Laser Eye Surgery
So, I wasn't as severely near sighted as some (my prescription was -3.75 on
both eyes), but I can tell you that without glasses or contacts, it's
already quite scary to get out, and if I had to drive, I could have managed,
but it would have been dangerous.
My coworker and friend TM, who drove me to the
Hyver Laser Institute, had
a myopia of -9 and -10. I can only imagine how blind you must feel without
correction.
After trying contact lenses, I just was not going to go back to glasses.
Especially for sports, having sweat all over my glasses is just not fun, and
putting aside looks, it's just a lot more simple to wear sunglasses when you
have contacts (something I didn't have to do when I was in France, but I wear
sunglasses pretty much year round when I go out now that I live in California)
Working in the computer industry, I was well aware that you do not want the
first version of anything, or often even the second version for that matter,
but the time felt right now (february 2002), laser surgery has been around
for 10 years, and I'm sure we've been through several versions of the laser
machines.
You have to stop wearing contacts 10 days before surgery, which for me meant
going back to very old glasses that didn't offer near enough correction (a full
-1 of correction missing on each eye). That was kinda weird to live like
this for a while.
You also have to start taking antibiotic drops one day before surgery, and those
drops are spooky: they somehow make it up your tearducks and end up all the way
in your throat to give you a rather unpleasant taste.
Oh well, neither is the end of the world.
My friend TM nicely took some time off, drove me to the center.
If you are easily impressed, you may not want to watch the pictures of the
actual surgery, or if you go there, my place had a TV screen showing what was
happening and what the Surgeon was doing. While it is great for transparency
(you could also see through a glass window, which I thought was a good idea
when your significant other brings you there), it is also too much for some
people (I heard someone had fainted right before we got there), and while
watching didn't overly bother me, I don't know if I would not have been better
off seeing all this on the guy after me instead of right before having my
surgery.
After checking my vision one more time (the shape of your eyes can change a bit
after you stop wearing contacts for a little while), that was it: several kinds
of eye drops, and it's time to go
LASIK is
described in many places, but the quick version is that your eye is kept open
(your eyelids are taped open, you wouldn't want to blink on the laser, now would
you?), a flap of your cornea is cut of (not all the way through), the flap
lifted, and the laser removes part of your cornea under the flap. The reason
for this is that the part of the cornea that was burned off by the laser doesn't
stay exposed to open air after the surgery, it heals a lot quicker under the
cornea flap that is closed back on top of it
The pivot the laser is on actually tracks and follows your eye if you move it,
which is good because trust me, your eye movement can be a lot harder to control
there.
The first eye took more time, and the surgeon, Dr Hyver, had a harder time
getting the curvature of my eye to match what he needed to cut the flap out,
which by the way isn't done by hand with a scalpel, but with an automated
machine put on the top of your eye. The pressure that he has to put is supposed
to be a bit painful, but I while I obviously felt it, it was far from hard to
bear
I can't say that it was overly painful, nor did I expect it to be, it was just
rather uncomfortable, and while I did ok for the first eye, apparently, I
started losing some of my cool, for the second eye, I had a harder time to focus
(no pun intended), keep my eye in place, and wait patiently for this to be over
(it's only a few minutes in total).
While I thought I'd be able to bear the whole thing without any problems, let's
just say that I was very happy when the second eye was over with, the
overwhelming feeling was "get all those things out of my eye, they don't belong
here". I also do not know whether in the process my brain had blocked some of my
senses but while I was easily able to smell the ozone when the laser fired on my
first eye, but did not smell any at all the second time (Oxygen, O2 gets paired
with an oxygen atom from another broken down molecule to create the unstable
O3. The smell is easily recognizable).
As for the laser itself, it's true, you can't feel it at all (or even see it
fire for that matter). While I could kind of feel the flap of my cornea being
cut, the laser shots can't be felt (I've also had laser surgery to fuse a small
hole on one of my
retinas
and that however was very painful and uncomfortable).
Since the pictures of the actual eye (taken by TM on the TV screen) can be
kind of graphic, I'll just give you a link to them:
first the right and then the
left if you'd like to see more.
