I am a little suprised by this. Everything I have read (and I read alot, as I just has LASIK done a week ago) indicates that LASIK has the least amount of post operative pain. AFAIK, traditional RK (tiny incisions) is quickly moving to total obsolesence. PRK, which uses an eximer laser on the surface of the eye, is the "approved" use of the eximer laser equiptment. Often it causes some pain for several days following the operation and causes some scarring. LASIK, which uses the eximer laser underneath the corneal flap (which is cut with a "microkeratome") is considered an "off label" (unapproved) use the laser, but is quickly becoming the procedure of choice (I think already > 90% of laser correction). There is generally very little or no pain during or after and minimal scarring. When I first read about PRK and LASIK, I thought PRK was the obvious choice (why would I want someone to cut my eye??) But, I quickly realized that LASIK seemed to be a better choice (IMHO), which is why I ended up having that done. - Mike
I had the LASIK procedure done on both of my eyes last Thursday (1999.10.28). There are already several fairly detailed replies on this topic, and I am probably a few days too late to be of much interest, but here is my experience.
I did quite a bit of initial research and talking to friends, co-workers, and my eye doctor before deciding to have LASIK done. I suggest anyone considering the procedure do the same.
The cost was $4500 for both eyes. I elected to have both eyes done on the same day, which is commonplace but against the official recomendations (I forget the body of Government involved). They suggest you wait 3 months, but that would be highly unusual. I believe over 90% of people have both eyes done on the same day.
I went to a very reputable laser center. However, I choose to have my normal eye doctor do all pre-operative and post-operative care. This is (assuming there is a relationship between your eye doctor and the laser center) known as co-management. Obviously I can not compare my experience directly to a "non co-managed" experience, but I am very happy with this. It turns out that most good laser surgeons do not like to do this type of pre and post op. care (thorough eye exams, testing, etc.). Therefore, it is my understanding that if you do your pre and post op. care at the laser center, you will generally be working with newcomers and technicians, not seasoned eye doctors. I probably spent 8 hours in pre-op in the month leading up to the surgery, which sounds excessive, but it well worth the investment when you consider the nature of the surgury.
Anyhow, that is probably enough babbling. What I may think interesting is the exact sequence of events I experienced at the center:
(0) Starting 1 week before the surgery I start taking rewetting drops 4 times a day, a think lubricating eye drop 1 time a day, and an antibiotic eye drop 2 times a day.
(1) 0:00. Arrive, check in, sign consent form, take 5mg of Valium
(2) 0:05. The laser eye coordinator from my normal eye doctor's office shows up as expected. As far as I could tell I was the only one with an eye care professional in my company, and the other patients quickly started asking her questions about related issues.
(3) 0:10. Go to second waiting room. This room has about 20 people, most of which have eye shields and hair covers on (they have already had the procedure and are waiting, see below).
(3.5) during this time the valium kicks in. 5mg did not affect me much, but I could tell it was doing something.
(4) 0:50. Go to small room with three chairs, a sink, and an employee of the center. I am fitted with hair cover. Then my eyes are rinsed with saline and my face near my eyes are cleaned. I then got anisthetic eye drops (which stung a fair amount). For the next 10 to 20 minutes I sat with my eyes closed (mostly) and got about 30 eye drops (a mix of anisthetic and lubricants).
(5) 1:10. Walk into the laser room. Lay down on bed under cool looking laser equiptment.
(6) Right eye (I think) is taped shut. Left eyelids are propped open with metal device. Several eye drops. There is a little red dot blinking straight up.
(7) Metal device (with a hole you can see through) set on eye. This asserts some pressure, then vision goes black. Apparantly this device causes an effect like glaucoma.
(8) Corneal flap is cut. This was a little disconcerting. You could feel the microkeratome glide over the eye and feel some pressure. There was also a high pitched (dentist drill like) sound.
(9) Metal device is removed. Sight comes back. The doctor peels back the corneal flap which makes sight go very blurry.
(10) Told to stare at a flashing red dot, but not follow it if it moves. Clicking sounds begin. I feel that my eyes are moving a little, and the doctor mentions it once, so I do my best to keep looking straight. Clicking stops.
(11) Corneal flap is returned to position. I can see! But double (or triple) images. Doctor smoothes out corneal flap, which makes the vision come in reasonably well. Bandage contact placed on eye. Eye taped.
(13) Repeat for second eye. I feel that I held this one straighter.
(14) 1:25. Leave laser room (total time about 15 minutes). Clear eye shields placed on head. Back to the waiting room.
(14.5) At this point I can tell my vision is better, but I can not read the various signs around, so I am a little worried that the correction was not optimal.
(15) 1:55. Go to eye doctor office. A different doctor takes a look at my eyes with a lighted microscope device. He says everything is cool.
(16) 2:00. Leave the building and get a ride home.
