On Wednesday Aril. 16th 2008, I had CustomCornea LASIK. Anyone who has considered having their eyes zapped by lasers can imagine the anticipation that precedes the procedure. I am happy to say that life is great afterward. Seeing the world through clear eyes without glasses after 20 years is something that is just hard to overrate. In this post, I will try to outline the facts and thinking that went into my decision to undergo the procedure and provide as much detail as I think may be valuable to others, regarding my person experience so far.
The reason I am doing this is that over the past couple months, I have spent a decent about of time reading articles and person accounts about LASIK and was surprise that none of them quite fit my profile as a person who’s eye correction was nearly entirely astigmatism.
My Eyes Before:
1. I wore glasses for about 20 years. I first started wearing glasses in junior high after I began suffering severe headaches from eye strain.
2. My prescription was almost entirely astigmatic; in other words, I had nearly no other nearsighted or farsightedness to correct for.
Other options:
As I said above, my whole vision problem was caused by astigmatism. I won’t get into the details of astigmatism, but suffice to say that in my experience glasses have been about the only solution available for correcting astigmatism.
Quick side note on contacts: Contacts suck for astigmatism. The problem is, in order for contacts to correct astigmatism, they must be weighted in order to stay oriented on the eye in precisely the same way ALL of the time. Think about that… In order for contacts to work well for astigmatism, a thin, soft, rounded piece of plastic must stay EXACTLY in the same place over the eye at all time. No matter that the little thing is floating on a slippery wet ball that is moving around constantly, and has eyelids flapping up and down over it many times per minute… Long story short, this is an area where technology can only go so far.
Why Now
Over the past 10 years, I have asked several eye doctors about laser eye surgery. Time and again, I was basically told, “not yet.” The reason being, the surgery was not quite perfected for astigmatism. I was also seeing that the odds of ending up with “halos” were higher than I was comfortable accepting. The combination of these things kept me in a holding pattern. I figured eventually the technology would reach the point where the decision would tip for me.
Then, about three months ago, I read an article in a flying magazine that pointed out that NASA has approved Custom All-Laser LASIK for use on astronauts. The article talked about the latest technology, called WaveFront. To make a long story short, after doing a bit of goggling for more information, I decided to set up an appointment at the Casey Eye Institute to see what I could learn about my own eyes.
The Initial Visit:
My initial visit was about 3 weeks ago, when I went in for a preliminary exam. This is about a 3 hour full exam. This includes having some pictures taken of your eye using the WaveFront radar thingamajig. This alone is worth the cost of the visits if you ask me. I was able to get the technician to show me how it worked. Essentially, the cool thing about WaveFront is that it provides detailed pictures of what are known as “higher-level aberrations” and “lower-level aberrations.” These are essentially imperfections in your eyes. As I recall, I had about 13% higher-level aberrations.
A quick side note: Turns out that my sister had gone to high-school with my doctor (Dr. Rick Fraunfelder) , which made for some fun conversations but I’ll skip those here 
In the days before WaveFront, LASIK essentially applied whatever your glasses correction was to your eye. Today, this is still the case, but the laser also corrects the aberrations; making your eyes better not only to the degree that glasses can, but also in ways that correct for the aberrations.
This is all good and fine for those of us who like the idea of having laser perfect eyes, but the real benefit is that WaveFront LASIC also reduces the likelihood of negative side affects such as halos.
Anyway, on that initial day, the technician and doctor took a bunch of pictures of my eyes, poke at them, prodded them, put drops in them and otherwise checked to see that my eyes were well suited for the procedure. They also honed my prescriptions.
An interesting little tidbit is that they look to see how thick you cornea is. As I recall, they like see corneas that are thicker than 125ish (can’t recall the exact number). The procedure typically takes of 12 to 20 microns (again, these are my very loose numbers)…. In my case, I was starting with 200+ microns of corneal material.
