Question about Lasik Surgery

[Eric's Fat Brother]

Has anyone here ever had Lasik surgery? Beth and I went in and had an evaluation today, and it is something we are seriously considering doing for her. (I guess I should say Beth had the evaluation, since I already have 20/11 vision.) They offered us what looks like a very good deal, they really impressed us with their professionalism and their facility, and we like everything about it. Beth is just concerned that something will go wrong, and she will go blind.

I know from reading online that there has never been a single case of someone going blind from Lasik, so we recognize that it is an irrational fear. What I want to know is real-life pros and cons that people who have actually had the surgery can tell me. I am not really interested in stuff found on the Internet, because I can find that stuff just as easily. I am mostly interested in the opinions of people I "know" here who have had it done.

I guess I am also interested in the opinion of CMe2C, for obvious reasons.
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[stephsterr]

My dad had it done about 8 or 9 years ago, and has never regretted it. He needed glasses starting when he was about 7 yrs old and always wore thick glasses or contacts. Now he only needs reading glasses when his eyes are very tired. Amazing! And the technology has probably improved greatly since then! Good luck with your decision.
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[deepdish]

When my wife's boss (a real scaredy-cat) looked into having Lasik done, the doctor offered to do one-eye-at-a-time with a few weeks recovery time inbetween as a way to alleviate the nervousness. The thought was you get the first one done and if complications caused problems (which doesn't happen, but reality seldom gets in the way of irrationality) he'd still have one good eye with which to refuse the second surgery (and presumably litigate). Once the first eye was successful, the appointment was made for the second eye.

Chad

[Audrey]

My best friend had it done about 5 years ago, before she entered the Police Academy, because 20/20 vision was a requirement. She loved it and said the recovery period was surprisingly short, and that she has absolutely no regrets.

My aunt had it done also about 5 years ago. She used to wear Coke-bottle glasses that gave her headaches and ear and nose pain because they were so heavy. She now has 20/20 vision and says it was the best decision she ever made.

Another friend had it done last summer and it was great for her too. The only post-operative discomfort she mentioned was that for a week or so after the surgery her eyes felt like they had something gritty in them, like sand or something, and that she wasn't allowed to rub them at all, which took some getting used to. Apparently the doctor hooked her up with some good eye drops and that relieved the feeling pretty well.

My last mission companion had it done about six months before entering the field, and she only had one problem, which was that one day someone flicked her jacket string (the string that comes out of a hooded jacket), which was weighted down with a little metal ball, and it hit her square in the eye. We were on our way to an appointment, and when she checked out her eye she started screaming for me, and one of her pupils was fully dilated and the other one was the size of a pinpoint. She looked like Marylin Manson or something and it was pretty scary. She just had to stay in from the sun for 3 days or so as a precaution, but there were no permanent effects. Also, the doctor said the same thing might have happened to her eye even if she HADN'T had Lasik surgery, so who knows.

Finally, the father of another girl I know had complications afterward -- his eye got infected and he eventually went blind in that eye. Again, though, it doesn't appear that the blindness was a direct result of the Lasik surgery, but rather of the infection. Whether the infection was a result of the surgery, I don't know. It could totally be coincidental.

Maybe you weren't interested in hearing "I know someone who had it done" stories, but since I've never had it done myself I thought I'd pass them along anyway. Good luck to you guys in making a decision!
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[Spegs]

Everyone I know who has had it says it is the best thing they ever did. As soon as we save up, my husband and I are both having it done.
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[karinka]

i had it done summer 2001. although i miss my sassy glasses, i don't regret it one bit. i hated being dependent on the glasses. i now have 20/20 vision. the only issue is what i like to call the "starry, starry night effect". lights at night, especially rainy nights in a car with water on the windshield, appear in starbursts. it doesn't bother me except when it's raining. and later on down the road, touch-ups are really easy to do. what i hated during the procedure was the speculum in my eye socket. it wasn't very comfortable.

reading the accounts where problems did arise, the best thing i can tell you is to follow the post-op care instructions to the t. wear your goggles and use your drops when you are supposed to, take your antibiotic if you are given one, and stay away from activities that will jolt your body. for months afterward your eyes are vulnerable to infection because of the flaps cut in your cornea. tell beth no skydiving or deepsea diving.
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[CMe2C]