Outside of my optometrist referral, I picked the place for the following
reasons:
- Apparently some of the
best equipment you can get (but then, I'll have to admit to not being
much more knowledgeable in that field than the person who walks into Fry's
Electronics and asks a salesperson for what computer equipment they should
buy (if you don't know the store, it is well known for having some of the
most clueless sales people in the industry, so you really have to know
nothing to ask them for advise))
- One surgeon, Dr Hyver, so you know who you're getting
- The equipment is only used by him (I would be under the impression by
default that, contrary to a PC, having another professional use it would
not necessarily be a problem, but I may be very wrong, and having only
one person use the equipment can only be a good thing)
- Reasonably priced for the area ($3000 for both eyes, including all pre and
post care, and virtually free 2nd tuneup operation within a year if needed).
Note that the price can vary on what amount of correction you need, and I'm
sure it can change up or down with time, and equipment updates.
While I did compare prices with a few other facilities (and it was
attractive in comparison), it's obviously not something that you want to
spend the least amount of money you can no matter what: the latest up to
date equipment, can't be cheap, and a beginner surgeon trying to build up
a clientele will probably charge less, but would you want to settle for
less?
All I can say is that
Dr Hyver and
his team made this as comfortable as it could possibly be, and did a great
job in all aspects, from being friendly, convivial, having a nice center with
up to date equipment, and giving people access to the procedure by working
in a room with glass windows visible from the waiting room, and showing the eye
during procedure on a TV screen there too (although for some, it might be more
than you need to see).
From having enjoyed access to great medical care in France for 24 years (the
few times I've needed it), I've been critical of specialists here who treat you
like cattle (my worst was having to strip, put on a surgical gown, and wait in
a rather cold room for more than 30mn for the specialist who showed up, spent a
full 4mn with me, and went off where I never saw him again, when all I had was
back pain, which of course did not require me to strip, but god forbid that 5%
of the patients might waste 1mn of the specialist's precious time while they
remove some article of clothing if needed)
In this case, however, Dr Hyver, consulted me directly before the procedure,
checked my vision himself, even though he had staff fully capable of doing it
too, and he made sure to spend whatever time was necessary with me and answered
my questions. Let's just say that I could not have asked or hoped for anything
more.
Of course, while I was a bit traumatized, I could see right away the
difference with the short glances I had. Dr Heiver checked my eyes quickly
after the surgery, and I could see reasonably well when walking out of there
and felt quite well actually, to the point where I offered to take TM out for
Chinese and figured that I could have actually driven home.
And then, about 10-15mn after the surgery was over, it hit me like a brick:
"light very bad, not feeling that well anymore". TM, having already been
through this, nicely suggested that she drive me home.
Turns out, it was indeed the right thing to do, I spent the next two hours
with my eyes mostly closed, and those were two very uncomfortable hours. I don't
want to scare anyone away, especially because two hours compared to improved
vision for years, is worth it, but it sure wasn't a piece of cake
Had it been pain, it could have dealt with a lot more easily. It's known, it's
only pain and it can be mostly ignored. but this was different: it was a
very strong feeling of uneasyness, my eyes and nervous system were
just telling me how unhappy they were, and were confirming that there had been
clear trauma.
It drove me a bit crazy, simply lying down and keeping my eyes closed didn't do
it, I was too unnerved, and kept getting up, mulling around my rooms, barely
opening my eyes from time to time, because every attempt said "light bad"
(despite a fairly strong pair of sunglasses they gave me).
Long story short, the first two hours after I got home, were simply not fun.
IRAA, YMMV (individual results are atypical, your mileage may vary). My friend
TM, had a much easier time after her first surgery, and then had apparently an
experience close to mine her second time.
After that, I was able to start opening my eyes a bit, and felt a bit better.
Mind you, my eyes are still burning a bit as I write this (8H later), but it's
not a bad burning: it's noticeable without being painful (a bit like after
you've worn your contact lenses for twice as long as you're supposed to).
At the beginning, I still blinked quite a bit, and closed my eyes every so
often, but I was able to go around the house a bit, and do a few things.
