Posted On:7/27/2013 11:05am
Style: Hung Gar, Choy Lay Fut
I was talking to a guy whose job it is to develop technology so that the shittier surgeons can raise their bar.
Eye surgery came up and the slowest (read: least dextrous, ie shittier) surgeons typically take up to 5 times(!) as long to do the same procedure.
You Drs track record makes a huge difference, if you can access that info.
Posted On:7/27/2013 12:25pm
Style: Staying Alive
Originally Posted by NeilG
Looked into Lasik a long time ago but decided it wasn't worth the risk. Things have improved quite a bit so maybe I would change my mind now if I did the research.
At any rate, individual success anecdotes don't mean **** - do some research on what the risk factors are, especially for the equipment they are using. It used to be that the risk of worsened night vision was very high, like 25%. Dry eye is another big risk. Beware of the 20/20 percentage claims as there are a number of crappy things you can have such as double vision or spots or whatnot and still be able to read a test chart.
For older guys like me with presbyopia the surgery presents another problem. After surgery, I would still need glasses to read or work on the computer as my eyes like everyone else much over 40 have lost the ability to focus at close distance. Being near sighted I have an advantage - the myopia provides extra power so I can just lift my glasses to read very fine print. So even going for groceries or whatever I would have to cart around reading glasses, and I would wear glasses (a different pair) to work.
In addition to all that, my prospective surgeon straight-up lied to me about certain risks which was a huge red flag about the risks of for-profit surgery.
Anyway, just be thorough in your research. 10 pages of "worked great for me" stories mean nothing, find some stats.
I know that the anectodal evidence evidence is useless - due to the particular type of intervention the experiences are very varied. In the last years the technology in the field has progressed greatly, the Wavefront mapping for example was a huge leap forward as allows for accurate correction without having to depend solely on the skill of the surgeon. Also, it allows for correction of defects which we all have since birth, basically not only correcting the disfunction but also any eye imperfections.
In the LASIK area the introduction of femtosecond Intralase has allowed for better flap creation reducing greatly any post-op issues - dry eyes is still one of them (the cut is deep enough to affect the nerves) but is much less a problem now.
In LASEK the greatest risk is that of hazing - epithelial cells that re-grow of a different type and are not transparent as the normal ones, this is a natural body reaction as these opaque cells are faster to produce and heal the wound, that's why to control the re-growth properly Mytomicin C is applied during op and steroid drops after.
Diet and UV exposure are two other important factors for the hazing, that's why I'm keeping high my vitamin C and Omega 3 (Flaxseed oil is my new best friend).
There are of course risk as with everything, night halos, eye infection, incomplete correction. Also, I'm perfectly aware of the presbyopia but I'd rather wear glasses just sometimes than always. Actually, I could get a monocle which I believe looks damn cool :D
Fortunately I am a good candidate, my myopia is enough to justify a treatment but not enough to be in the trouble zone, I'm also caucasian with blue eyes and thick cornea, a series of factors which all put together give me a good chance of having a positive result. Also, it appears I have a high lacrimation rate which will reduce the risk of dry eyes.
My surgeon was also very clear on everything that could go wrong, also as during the exams my left eye optic nerve did look a bit strange I had a field of vision test to ensure there was no initial Glaucoma - turned out my field of vision is great fortunately.
Last edited by Zargor; 7/27/2013 12:29pm at .
His heart was visible, and the dismal sack that maketh excrement of what is eaten.
Posted On:7/27/2013 12:44pm
My surgeon went through all the potential complications before my surgery and I almost didn't do it. Even though the likelihood was very small, some of the **** was scary as hell. Like, your eyes burning for the rest of your miserable fucking life.
Glad I did it though. I experienced some dryness for a few months but it cleared up.
Posted On:8/06/2013 1:10pm
As promised here is my experience:
Operation: performed at around 1630, no more than 30 minutes in all, the proper scrubbing and laser correction was about 5 minutes per eye max. No pain during surgery, the biggest discomfort experienced was during the eyelid clamp insertion.