I guess I'll chime in. Let me preface my remarks by disclosing some things and adding that anything I say on an internet bulletin board does not substitute for professional recommendations and information from your personal eye doctor.
I've been an optometrist for 2 years. To date, I haven't had a patient of mine go out and get LASIK (my patient base has almost the lowest per capita income in Montana), but I do keep current by reading up on the literature. During my last year of school, I did a 3 month rotation at The Eye Institute of Utah in the SLC. The founder of that clinic apparently isn't doing surgery anymore, but he was very, very good. His replacement for LASIK, Kevin H. Merkley, MD, is a good one though. Of course, there is statistical 1% chance or less that you could loose vision (for example have only 20/40 vision even with glasses). Your chance of having 20/20 or 20/15 vision without glasses depends on your amount of prescription (refractive error) before surgery. I’ve had three siblings get it, and all three of them go without glasses during the day, but two of them need glasses for night driving (since a small amount of nearsightedness is more noticeable when the pupils are dilated in low light conditions).
By the way, all 3 had it from Bradley Gardner, MD at the Idaho Eye Center. He is very good, and I highly recommend him. Also, the doctor at PCLI who comes down to Boise, ID and Great Falls, MT to do surgery is very good. Also, I could recommend Dr. Boes at TLC in Billings, MT because I think he’s a great guy and an excellent cataract surgeon. Each LASIK doctor/clinic should have available statistics for you about their outcomes.
I should also disclose that I have a -6.00 (nearsighted) prescription with a buck of cyl (low astigmatism), but I have not gotten the laser eye surgery yet. I’m actually very comfortable wearing Ciba Night and Day contact lenses for now. I am risk averse, so I didn’t want to get it in its early days. Now, I’m more waiting for the right opportunity and financial situation. I’m still not sure if I will opt for LASIK or LASEK( a modified PRK). PRK and LASEK hurt a lot but would be a good option for people who are in the military or law enforcement. There have been instances where a couple years after LASIK, a tree branch wacked the person in the eye and dislodged the LASIK flap, so the surgeon has to go back in and re-float it. Since there is no flap with PRK/LASEK, one wouldn’t have to worry about that. However, hazing in vision is frequently reported with PRK, which is minimized by taking steroid drops like Lotemax. Most people only get PRK/LASEK if their cornea is too thin for LASIK.
The flap in LASIK is where the biggest source of potential complications arise. This is why it’s so important to choose a quality surgeon. In general, I would avoid fly-by-night-$600-per-eye laser centers with no vested interest in the community, but that also means you will have to go somewhere where the average cost is $1400 per eye. Also, there are two ways to create a flap: by a micro-keratome (sharp rolling knife-like thingy) or the new femtosecond laser (aka Intralase). The jury is still out if the laser thing is any better than a micro-keratome. Today, I would prefer the micro-keratome. I would go with whichever your surgeon does most (again, probably the micro-keratome since Intralase is so new).
Also, I like the LADARVISION laser system with wavefront (aka Custom Cornea) because it currently holds the widest FDA approval for refractive error ranges and it’s so expensive only the best surgeons can afford it (that’s a fallacy, but it seems to me like a general trend. See http://www.revoptom.com/index.asp?page=2_1389.htm for a list of other lasers.) The newer wavefront correction is cool because it should make the vision a little sharper, but in some individuals it may not be necessary. You would just have to see by “putting your chin in the chin rest and forehead against the band� of a wavefront analyzer. If you have a higher refractive error like mine, then seriously consider paying for wavefront regardless.
People ask about halos, and what I’ve heard is that those individuals who get them notice that they get less noticeable after a year or so. If your low-light pupil size is 6 millimeters or less, you should have less chance of getting the halos. Talk to your surgeon about halos. I can’t comment much about them.
Patient Pearls:

-If you find that your eyes frequently itch (before surgery) or have allergies that effect your eyes, make sure you ask your co-managing optometrist about getting a prescription for Patanol or Zaditor to take for a few weeks before (and after) surgery.
-What ever amount of time they tell you to go without contact lenses before surgery-double it.
-They will offer you a sedative (like half a Valium pill) to calm your nerves. Don’t ask for more than the usual dose because it can cause your eyes to involuntarily wander around.
-Make sure you take your eye drops as directed and never miss a follow up appointment. If your optometrist is seeing you for all the pre- and post-op work, make sure (s)he has a corneal topographer or go somewhere that does. (I say that because a rare but serious complication can be thinning and steepening of the bottom cornea after laser vision correction surgery. This is best detected and monitored with a corneal topographer.)
-Go to a place that offers “touch ups� at no additional charge (in case your first laser procedure gives you 20/30 or worse uncorrected vision but lenses can still get you20/20).
-If you are a person approaching or having arrived at presbyopia (Greek for old person vision, generally starts around age 40), then have a long talk with your eye doctor about whether LASIK is right for your lifestyle. Example: I had a neighbor who was nearsighted and got LASIK. Now she has great distance vision but has to place reading glasses in every room of her house. Before LASIK, she could just take off her glasses to read and play piano since she was nearsighted. She sometimes wishes she wouldn’t have had LASIK because she didn’t realize how much her day-to day life is involved with near work. Of course, every emmetrope encounters this after 40, so if taking glasses on and off bothers them, they buy progressive addition lenses and wear the glasses full time. (But they don’t feel cheated because they didn’t just have to pay $1400 per eye.)

So that’s my free advice. Remember, you get what you pay for.
Also refer to my favorite patient information pages on LASIK:
http://www.fda.gov/cdrh/lasik/
http://www.lasikinstitute.org/LASIK_Patient_Screening_Guidelines.html
http://chppm-www.apgea.army.mil/doem/vision/Army/RF_surgery.asp
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Don't ask what you can do. DO what you can do.

[CMe2C]

Post Script
Keep in mind laser surgery isn't the only option out there. Every option has its own risks that I won't go into here.

-If your nearsighted refractive error is under -4.00 you can do something called CRT (formerly known as orthokeratology). It's where you wear a hard lens at night and go without glasses during the day.
-Wear a highly oxygen permeable contact lens continuously for 1-4 weeks at a time.
-CK for presbyopic, farsighted folks
-Intacs (see http://www.allaboutvision.com/visionsurgery/inserts.htm and http://www.fda.gov/cdrh/mda/docs/h040002.html ) I've heard of an ophthalmologist who was a LASIK surgeon, but now is only going to do intacs because that is what he believes to be the best choice. (Remember Radial Keratotomy? The surgeons made incisions into the nearsighted cornea to flatten it out to hopefully come out sort of close to emmetropia and prayerfully not get too much astigmatism or something. Barbaric by today's standards.) From what I understand, intacs can be reversable, but it only corrects for low nearsightedness-not farsightedness or astigmatism yet. It has also recently been approved for treating certain kinds of keratoconus.

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[RenLass]

I had Lasic done. I love the results now. But for twelve hours after the surgery I was in SUCH misery!. It felt like I had a handful of sand in both eyes. I finally just went to sleep and when I woke up the next morning all pain was gone. (Get yours done later in the day, so you can just go to bed afterward)

My other problem was that one eye was 20/20 the next day but the other eye was 20/80 for about three weeks afterward. They said it sometimes take time and it would probably get better so it wasn't worth getting glasses for such a short time, but it was impossible to safely drive without closing one eye. Then one day I woke up and the world was clear, and I have had 20/20 ever since.

That's my experience with it.
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[georgebrat]

Mark's best friend had it done a year ago and doesn't regret it at all. He had really bad vision and now we're both jealous of him not having to wear glasses (both Mark and I wear glasses). Even his wife is jealous!
If you can afford it- go for it!

[wilkster1]

I had LASIK done in Portland about ... four years ago now, I guess. I was pretty concerned about something going wrong, even though the odds are very, very low that it will, so I did a lot of research before-hand to make myself feel better--including researching the various options of clinics and opthamologists that do it locally, what laser they would use, etc.