(17) Get home. Take sleeping pill provided by the laser center. Take a nap (4 hours)
(18) Wake up. Sight is much better than immediately after surgery. Use several eye drops (anti-inflamatory, anti-biotic, and lubricant).
(19) Eat dinner. Chat with a few friends that stopped by. Take second sleeping pill provided from laser center. Lay in bed with eyes shut and talk to friend for a while and eventually go back to sleep.
OK, probably more detail than you wanted. When I got up the next morning, my sight was very good (after I took off the plastic shield anyhow). I went to my normal eye doctor, and everything looked good. I was supposedly between 20/20 and 20/25 at that point. [BTW, my initial eyesite was about 20/400 with -4.75 and -3.50 diopters of near sightedness with trace astigmatism.]
My eyes felt a little funny the first night and following day, but there was never any pain. I am going back to my normal eye doctor in a few days for a 1 week followup. I believe there will also be a 1 month followup.
So far, I do not think I will need to have any enhancements, as I can see well. Time will tell. My eyes do not look quite normal yet. There is one blood "spot" and several pink areas in the whites of my eyes from blood. Apparantly, most contact lense wearers bleed when the corneal flap is cut because the veins grow in close to the eye. This happened to the 3 people that went before me according to my guest. The pink color and blood spot are supposed to fade in a manner of weeks.
NOTE: I stopped wearing my contacts about 1 month before the surgery. Typically 72 hours is suggested, but I was advised by my eye doctor longer is better because contacts soften the surface of the eye and cause other minor effects. These should not matter in the surgery, but why take chances?
I was given a video of the surgery, which is really cool. I had seen one before I went, which I advise.
I have noticed some halos at night, although it is very difficult for me to tell if this is different then before the surgery. It is certainly not severe, and my night vision otherwise is very good (seems better then with contacts).
Anyhow, I hope this account is useful to someone. I would be glad to answer questions based on my experience. Obviously I am pretty happy so far. I found both glasses and contacts to be a pain, and my eyesite was bad enough that I could not cope without correction.
In general, I would say not to hurry, especially if you do not have a compelling reason to get the surgery. There is risk, and I was nervous for a few days leading up to the surgery. Over time the procedure will get cheaper and better. And until this procedure becomes routine (it is still not official approved [it is considered an "off label" use of the laser, where PRK is approved {but inferior in general}] and has only been done to a few hundred thousand people in the U.S.), you should do your homework and find out about the procedure and doctor. (That last sentance sucked - sorry!).
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I am a little suprised by this. Everything I have read (and I read alot, as I just has LASIK done a week ago) indicates that LASIK has the least amount of post operative pain. AFAIK, traditional RK (tiny incisions) is quickly moving to total obsolesence. PRK, which uses an eximer laser on the surface of the eye, is the "approved" use of the eximer laser equiptment. Often it causes some pain for several days following the operation and causes some scarring. LASIK, which uses the eximer laser underneath the corneal flap (which is cut with a "microkeratome") is considered an "off label" (unapproved) use the laser, but is quickly becoming the procedure of choice (I think already > 90% of laser correction). There is generally very little or no pain during or after and minimal scarring. When I first read about PRK and LASIK, I thought PRK was the obvious choice (why would I want someone to cut my eye??) But, I quickly realized that LASIK seemed to be a better choice (IMHO), which is why I ended up having that done. - Mike
I had the LASIK procedure done on both of my eyes last Thursday (1999.10.28). There are already several fairly detailed replies on this topic, and I am probably a few days too late to be of much interest, but here is my experience.
I did quite a bit of initial research and talking to friends, co-workers, and my eye doctor before deciding to have LASIK done. I suggest anyone considering the procedure do the same.
The cost was $4500 for both eyes. I elected to have both eyes done on the same day, which is commonplace but against the official recomendations (I forget the body of Government involved). They suggest you wait 3 months, but that would be highly unusual. I believe over 90% of people have both eyes done on the same day.
I went to a very reputable laser center. However, I choose to have my normal eye doctor do all pre-operative and post-operative care. This is (assuming there is a relationship between your eye doctor and the laser center) known as co-management. Obviously I can not compare my experience directly to a "non co-managed" experience, but I am very happy with this. It turns out that most good laser surgeons do not like to do this type of pre and post op. care (thorough eye exams, testing, etc.). Therefore, it is my understanding that if you do your pre and post op. care at the laser center, you will generally be working with newcomers and technicians, not seasoned eye doctors. I probably spent 8 hours in pre-op in the month leading up to the surgery, which sounds excessive, but it well worth the investment when you consider the nature of the surgury.
Anyhow, that is probably enough babbling. What I may think interesting is the exact sequence of events I experienced at the center:
(0) Starting 1 week before the surgery I start taking rewetting drops 4 times a day, a think lubricating eye drop 1 time a day, and an antibiotic eye drop 2 times a day.