Ok, things a still a tad hazy, but I can now keep my eyes opened, and started
to watch the movie I naively thought I'd watch right after getting home (thanks
Xavier for providing the said movie)
I seriously considered going to my aerobics class, as I felt up to it, but
eventually decided against it because I figured I didn't exactly need a drop of
sweat to fall in one of my eyes
Ok, I lasted 8H before checking Email, sue me
(I was not supposed to read or use a computer until the next day not to strain
my eyes, but they did feel a lot better after 8H).
I started with easy things like going through the pictures in my camera and
fixing them on my computer, and took breaks from time to time. This didn't
require my eyes to focus on the ludicrous small fonts I usually use on my
2048x1536 desktop (on a 21" monitor)
10x20 Unix "misc" font vs 6x10 which I usually use
The 6x10 font allows 340x153 characters on one screen (vs a measly 203x77)
Since it had gotten dark outside, I went to test my night vision. Well, at
least for the first day, all I can say is that I can see fine, but I could
definitely notice the "halo effect" around lights, and while I could read street
signs, they were somewhat blurry from a distance.
If you aren't familiar with the problem, the short story is that when there is
little light available, your
pupil
opens a lot wider to let more light in, and because the laser treatment is
mostly only on the center of your cornea, some of the light comes in your pupil
through part of the cornea that hasn't been reshaped as much or at all, which
explains the halo or possible non consistent vision.
You can see how big the pupils can dilate on
these pictures
I can't tell if it's going to get a bit better later, or if it's going to stay
this way, but either way, while it's not great, it's liveable (especially
considering that I've never had great night vision anyway)
While I'm still using the bigger 10x20 font, just to go easy on my eyes, I feel
a whole lot better being able to focus on my small fonts again (the ones that
apparently 90% of the population with corrected vision or not can't seem to
read. See screenshot above for comparison). They're not super sharp yet, but
at least I can read them
Basically, 10H after the procedure is over (as I write this), my day vision
seems close to perfect (both eyes working together that is, my right one by
itself it still a bit weaker due to the slight astigmatism I have). I'll
know for sure tomorrow after the followup eye exam.
I went to bed with my eye plastic shield (my guess is that they do not
want you to have your eyes against the pillow, apply pressure, and
possibly move the flap of cornea that is trying to fuse back in place)
Woke up the next morning after a mostly ok night. I can still feel something
happened to my eyes, but I can see quite well. The only exception is my really
small fonts, which still look a bit blurry, but that's supposed to be normal
for the first days/weeks
Well, off to my eye exam for a checkup and to get the first figures on my
corrected vision.
The preliminary numbers are in: I'm off by about 0.25 on each eye, which with
both eyes together equates to about 20/20.
My vision will not be perfect though because I still have a slight astigmatism
that tends to come and go and isn't easily correctable as a result. I'll also
get more precise numbers next week. My eyes are still healing and I can still
notice that on very small characters, my vision is slightly blurry.
After driving home from work after nightfall, I found that while I do see halos
around lights, it doesn't get in the way of getting a good picture, or being
able to see cars or signs from a distance. I guess it can mostly be seen as an
artifact (but it's true that while I haven't tested it, I think my vision is a
bit weaker at night).
While the results aren't perfect yet, it's already a whole lot better than
what I started with. I can live without corrective lenses right now, which
sure wasn't the case before.
The weekend, 4 days after the surgery, I went to Lake Tahoe for a snowboarding
weekend (with permission from Dr Hyver). Not a single problem there. It's kind
of amazing that except for a few eyedrops, I was off snowboarding in bad weather
4 days later and not even remembering the surgery.
This morning was my 2nd eye checkup. It's kind of surprising how much my eyes
changed in one week (actually, not quite for the better right now
).
My left eye got a quarter of astigmatism, which is not a big deal and can go
away. It's still near sighted by a quarter, which is nothing to worry about
either.
My right eye however is now farsighted by .5, and I have .75-1 of astigmatism.
That's more annoying because I can't read my small fonts with it at all. Good
thing that I have the left eye to compensate for now.
Anyway, now I get to wait another month and see how things stabilize
I had a few checkups in the meantime, but basically nothing changed from my
one week checkup. However, you do have to wait 3 months as a rule to see if
things stabilize or not.