My prescription beforehand was -6.25.

My research led me to believe the following, which may or may not actually be true:
- Probably the single-most important factor is the number of surgeries conducted by the doctor and the number of complications that have arisen. They usually report this stuff, and you should certainly ask to see it.
- Another factor is the thickness of your corneas going into the surgery. My impression is that the thicker your corneas, the greater the chance that the surgical "flap" can be created successfully--and the more the doctor has to work with before and after the surgery.
- There's a specific list of possible complications that can arise--looking that over and deciding whether those complications and their remedies are something you could live with is also a good idea.

Most places seem to tell you that if you get the surgery done with them, and want additional correction, they will do it later. However, I think the reason they say this is that the vast majority of people will end up with vision so much better than before and so close to perfect that you'd never think it was worth the risk or the inconvenience (once again, still very small) of going back in for the surgery.

The thing my optometrist said to me, which I think is very wise, is that going into it, you have to have reasonable expectations. Your vision afterwards, especially if you wore RGP contacts or glasses with a really current prescription, will NOT be quite as good in many cases. If you are a detail freak and are expecting perfection, you may be disappointed and this disappointment may drive you a little crazy. Personally, my vision within a couple of days was AWESOME, and even now, four years later where I have some astigmatism that has crept back in, it's great. And the fact that I never have to deal with contacts, glasses, I can play rugby or swim and not worry about my lenses getting knocked or washed out, that I can see the clock in the middle of the night, etc. -- PRICELESS.

I agree with those who have said it was one of the best things they have ever done. Of course, I picked a place where it was $1800 per eye--I didn't go for the $299 per eye thing--although I have a friend who did and his came out fine, as well.
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[Benny]

I work as an optician for an optometrist and we are partners with TLC, the laser eye center thingy with the bad commercials by Tiger Woods. The doctors there recommend the flap method as usually you can see within a couple hours of the surgery, although some people do have problems for a day or two. The other method CME2C mentioned is not liked by the TLC doctors as it causes a lot more pain and swelling that can last for a week or more.
Generally, the places that cost more offer life time touch-ups if your Rx isn't too high or hyperopic. The problem with high Rx patients is there may not be enough corneal thickness. Some less scrupulous doctors will do it, but if the cornea is too thin the intraocular pressure could cause it to bubble outward and then you need to have a shunt stuck in your eye. So most people can have it done, you just need to find someone who has a different definition of "thick enough."
Really the biggest issue is their machine. The more expensive the surgery, the newer and more advanced the machine. The doctor only cuts back the flap and the machine does pretty much all the rest. A competent doctor will know the better ways to cut the flap and while monitoring the machine will be able to tell if something isn't going quite right than a newbie doctor. With the newer machine there is almost no chance of anything going wrong during surgery or after.
Of all the surgeries out there LASIK is probably the easiest one. In VA (not Virginia) hospitals they allow optometrists to do it (although that's currently under review last I checked)(also not to impugn the skills of an optometrist in any way; most opthamologists I've met are jerks and hire bigger jerks to work for 'em)

[Eric's Fat Brother]

Just wanted to let you all know that Beth had the Lasik yesterday afternoon, and it went great. We went back for her checkup this morning, and she is already 20/20, which is apparently really good for 20 hours after surgery. She was scared to death, but she did great, and she is very happy with the results so far.
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"I'm crazy but I get the job done."
***
My blog about baseball and web development and other stuff
***
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[Mark]

Actually, my friend Erin talked about got The PRK surgery. But It seems to be closely related to lasik/lasek, right, Cme2C?


I couldn't do the surgery. I can't stand anything in or near my eyes, which is why I can't even wear contacts.

[Spegs]

Congrats to Beth. I'm glad everything went so well for her. I can't wait until I can do this.
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[ImAdhis]

Cool beans for Beth.
As for me, I'm still reluctant to do it because of the night vision thing. I value my n.v.

Five years ago, my Company Commander, had LASIK done. His biggest complaint was that he did it so he wouldn't have to wear glasses but he still had to wear glasses after the surgery because his vision was not correctable to 20/20.

