention of ever posting my own story on that site.

    And what's wrong with glasses/contacts anyways? Would your quality of life improve that much if you don't have to wear them?

    Just my two cents.

    reasons (none / 0) (#55)
    by theantix on Mon Nov 19, 2001 at 04:50:31 PM EST

    I have no intention of ever posting my own story on that site.
    Neither do I.
    And what's wrong with glasses/contacts anyways? Would your quality of life improve that much if you don't have to wear them?
    Glasses are a phyiscal object that needs to be brought with you in order to see. They can be lost or broken, rendering you without sight. I've lost my glasses a few times in my life, and recently had them broken when I was dancing and someone accidentally elbowed me in the head and they got smashed by other dancers. I had to have a friend to drive me home, and I missed a 1/2 day of work. Also, check out the reasons I listed in my article. I would say my quality of life has improved dramatically since the procedure, and would do it again with no questions asked. Of course it isn't for everyone, but I just thought I would share. Information is good, and your link is also good to know of as well.

    You sir, are worse than Hitler!
    [ Parent ]
    New technique may give BETTER than 20/20 (2.50 / 2) (#56)
    by snub on Tue Nov 20, 2001 at 09:02:09 AM EST

    There's an interesting article in this month's Popular Science magazine about researchers using a new technique for LASIK. Link here. What they did was use a laser first to map the way light is reflected off the cornea, then they use an algorithm to compute the perfect shape of the cornea for focusing. Once this is done I would guess that the algorithm guides the laser during the surgery to reshape your lens as perfectly as possible. The result is 20/10 or better vision! The article said that it could be commercially available within two years.

    "Shredded cabbage and mayo go good together."
    Cole's Law

    Laser Eye Surgery | 55 comments (53 topical, 2 editorial, 0 hidden)
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