On Thursday, June 23, 2011 at about 11:30am, I had LASIK. It took years of coming to terms with the idea that if something failed I may end up blind for the rest of my life. Having come through the procedure successfully, and with practically no issues whatsoever so far, I wanted to give a basic heads up on what's involved in having LASIK, and what you should expect based on my experiences.
Consultation (~ half hour)
Choosing a place to have LASIK is the only decision you'll have to make. For me, I polled some friends to see where they had been and 2 here in Orlando suggested Dr. Magruder -- including one who had successfully had LASIK there the year before. An optometrist friend of mine suggested the same place, and for me that settled it.
Consultations are typically free, so this the time to shop around if you want to. Prior to talking with the doctor that will be doing the procedure, you will have eyes mapped out, your prescription checked and your tear generation measured. These measurements, coupled with a few basic questions, let them know if you're a good candidate for LASIK.
The only part that is uncomfortable is the tear generation test. Small tissue-like papers are put under your eyelids and kept there for a minute to measure your body's automatic response. Most people tend to have dryer eyes after LASIK, so if your eyes are already extremely dry according to this test, it's a warning sign.
If you're a candidate for LASIK, you will probably talk to the doctor that will be performing the operation next. In my case Dr. Magruder was extremely personable and seemed to want to stay and keep prodding me for questions to make sure I'd asked everything that was on my mind. This the typical part where he'll go over the format of what to expect.
If you're interested in going forward at this point, you'll end up talking with someone who sets up the appointments. They'll go over the billing details, any discounts or financing available. In the case of the place I went, the procedure would be $5,000, which includes the pre-operation appointment, follow up appointments for a year and any adjustments necessary in the first year. They also offered a $500 discount if you schedule your operation within a month of your consultation (although the discount cannot be used if you use financing).
They listed out some dates they have available, and went over what the next steps would be if I did decide to have the procedure on one of those dates. I didn't feel pressured to make an appointment right then and there -- instead they gave me all the information I'd need to make it on my own, and call back to schedule it. I called back and made the appointment a few days later (after Marilyn had confirmed taking a day off to help me).
Types of LASIK
The Wikipedia Article on LASIK goes into much more detail, but the two forms flap creation (might want to read the wikipedia article if that term isn't familiar) are either by laser or blade. I went the laser route.
Depending on what type of contacts you wear, you will need to stop wearing them for some time before the actual procedure can be performed. This ranges from 14 days up to 2 months for harder lenses. If you don't wear contacts there is no waiting period required before proceeding
Homework before the Pre-Operation
After calling in and scheduling the procedure and the pre-operation, they called in two prescriptions for me to pickup at my local pharmacy along with an over the counter lid cleaner. 7 days before the procedure the lid cleaning began twice a day. The two prescriptions they gave me were:
- FML Forte - Used for treating inflammation (swelling, warmth, redness, pain) of the eyes and eyelids.
- Ofloxacin Ophthalmic Solution - Used to prevent infection
Both of these eye drops were started 5 days before the surgery and taken 4 times per day.
Pre-Operation Exam (2 hours)
The pre-op is the most intensive eye exam you've ever had. Think of this way - if after you have LASIK you discover you have XYZ wrong with your eye, it's difficult to prove if it was a result of the LASIK or not. Their protective response to this is a very long examination of every millimeter of your eye.
- Re-scan and mapping of your retina
- Thorough eye sight test (the "which is clearer, #1 or #2?" test)
- Numbing drops following by measuring your cornea (used for creating the flap later on)
- Tests for blind spots in your vision
- Eye dilation followed by thorough investigation with a head mounted magnifying glass
In the last part, they were able to uncover that have I small holes in the back of my retina, which is why I occasionally have seen floaters in certain parts of my vision. I rarely ever saw these, but it was interesting to know the actual cause of them.
After the op is over, you're given the usual sunglass shields (to protect your dilated eyes), and are now set for surgery.