(1) 0:00. Arrive, check in, sign consent form, take 5mg of Valium
(2) 0:05. The laser eye coordinator from my normal eye doctor's office shows up as expected. As far as I could tell I was the only one with an eye care professional in my company, and the other patients quickly started asking her questions about related issues.
(3) 0:10. Go to second waiting room. This room has about 20 people, most of which have eye shields and hair covers on (they have already had the procedure and are waiting, see below).
(3.5) during this time the valium kicks in. 5mg did not affect me much, but I could tell it was doing something.
(4) 0:50. Go to small room with three chairs, a sink, and an employee of the center. I am fitted with hair cover. Then my eyes are rinsed with saline and my face near my eyes are cleaned. I then got anisthetic eye drops (which stung a fair amount). For the next 10 to 20 minutes I sat with my eyes closed (mostly) and got about 30 eye drops (a mix of anisthetic and lubricants).
(5) 1:10. Walk into the laser room. Lay down on bed under cool looking laser equiptment.
(6) Right eye (I think) is taped shut. Left eyelids are propped open with metal device. Several eye drops. There is a little red dot blinking straight up.
(7) Metal device (with a hole you can see through) set on eye. This asserts some pressure, then vision goes black. Apparantly this device causes an effect like glaucoma.
(8) Corneal flap is cut. This was a little disconcerting. You could feel the microkeratome glide over the eye and feel some pressure. There was also a high pitched (dentist drill like) sound.
(9) Metal device is removed. Sight comes back. The doctor peels back the corneal flap which makes sight go very blurry.
(10) Told to stare at a flashing red dot, but not follow it if it moves. Clicking sounds begin. I feel that my eyes are moving a little, and the doctor mentions it once, so I do my best to keep looking straight. Clicking stops.
(11) Corneal flap is returned to position. I can see! But double (or triple) images. Doctor smoothes out corneal flap, which makes the vision come in reasonably well. Bandage contact placed on eye. Eye taped.
(13) Repeat for second eye. I feel that I held this one straighter.
(14) 1:25. Leave laser room (total time about 15 minutes). Clear eye shields placed on head. Back to the waiting room.
(14.5) At this point I can tell my vision is better, but I can not read the various signs around, so I am a little worried that the correction was not optimal.
(15) 1:55. Go to eye doctor office. A different doctor takes a look at my eyes with a lighted microscope device. He says everything is cool.
(16) 2:00. Leave the building and get a ride home.
(17) Get home. Take sleeping pill provided by the laser center. Take a nap (4 hours)
(18) Wake up. Sight is much better than immediately after surgery. Use several eye drops (anti-inflamatory, anti-biotic, and lubricant).
(19) Eat dinner. Chat with a few friends that stopped by. Take second sleeping pill provided from laser center. Lay in bed with eyes shut and talk to friend for a while and eventually go back to sleep.
OK, probably more detail than you wanted. When I got up the next morning, my sight was very good (after I took off the plastic shield anyhow). I went to my normal eye doctor, and everything looked good. I was supposedly between 20/20 and 20/25 at that point. [BTW, my initial eyesite was about 20/400 with -4.75 and -3.50 diopters of near sightedness with trace astigmatism.]
My eyes felt a little funny the first night and following day, but there was never any pain. I am going back to my normal eye doctor in a few days for a 1 week followup. I believe there will also be a 1 month followup.
So far, I do not think I will need to have any enhancements, as I can see well. Time will tell. My eyes do not look quite normal yet. There is one blood "spot" and several pink areas in the whites of my eyes from blood. Apparantly, most contact lense wearers bleed when the corneal flap is cut because the veins grow in close to the eye. This happened to the 3 people that went before me according to my guest. The pink color and blood spot are supposed to fade in a manner of weeks.
NOTE: I stopped wearing my contacts about 1 month before the surgery. Typically 72 hours is suggested, but I was advised by my eye doctor longer is better because contacts soften the surface of the eye and cause other minor effects. These should not matter in the surgery, but why take chances?
I was given a video of the surgery, which is really cool. I had seen one before I went, which I advise.
I have noticed some halos at night, although it is very difficult for me to tell if this is different then before the surgery. It is certainly not severe, and my night vision otherwise is very good (seems better then with contacts).
Anyhow, I hope this account is useful to someone. I would be glad to answer questions based on my experience. Obviously I am pretty happy so far. I found both glasses and contacts to be a pain, and my eyesite was bad enough that I could not cope without correction.
In general, I would say not to hurry, especially if you do not have a compelling reason to get the surgery. There is risk, and I was nervous for a few days leading up to the surgery. Over time the procedure will get cheaper and better. And until this procedure becomes routine (it is still not official approved [it is considered an "off label" use of the laser, where PRK is approved {but inferior in general}] and has only been done to a few hundred thousand people in the U.S.), you should do your homework and find out about the procedure and doctor. (That last sentance sucked - sorry!).
- Mike