My Laser Eye Surgery Experience

2014-02-07

How it works

Laser surgery works by re-shaping your cornea to compensate for any nearsightedness, farsightedness and astigmatism (where your eye is stretched into an oval instead of being a perfect circle). There are two popular methods to do this. Both burn away part of your cornea with a laser. PRK does this right on the surface. There is more irritation, slower recovery, and higher chance of infection with PRK. LASIK cuts a flap in your cornea, and does the surgery under the flap before sealing it back up. It heals faster (they say you can work within 24 hours as opposed to several days to a week), but the cutting part isn’t exactly pleasant, and even after healing, the flap does weaken the eye a bit such that a severe blow to the eye in the future could dislodge the flap or cause more damage to the eye than would have happened with a PRK patient. As always, talk to a real doctor (ophthalmologist in this case) rather than taking anyone’s explanation over the internet at face value, especially someone who doesn’t even claim to be a doctor. That said, that’s pretty much it as far as I can tell. I went with LASIK; I didn’t have to take much time off work, but I probably shouldn’t become a UFC fighter now.

Eligibility and scheduling

First thing you have to do is find out if you’re eligible for surgery. Your regular optometrist doesn’t do this. If you’re in Terrace you’ll want to schedule an appointment with Dr. Thomas Nagy at the Vision North Eye Centre in the medical building. They have special equipment there to measure the thickness of your corneas, and presumably other things as well. They do all the regular checkup stuff in the process, and the whole visit cost $125 at the time. They’ll tell you what your options are then, and you can decide to schedule your surgery any time once it’s confirmed you’re eligible. In my case I decided the next day after some research. How long in advance you have to wait will usually be a matter of months from what I hear, but in my case it was only ten days. With Dr. Nagy, LASIK and PRK surgeries were both $1200 an eye, or $1800/eye with the wavefront guided option. This included all the drops, sunglasses, and follow-up appointments, basically everything except travel and accommodations.

Surgery experience: pre-op

The LASIK MD office where your surgery is performed is at 1281 West Georgia Street in Vancouver. It’s a few minutes’ walk from the Granville Skytrain station. I showed up at 8:00 for my 8:30 appointment, and they immediately set me to work filling out consent forms. I also had to sign off on some things I was a little bothered I didn’t remember discussing in advance — in particular the possibility of regression, which would require a second surgery down the road if my eyes healed too much, and that I had larger than normal pupils, increasing my chance of haloing. Regression surgery wouldn’t be at additional cost, but was apparently between 25% and 40% likely to be required (I got different figures from different doctors).

Overall I was there for at least a couple hours before my surgery began. During that time I met with three different doctors who confirmed my current prescription, reconfirmed various other aspects of my vision, and reviewed how to apply my medicated drops and when to wear protective sunglasses. Since I had never used contacts before, they were especially thorough about how to use the drops without poking myself in the eye.

Operation

Eventually they got me in a room all by myself, put a hair net on me, and applied some numbing drops. I waited 15 minutes, then was brought into surgery. First, they have you lay down. As soon as I did, a nurse handed me two stress balls. She said “If you feel the need to close your eyes squeeze these instead”.

The next shocker was the instrument they pull down over my face with all the lights and lasers attached. Four wide rectangles of bright white LEDs angled to form a wide, open-ended diamond. Inside the diamond were two green lights with a red light in the centre. It completely overwhelms your eye, flooding everything you see with red static.

First they cover one eye, tape the other open, then insert a speculum to hold it completely open. Honestly, this speculum was responsible for at least 50% of my discomfort. Next they mark your eye with a bit of ink, then comes the hardest part (LASIK only): a small metal device goes over your eye, applies suction, and cuts across the surface of your cornea almost end to end. You don’t feel pain, but there is pressure, and it’s intense. Your vision goes a little red.

Once that’s done they flip the flap back. At this point your eye isn’t the right shape anymore — like looking through privacy glass. They ask you to look into the laser (which tracks your eye movement and stops if you look away). You stare at it for 15 seconds. You can’t tell it’s doing anything. Yes, there’s a burning smell.

After the laser does its work, they flip the flap back into place, and your vision is miraculously restored. Then they release the clamp — and only then do you realize just how much that clamp was at fault for any discomfort you felt.

But then they do the second eye.

Afterwards they check alignment, apply the first round of medicated drops, put sunglasses on you, and tell you to lay still for 45 minutes, then go home and sleep.

Post-op

I walked out of the building, my eyes slightly irritated but really not all that bad, and realized I could already see fairly clearly. Understand something: I’d had glasses for 18 years. For 18 years, I had been unable to look myself in the eye. Really being able to look myself in the eye — watch my iris grow and shrink, look around my eyelids, see my tear ducts — it’s an amazing experience.

A hotel is a great place to discover life with eyes, because the bedroom and bathroom are the two places I’m used to functioning blind. Seeing the texture in towels I hadn’t noticed, a subtle edge on the black TV against the white wall even in utter darkness.

Drops: a clear antibacterial drop and a white steroid anti-inflammatory 4x a day for the first 5 days, then artificial tears whenever eyes feel dry. The steroid drops are thick and bitter — enough makes it into your sinuses that you get a gross taste. I spent the rest of the day in the hotel listening to stand-up comedy and sleeping.

Next morning checkup: 20/20 in my dominant eye, 30/20 in the other with likely improvement. One amusing side effect: since my glasses subtly shrank everything, walking through Metrotown I was convinced a new generation of obscenely large phones had come out, and a 591 ml pop bottle looked like 700 ml. I also felt uncomfortable not having glasses on for the first three days — relieved whenever I put sunglasses on.

Haloing is very common in the first few months — a glow around bright lights, like smudged glasses. It usually goes away.