Immediately post-op vision quite sharp but with a foggy quality to everything.
First 6 hours: once the anesthetic started to wear off I had to take immediately a painkiller to alleviate the discomfort – tried to sleep once home but was impossible due to pain, burning and object-in-the-eye sensation. Almost impossible to keep the eyes open, very high photo-sensibility, eyes fill with tears each time I try to open them even the slightest. After supper I took two pain-killers (max dose) and two sleeping pills (max dose) to get some rest.
1st day: Managed to sleep thanks to medications but once they wore off awakened in pain. Got up at 6 am with eyes swollen and badly hurting. Spent the rest of the day between drops, pain-killers and sitting around the house in the dark trying to doze off. Eyes very photo-sensible. The pain and burning is starting to subside a bit in the evening. Having a person around is absolutely essentially as cooking in this state would be impossible (can't see ****, eyes fill with tears each time I try to open them).
2nd day: Sleep was better and only with one pill – I wake up with upset stomach though. Do not know if due to pain-killers or antibiotic drops which end up in my digestive tract. Also, the painkillers and sleeping pills daze me too much. As the pain and burning have subsided quite a bit I decide to try to avoid them unless necessary. This day feels definitely better, eyes are not watering as much, can actually look around a bit, the discomfort is present but not predominant. Eyes still photo-sensible but I mange to take my glasses off now and then. Towards the evening I manage to have a quick look at my email but focusing on the screen is painful and can't stand it for more than a minute.
3rd day: I manage to sleep almost well, the pain is mostly gone, most discomfort seems to come from the bandage lens. I manage to do stuff around the house without problems, computer is ok in short, 5 minutes bursts. Eyes feel better after the drops, probably due to lubricating the contact lens. Eyes still slightly photo-sensible but can manage without the sunglasses most of the time (at home).
4th day: The swelling is almost entirely gone, eyes behave normally. Bandage lens is really annoying me and drops are the only solution. I manage most of the tasks besides reading. Computer ok but no longer than 25-30 minutes as it's hard to focus. My vision feels good, clear, everything looks bigger and more defined, colours more vivid and depth perception better. I'm starting to think this was really a good idea :)
5th day: Got the bandage lens off and a quick check on my eyes. Have around 20/15 in the right and 20/40 in the left but testing at this moment is not very reliable yet. To have a more definitive result will have to wait a month. Without the lens eyes feel very good now, resumed all of my activities, can use computer ok, just have to take breaks each hour or so as they tire a bit. I have the next check-up scheduled in 10 days, in the meantime I have to continue with the drops (antibiotic, corticosteroids and artificial tears as needed. No physical activity for the first week, I will re-start cycling after that, Kendo at 2 weeks time and Judo at 4. Photo-sensibility seems almost back to normal levels but will keep sunglasses outdoors for the next months as UV damage can induce epithelial scarring and cornea hazing.
I have not experienced any dry eyes problems at all. My vision is still fluctuating, I did not notice significant difference between morning and evening. Eyes definitely work better when rested though so eyesight is sharper after keeping them closed for some hours.
I do not seem to have any halos or star burst issues at the moment but it is still a bit early. Mitomycin C was used during op so the probabilities of this complication should be reduced quite a bit.
Overall the worst part was the first 24 hours which the best thing to do is probably to spend asleep. After that each hour felt better as the improvement was very rapid.
As for now I'm quite happy with my decision, would definitely go through this again if necessary.
The only good advice I can give to anyone undergoing the same procedure is to try to sleep as much as possible in the initial period and to make sure you have your painkillers ready. Having somebody to assist you in the first two days, especially for cooking is essential. Also, I received a pair of eye-shields to keep on at night by taping them to my face – I discarded them almost immediately and used a pair of ESS Ice (Airsoft relic). These worked very well on protecting my eyes both when sleeping and from the light.
If you have any questions, fire away!
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