I remember when LASIK was $2500 an eye. I can't believe how much the price has dropped in such a short time.
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[wurlybird9]

hi everyone. i wandered over here on my 'vision quest' and signed up for the board so I could share a few thoughts.

First, I find that visual acuity on an eyechart may have very little to do with overall visual comfort. Those with especially high prescriptions who wear glasses, will experience distortions on the edges of their lenses, with a small range of actually useable vision. The eye is a resilient thing and can adapt but it is an extra strain.

I was experiencing blurred vision with contacts but reluctant to give them up for the reason of visual comfort, although the lens itself was uncomfortable, being all icky and dried out and covered with gunk quite quickly due to my dry eyes. (meibomian gland dysfunction, actually....and a dusty house)

Basically, glasses only give 20/20 straight ahead, and only if they are clean and free from glare. Contacts will get blurrier as the day goes on if they dry out and collect deposits. Nerve damage of the eye surface is a concern with LASIK, but contacts will deaden the nerves over time as well.

I have heard the the latest wavefront tech is a big step forward for those with large pupils. That was a deterrent for me in the past. Keep in mind, that if you have large pupils, you are probably already seeing halos at night, anyway. (i know i do...i figured it was normal). So sounds like things aren't really going to get worse...they just might not get as much better as you might hope for, from something so high-tech.

For those concerned about still having glasses....at least they will be weaker, and therefore lighter and more distortion-free. I am nearsighted to the point that I can't read further than 8 inches from my face....so I don't read without glasses anyway.

For those who are less nearsighted and therefore more attuned to a comfortable reading distance....and who spend most of their time reading....personally if that were me, I would not get LASIK....in most cases. For those with an irregular corneal surface the wavefront can actually smooth things out and produce better vision at any distance, than glasses could ever give. There is no "one size fits all" advice unfortunately.


Keep in mind I am simply an avid consumer, not a professional.

I'm going to get checked out again soon. Pray that it works out this time and I get the go ahead. I've been dreaming of being free of lenses since I was 10 and RK surgery was the current method.

Hope to hear an update from those who have had the surgery, are things still going well?

[Eric's Fat Brother]

It's been almost a year since Beth had her Lasik done, and she loves it. She ended up having to go back for a tweak on her right eye, which didn't get quite as good as the left, but now they are both great. It's been about two months now since the touch up, and she sees great. She absolutely loves the fact that if she wakes up during the night, she can look at the clock and see what time it is without having to fumble for her glasses and whatnot.
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Jeff J. Snider
"I'm crazy but I get the job done."
***
My blog about baseball and web development and other stuff
***
My weight-loss blog

[bCurt]

I would love to have Lasik. The costs around here start at $2,000 an eye which puts it out of reach for me as such surgery is low on the priority list. I noticed while visiting SLC ads for surgery with a cost of $899 per eye. That doesn't seem to be the "cheap" cost as I have heard from some that you can get Lasik even cheaper in the SLC area but I would hesitate to pick the low-cost leader when it comes to Lasik. Frankly, the locals here that do Lasik charge $2,000+ per eye because they can, not due to equipment cost or anything like that.

I've had glasses since 2nd grade and have astigmatism. I wear the toric contact lenses that, while are annoying at times, are still far preferable to the gas permeable (semi-soft) ones I used to wear. The winds and dust of the Texas Panhandle (with a little ash mixed in this last week) are annoying. I would sure love to see the clock at night without getting up (squinting doesn't work too well even with the big numbered digital clock I have).

[Eric's Fat Brother]

We didn't go to one of the places that advertised ridiculously low prices. When we went in for our consultation, it was really just to get an idea of what it would cost, but we didn't plan on doing it for five years or so. But the price wasn't too bad, and then we got them to lower it a little more, and we ended up only paying about $2000 total for both eyes. That included the "Lifetime Acuity Plan," so this last tweak and any other adjustments she ever needs are all free. It is still a lot of money, but between the cost of contact lenses and the intangible value of Beth being happy, it was definitely worth it.
_________________
Jeff J. Snider
"I'm crazy but I get the job done."
***
My blog about baseball and web development and other stuff
***
My weight-loss blog