Operation Day (2 hours total, 5 minutes of action)
You won't be able to drive home, so you'll need someone to accompany you the day of the procedure. After getting there, they'll go over things once more, and give you instructions on what to do in the time following the procedure. For me this included:
- Don't expose your eyes to bright sun.
- Go home and sleep for 6 hours.
- Take the 2 eye drops you have even more often (FML Forte every 2 hours, Ofloxacin every 4).
Once you know what you're in for, they give you a Valium to calm you down. Having never had Valium, I didn't realize just how much this calms you down. After waiting 20 or so minutes, and with absolutely no fear at that point, they led me into the operating room. There are three stages to the procedure, each taking a very short time.
Creating the flap
In reading about LASIK, or watching The Discovery Channel, this always looked like the worst part of the procedure. They put a corneal suction ring in place around your eye to hold it in place while using a laser to cut a hole and in your eye and fold it back. While this sounds like a highly invasive part of the process, I actually had to ask the doctor "Did you just create the flap?". There was no pain, and no discomfort - I didn't even know what hit me and the process took only a minute or two.
At the place I went, they had one chair for flap creation and another for the procedure. They led me over to the second chair, but I could still see alright even with the flap created. I imagine this is because I had IntraLASIK rather than the steel blade method.
After laying down in the chair they lowered a large machine down over one eye at a time. They asked me to stare directly at the green light at the very center while the red lasers that took up most of my vision did the work. At this point my vision became so blurry that all I could make out with a red haze, but I tried to keep my focus on where I thought the green light used to be. The equipment is smart enough to track your eye to impressive accuracy (4,000 times per second), so it'll stabilize for minor movements. Do you know that smell when you're at the dentist having your teeth drilled? During this stage I was able to smell the same thing.
My perception of time might be off, but the entire procedure couldn't have taken longer than 5 minutes.
Repositioning the Flap
After everything is set, the doctor took what felt like a very damp paint brush and lightly brushed the flap closed. This only took a few seconds.
Immediately After the Operation
I kept my eyes closed for the drive home, but I wasn't feeling any pain at this point (thanks to the Valium). My eyes weren't itchy, but I took their advice and downed a Tylenol PM and went to sleep. The 6 hours immediately after are considered the worst, but it's easy to knock yourself out for that period. Your eyes heal best when they are closed, the more sleep you can get, the better off your eyes will be.
6 hours later I woke up and could see pretty darn well. Over the next few hours vision returned more and more to where I was seeing almost as well as with glasses. Things would occasionally go slightly blurry and my eyes would have trouble adapting - similar to the feel when you wake up in the morning before your eyes focus.
The day after the procedure, they wanted to schedule a follow up to see how things were progressing. This is a really quick followup where they do an old fashion eye test (the big E test) and the doctor asks you a few questions. The day after the procedure my vision was 20/20 in my right eye and 20/25 in my left. According to the doctor it takes a few days for the swelling in your eyes to go down, and in that time your vision will improve. The best thing to do in the meantime is stay on top of your eye drops.
For me the hardest part of the entire experience came after the follow up. This is when your eyes are most sensitive to light and your body hasn't yet adjusted to the new vision you're now seeing. After 6 more days when I discontinued the anti-pain/inflammatory drops my eyes went through withdrawal for a night. They were both extremely itchy and all I wanted to do was rub them. By the next day the itching had subsided.
The night visor only needed to be worn for the 6 days after the procedure. This is just to prevent you from rubbing your eyes in your sleep or sleeping on them wrong.
The only side affect for me was that my eyes are now a little dryer than they used to be. Unless I was wearing contacts, I never needed to use eye drops. Lately I have been finding myself using them once or twice a day (at most). The oddest realization was that the feeling of having "dry eyes" seems to feel different than it did before. It's a tough change to explain, but it's not uncomfortable to the point where eye drops have ever been urgent, or even required.
By the Monday after the surgery I was back at work programming all day without any problems. Twenty days later my vision is up to 20/20 and things are going great! If you've been thinking about getting LASIK, based on my experience it's a good time to do it. Good luck!