Decision:
The decision was a no-brainer for me. I have had several friends who have had LASIK and was not overly concerned about the risks having done my research… I set up the appointment for the procedure two weeks after the initial exam. Cost would be ~$4000…
Day of the Procedure:
I am not much for formalities or drama, so I had my lovely wife, Sara, drop me off at OHSU at 8:30 last Wednesday morning. The doctor has tried to give me a prescription for Valium to calm my nerves the day of the procedure and Vicodin (sp?) to take for the rest of the day to sleep off the worst of the recovery time that day. I declined both. In hindsight, I might have taken the Vicadin, but I am not sure.
8:30am – The technician takes 5 more pictures of each eye to make sure they have a prefect picture to work from.
8:40am – The technician put some numbing stuff into my eyes for the first time; they would continue doing this until the procedure was over.
8:45am –The technician drew some dots on my eyes that the laser would use to orient my eye. You see, the laser tracks your eyeball, it your eye moves, the laser adjusts.
9:00am – The doctor gets started. The first part of the procedure is when the doctor tapes open your eye, puts a little suction cup thing on your eye ball, and then put you under a simple looking machine that cuts the flap in the eye ball survey layer. This doesn’t really hurt, but it’s not something you would want to do on a regular basis. Think of it as being a bit like getting a filling: Actually, it not quite as bad a getting a filling. Total time per eye: 15 seconds. The good news is that even if I did need to have an adjustment to my eyes after the procedure, I would NOT have to do this again. Apparently, the doctor can use the same flap again in the future. It sounded like this is the case for ever, but I may be wrong about that.
9:05am – I walked over to the LASIK table and lay down. Things were a little blurry, but not bad. I give the doctor a hard time about getting it right the first time.
9:10am – The laser is fully calibrated and lined up… Doctor flips back my eye flap (using a tool called a Flap Flipper, by the way) and tells me to look at the light. I do… Right eye first… time in the machine 57 seconds.
9:12 – Onto the left eye. Same routine. Except on this eye, I was trying to breathe through my mouth to avoid the smell of burning eye (it sounds FAR worse than it is) but non-the-less, I thought I would be smart and just breath through my mouth… But, half way through the procedure the machine stops and beeps. Not a lovely feeling… The doc tells me to lift my chin and the laser gets back to work… Total time: 59 seconds (plus 1 for my little chin incident).
9:15 – The technician puts on a pair of goggles that I am supposed to wear until the next morning when I come back for a checkup.
9:17 – The world looks fine and my eyes don’t hurt yet. I stand up and walk out the door. Call Sara who is already on her way.
9:35 – Home I go. I take a couple Advil and lay down in bed knowing that the numbing drops will wear off soon…. They do!!!!
First three hours - My eyes are a bit sore. The run when I open the. The doctor had told me to keep them shut for the first 4 to 6 hours, but I am not very good at listening to directions. I take off the goggles occasionally to dry my eyes, which are tearing quite a bit.
Hour 6 – My left eye still really hurts when I open it. But I try anyway… Bad idea… But now I am starting to wonder; could I have moved the little flap thing? The worse part about the day was just worrying that I could have dislodged the little flap.
6pm – Damn, my left eye is actually worse than it was a couple hours back… I call the on-call doc to ask what he thinks… he tells me to just wait until the morning, there is no risk of doing harm…
8pm – I fall asleep for the night.
Thursday:
1am – I wake up and my eyes don’t hurt… I take of the goggles and the world looks GREAT. Wow… is that it?
6:30 am – My 4 year old son comes into my room and snuggles with me a bit. We get up for the day. By the point, I can’t put the goggles back on… Sorry doc, I just couldn’t do it.
8:00am – I go back into the doctors office and they check my eyes… 20/15, both eyes. They given me two types of eye drops to take 4-times per day for a week and another set to take for up to a month. Apparently they slow down the healing processes, which is good.
I took the rest of the day off, sort-of. I only did occasional work on the computer, a conference call, and a single in-person meeting.
Friday:
Life was back to normal. I had a 4-hour strategy session with Pacific Rivers Council and cleared out my email, etc.
Now: different people have different post-procedure experiences. I think my Wednesday was actually worse that most. It really did take me about 16 hours to get my eyes to a point where I could open them without pain.
Today:
I have no eye dryness other side affect. All is groovy.
