What getting laser eye surgery is like, part 1.

Recently I decided to take the plunge and get laser eye surgery to correct my myopia and astigmatism. This happened a mere 5 days ago. I thought it would be a good idea to post my experiences here so people can know what it’s like to undergo this procedure. Note that I really give no medical advice at all. This story should be taken as a testimonial only!
Now my eyesight has pretty much always been bad — I’ve been wearing glasses since the age of four — and I had recently become more bothered by my inability to function at all without the help of corrective lenses. So I got some recommendations, went to see the recommended doctor, had an eye exam to confirm that I was a good candidate for the procedure, and decided to go ahead with it.

As you can imagine there is nothing really natural about deciding to have your eye sliced up, burned with lasers and then put back together. I couldn’t even stand to wear contact lenses, so you can imagine that I was quite hesitant to go ahead with this.

Another factor which didn’t help was a testimonial from a friend who had undergone a somewhat-but-not-quite-similar procedure (“PRK Wavefront”) and had been literally bedridden for a week because of it (I will ask him to write a post about his own experiences).

Still, I went with my clinic’s assurance that most people were even able to go to work the next day after the procedure (“Lasik Wavefront”), and showed up at the clinic at the appointed time. I was nervous as hell, but I was there.

Most people are expected to be nervous on operation day, so the clinic kindly furnishes a dose of valium to its patients. I’m not sure if this noticeably helped, however, especially when I consider that I (at 250 lbs.) was given the same pre-packaged dose as everyone else. One would think that a lady weighing 100 to 130 pounds would get a lot more mileage out of that little pill than I did. Then again perhaps the drug is there to make it easier for you to part with the thousands of dollars which the surgery costs! A heavy correction such as mine carries a matching price tag.

Getting prepped

My payment was processed and I had reached the point of no return. After a short wait in an inner waiting room a nurse called me in and prepped me for surgery. This involved putting anaesthetic drops in my eyes, an anaesthetic ointment on my eyelids, and then sterilizing the area around the eyes.

After a few minutes the nurse tested the anaesthetic by touching my cornea with what I think was a q-tip. This is unsettling to think about, but with the anaesthetic you really don’t feel anything. You are warned that your vision will go dark briefly and that you will feel some pressure on the eyeball during the procedure. Contrary to what some people thing the anaesthetic does not make you blind temporarily; you see *everything*.

When you’re ready, it’s the moment of truth. I stepped into the operating room. The laser itself is housed in an inconspicuous-looking white metal box that was located above the headrest of the chair I was told to lay down on. I probably would have been more nervous if I didn’t already know that the doctor who was about to carry out the procedure had already performed tens of thousands of procedures successfully! As it were I was quite confident to put things into his hands. He put more anaesthetic drops in my eyes and tested them again.He also told me about the keratotome, which is a good thing since it’s quite a scary instrument, as we will soon see.

The procedure

Once the explanations and questions are done, the actual procedure starts. It all happens quite quickly, and takes less than 2 minutes per eye. The eyes are done sequentially, first the right and then the left (for specific equipment-related reasons). The doctor will tape your non-operated eye shut while the procedure takes place.

First, the doctor has you align the current eye with the machine. There are 3 lasers to the wavefront machine, two red rays coming from the right and left, and one blinking green ray in the middle that you must fixate with the current eye. You also see a large group of pure white LEDs that are there to let the doctor see what he’s doing.
The doctor then uses an eyelid separator to keep you from blinking. If you’ve seen A Clockwork Orange, you’ll remember the wires that keep Alex’s eyes open during his therapy — it’s basically the same thing. Because both your eyes and eyelids are anaesthetized, it doesn’t hurt at all, it doesn’t even feel particularly bad.

The doctor then warns you that he’s about to use the keratotome. This is a circular instrument that is pressed against your eyeball and literally makes a round cut less than 1mm into the cornea. It’s mechanical, and makes a buzzing sound somewhat like an electric toothbruth.

As the keratotome is pushed against your eyeball everything goes dark and you feel the instrument buzzing. When your cornea has been cut you see the lights again. You also notice what looks like a toothpick sweeping across your eyeball. This is the doctor moving the corneal flap away so the laser work can begin. There is no sensation at all on the eyeball.

The actual Wavefront laser part of the operation lasts a very short time (it felt like about 30 seconds per eye). Basically you know it’s working, but still don’t feel anything. However this is also where you notice the creepiest part of the whole surgery — the smell. The laser works by burning little incisions into your eyes, and so while it’s working you notice a smell of something burning and quickly realize that it’s coming from your eyeball. Trust me, you’ll remember that smell.

Once the laser surgery is done, the doctor puts the corneal flap back in place and makes sure it sits flat on the eye. This involves (once again) seeing a small stick-like object sweeping across your eyeball, but this time the motion is repeated many times. The doctor also adds some eyedrops at this time; I’m not sure what type they are (anaesthetic or lubricant).

You notice the improved vision right away. My sight was so bad that even close-up objects like the LEDs of the laser machine were blurred before the operation, but I could see them sharply immediately after the corneal flap was back in place.

After the right eye is done the same procedure is applied to the left. For some equipment-related reason there is additional discomfort on the face during that part of the procedure.

Getting prepped to go

Once both eyes are done you get more eyedrops in both eyes, and the doctor leads you out of the room. Right away you see things clearly, except of course that you are a little light-sensitive, can’t keep your eyes open for more than a second, and you tear up like crazy (as in, teardrops, not ripping).

You are led to a secondary room where more eyedrops are added, and your eyes are covered by big plastic protective shells held fast to the face with surgical tape. These shells must stay on your face until the next day. They prevent you from doing stupid things like rubbing your eyes, which you will definitely feel like doing a couple of hours later.

After this you are sent on your way. The clinic insists that you come accompanied, because you couldn’t possibly drive after this procedure. You are given a set of instructions:

  1. For the next four hours you should keep your eyes closed, but blink about once a minute. You must not sleep during this time.
  2. After the initial four hours are over you may sleep. You can also open your eyes, but you shouldn’t try and do visually-demanding tasks like work at a computer or watch TV.

You’re also told to show up at the clinic early the next day (between 8:00 and 9:30 if possible) for the followup appointment. And you’re sternly told not to rub your eyes at all. That’s a very important piece of advice; rubbing your eyes could potentially cause the corneal flap to shift, causing all sorts of problems.

After leaving the clinic I was absolutely amazed at the fact that I could read the license plate of the car in front of us. This is something I have basically never been able to do without glasses before.

Stay tuned for part 2!

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