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Laser Eye Surgery, Revisited 10 Years Later
gunner_von_diamond (3461783) happened upon Ask Slashdot: Experiences with Laser Eye Surgery from ten years ago, and asks: I was just reading a story on /. from 10 years ago about Lasik Eye Surgery. Personally, I've had Lasik done and loved every single part of the surgery. I went from wearing contacts/glasses every day to having 20/15 vision! In the older post, everyone seemed to be cautious about it, waiting for technical advances before having the surgery. Today, the surgery is fairly inexpensive [even for a programmer :) ], takes about 10-15 minutes, and I recovered from the surgery that same day. So my question is: what is holding everyone else back from freeing themselves from contacts and glasses?
...my astigmatism is too great for lasik.
It is better to be the hammer than the anvil.
I'm not a candidate because my eyes never stop changing. So if I had it, in a year or two I'd just need glasses again.
When the figure out a way to "stabilize" the eye itself, or whatever's affecting things, then great. But until then, glasses/contacts for me.
I'm missing part of a finger, but I can manage.
I could live with a limp.
But eyesight is a pretty big gamble. Yeah its small. But still higher than lottery.
That's why I opted for orthokeratology. I put my lens for one night, once every 7-ish days, and have 30/20 vision for the first 24h and then 20/20 for the rest of the week.
I'm not sure that this is still true, but don't you go blind for a few minutes while the procedure is going on? That's what frightens me - the thought that I might go blind and not have my sight come back.
Yes you do (but it is seconds, not minutes). The part of the procedure they don't really tell you about in advance is that they basically use a vacuum cleaner to suck your eyeball out of your head while they do the procedure. Actually they use suction to slightly pull on your eyeball and hold it still while the laser is doing it's work; while this is happening, you can't see out of the eye -- it all goes dark. This part of the procedure (which really only lasts for a few seconds on each eye) is fairly unpleasant and is probably the reason they give you Valium.
It depends on the specific procedure. I had PRK done and I could actually see the LED target get clearer with each shot of the laser during the actual surgery. But yes, take the valium... It's extremely stressful to be immobilized for such a long period of time and having your eyelids clamped open.
Yes it's an anecdote! Were you expecting original research in a Slashdot comment?
I Lasik on both my eyes 7 years ago, and it was the best $4000 I ever spent. Went from 20/50 and 20/200 to 20/15 and it hasn't changed since. My big concern was dry eyes. Mine were dry frequently at first but after about 6 months it went away and now it's like I had good vision from the start, I don't have to take any extra care than average. I don't have any haloes or night vision problems either. Sometimes at night I still marvel at how crisp all the neon lights look from a distance.
My advice on the whole thing:
1 - Don't cheap out, you only have 2 eyes. Go to the best place in town. They offered a "custom wavefront" option for a few hundred more, basically it was a better/more automated scanning technique that helped customize the procedure for my eyes and I went for it. The procedure I had used a laser to cut the corneal flap and I think the entire thing was automated, the doctor just verified everything and then hit "go".
2 - Follow all their instructions to the letter and beyond. I wore the night goggle things twice as long as they said to and was religious about taking the different eyedrops, not swimming, not touching my eyes, etc etc. I didn't rub my eyes for 18 months but now I do whenever I feel like it. I wear safety glasses when I'm doing woodworking but the occasional chip still sneaks in there and it doesn't cause any more problems than normal. Anyway I didn't have a single hint of a complication and I think following the directions went a long ways towards achieving those results.
3 - Wait until your prescription doesn't change for a few years before getting lasik. I had to wait until my mid 20's.
I had it done about 11 years ago. The day after I had it done, one of the flaps came loose (left eye) and I had to go back to have it re-seated. Then the day after that it came loose again, so I had to have it reseated (again). The day after that it came loose AGAIN, so they put a contact on it and left it there over the weekend, and even after all that, one of the edges of the flap became wrinkled, which makes that eye see more blurry in low-light conditions.
About a month later, my right eye had a sharp pain, so I went to the doc who said nothing was wrong. For the next 6-8 months, I had vision in my right eye that was torqued and weird looking, giving me massive headaches. I went back for a checkup at that point, where they said the edge of the flap on my right eye had come loose, and cells from the surface of that eye had grown under the flap. So we scheduled another appointment, where they lifted that flap, cleaned it out, and put it back. It has stayed in place since then, but there have been other effects:
I can't get less than about 7 hours of sleep per night for longer than a few nights in a row, otherwise my right eye dries out and gets blurry and the headaches come back, I can't sleep on my front because my eyes dry out and I can't see, I can't rub my eyes hard, night vision is significantly worse than day. For about 4 years after the re-seat on the right eye, I had to carry lubricating eye drops around with me all the time.
Even as I type this, my right eye is slightly dry and blurry, giving me a headache. I realize I'm in the 0.1% of people who have issues, but I wish I had just stayed with glasses/contacts. At least you can take those off or out and they don't permanently damage your eyes.
As many who have replied to you have already noted, they do full remapping and correct for 2nd and 3rd order abberations. It's amazing tech now. If you can, go in for the free scan where they do a 3d surface map of your eyes, the detail and resolution of the mapping machine is just pure nerd-porn, especially if you're an optics guy. I've done both eyes, and would like to share my story: I've been extremely near-sighted with astigmatism my whole life. I'm now in my late 30s, and my eyes stopped changing in any real fashion about 5 years ago -- they stabilized around -8.75 diopters of correction needed. I'd always worn disposable contacts, but hated being blind at night when they were out. When I was 5 or so, I walked into a branch that left a scar on my left cornea that previously excluded me from lasik -- UNTIL the new 3d wave mapping came out. They did have to use the blade to cut the flap on my left eye (as opposed to the ilasik cutter on the right eye), but I can now see at 20/25 out of my left eye for the first time since I was 5. Previously it was correctable to a best of 20/40. They actually almost totally removed the scar tissue automagically while at the same time corrected for the extreme nearsightedness. I'm a believer. If you are worried about the night vision effects, those are truly present in the first couple of months. Those that say they're not are the same people that don't notice the low bitrate on satellite radio.. ;)
After about a year, however, I personally have zero effects, starbursts, rings, hazing, or lack of contrast anymore. It takes a while for the lens to heal up, but it did for me.
Negatives:
I now need UV protection in the sun. I didn't realize that my contacts previously provided UV blocking, and the sun is annoying now without sunglasses.. :)
That's not entirely accurate, and to me is high on the scare-factor. As someone who has had LASIK, here is the full procudure:
They have you come in and lie down on a table. They then use a very small device, really nothing more than just a couple of wires, to prop your eyelid open. Next, they do use a very tiny bit of suction to pull on the eyeball (I couldn't really feel it, but your mileage may vary), to ensure you can't move it very much during the operation (the eye does still move slightly, but the laser can track the movement and compensates or cuts off - it does the same if you twitch your head). They then use a laser to cut a very tiny flap in the front part of the eye, and the device causes it to flip open. This is the moment you go "blind". The reason is because once that flap has been moved, the normal refraction of light onto your retina no longer occurs. They used to use a very small blade, but from my understanding the laser is cleaner, has basically zero risk for contamination/infection, and creates a more precise cut. At this point, they shoot the laser onto your eye. This is probably the most frightening moment, because while you don't see or feel anything (even with the eye not currently being operated on), you can smell what is happening. However, it really does not last very long, 60 seconds in my case, and the doctor counted down the time for me (your mileage may vary on this). Once he was done, he put the flap back, removed everything, put on a contact lens used as a "band-aid" on the eye and told me to go home and take a nap. I had a follow-up in the afternoon, and I had something like 20/40 or 20/50 vision. The contact lens came off, and I could do things that day. By the next morning, I was back to normal. I ended up with 20/30 vision at the end.
Personally, I never was given anything to help me relax. The closest thing was a small animal-shaped pillow to keep my hands busy and out of the doctor's way. If a person is really nervous, they may give them a Valium, but that is a case-by-case/doctor-by-doctor thing, not standard procedure. Frankly, it was one of the easiest doctor visits I have ever had. At most, it is about fifteen minutes of being slightly uncomfortable, pretty much all of it a mental thing, and then your done.
Remember, you can't look dignified when your having fun! Don't take life too seriously, you'll never get out of it alive
That's what happened to me. I got the surgery when I was around 23 or 24, and yeah I had 20/15 vision for at least a year, but my eyes kept changing. After about 7 years I went back for glasses and to talk about doing the surgery again. I was advised that 7 years between surgeries is risky, because the original cut portion would have healed and they would need to cut it back again. Additionally, the possibility of complications had risen, I had something like a 20% chance of things going wrong like my lens collapsing from being too thin after 2 surgeries, things that would be fairly serious for my vision. 20% is a fairly low chance, but I considered it unacceptably high when dealing with my vision. My doctor also said that, as my eyes are now, I won't need reading glasses when I'm older. I opted to just get contacts and glasses again. I went back for contacts again recently and my eyes had only barely changed from the previous prescription. If I had waited until around 32 or 34 to get it done the first time then it probably would have stuck around a lot longer. It was really great while it lasted though.
"Our two-party system is like a bowl of shit looking at itself in a mirror." - Lewis Black
Halos are caused by the correction area being smaller that the dilated pupil size, has nothing to do with the type of LASIK.
More info: http://www.usaeyes.org/lasik/f...
The most common post LASIK problem is actually dry eyes, 50% of patients.
It is certainly not a perfected surgery IMHO.
Also the fact that it won't prevent future changes to vision. I'm thirty now, and my vision still continues to slowly get worse. I fear I'd be paying for a 5 year reprieve from glasses and then be back to wearing them with side effects I also have to live with for the rest of my life.
I had PRK since I had too much correct to do normal lasik. Its essentially lasik but they don't cut a flap first, has a longer recovery time, but is actually more accurate than lasik. I went from a -10.5 diopter prescription with contacts (pretty thick if I wore glasses) to 15/20 vision without. The only noticeable side effect was a very slight halo effect around bright objects at night. This is caused by the edges of the laser correction area becoming visible when the iris is fully dilated. For heavier corrections the max diameter of the correction area depends on the prescription and how much material they can take off in the center of the correction area, and for lasik how big they can cut the flap.
I made it about 10 years without glasses after that and now use very light prescription glasses mostly for driving and reading. I still don't need glasses for most things, and its awesome to see the alarm clock in the middle of the night without having to fumble for glasses first. I also don't worry about losing a contact and having to drive home with very impaired vision. I don't regret the decision at all even though I'm back to wearing glasses.