Quite frankly with both eyes, my vision was close enough to 20/20, and as far
as distance vision was concerned, I was more than happy with the result.
My problem however was that, as mentioned earlier, I spend 10 to 12 hours
a day working on computer screens with very small fonts. Sure, I could make
the fonts bigger, but that would mean that I'd lose valuable workspace.
Because my left eye was close to perfect, I could actually read, but it was
my left eye that was doing all the reading, my right one was just along for
the ride, and was barely able to guess the letters if my left one was shut
or temporarily blurry.
While it wasn't a lot of astigmatism, I did end up with worse vision in my right
eye as a result, and correcting that amount astigmatism with contacts is not
something easy, besides, the whole idea was to not have to worry about contacts
anymore, so it wasn't a complete success in that respect.
True, I could have lived with my current vision, but I realized that I'd have
been compromising, and that now was the best time to do something about it, so
I went to see Dr. Hyver again to see what my options were.
Since this was a minor correction, I wasn't sure what the odds of not improving
or making it worse were. Had it been 33% better, 33% same, and 33% worse for
instance, I wouldn't have gone for it.
However, while Dr Hyver did jokingly mention that considering my current vision,
he could have told me to get lost (and some places probably would have),
he also told me that in my case, he could make it better, and that while he was
actually going to lose money on the operation (you only pay $200 for an
enhancement), he was willing to do it because he wanted his clients to be
completely satisfied.
I have to give him credit for being straightforward with me, and I think it
helped that I told him how I was not looking forward to the surgery again; he
did realize that, while it'd have been minor for most other people, even that
small amount of astigmatism was a big deal for me. He knew that I was not just
casually asking for a little extra notch that I didn't really need.
I didn't really take pictures that time, there wasn't much of a point, they'd
have looked pretty much the same anyway
Again, I was greeted by the friendly and cheerful
Hyver Laser Institute staff.
I really have to give them credit again for their outstanding friendliness,
and the fact that I really didn't feel like cattle, which is the case in some
other places I've been too.
They checked my vision one last time, and then I met Dr Hyver. I hadn't realized
it at the time, I thought he was just putting a few marks on my eye, but he had
already mostly broken the seal on my flap, and while I wasn't looking forward
to going back to the operation room, I have to admit that it was extremely
fast and painless
I do remember now that indeed the worst part of the operation is the mechanical
knife that has to be pressed very firmly against your eye before it can roll
and cut the flap. Luckily this time, I only had one eye and skipped that whole
part, so in about a minute, my eye was ready, the flap lowered, the laser fired
maybe 5 or 6 times, and I was done.
I don't want to say that it was a walk in the park, because it never is, but
quite frankly, it was a lot more painless and pleasant than I was prepared for.
I was really dreading the time right after surgery too, because last time, it
really hit me like a brick, maybe 5-10mn after I was done.
I had my brother drive me there because last time, even though I could have
seen with my eyes, my body was way too traumatized for me to have driven home myself.
Well, this time, I didn't exactly feel great, but I could have made it home
(granted, I only live 7mn away). That said, you don't know in advance, and I
would not recommend that you plan on driving home, even if you're just getting
one eye done.
The first two hours after the surgery weren't the hell I had last time. Sure,
I didn't feel great, but I wasn't in the same state of disarray than last time.
I guess, I just didn't have that much trauma because the surgery was probably
4 times shorter, only one eye got done, and the flap only had to be gently
re-opened, not cut like last time.
I was able to get rid of the heavy sunglasses I wore back from the surgery,
and was able to work instead of having my head between my hands, keeping my
eyes mostly closed, and walking around madly in circles waiting for time to
go by. Trust me, it was a lot better.
For that matter, after two hours, I was already able to easily read my computer
screens, even with just the right eye. It looked a tiny bit blurry, but it was
already noticeably better than before surgery.
While my eye was still a bit sore 5-6H after the surgery, the minor pain and
uneasiness was already gone, and it felt like I had pretty much recovered.
Simply amazing!
I have a followup appointment tomorrow morning to get my first check, but I'm
fairly certain that my astigmatism is under a quarter if it isn't totally gone.
Likewise, my near or far sightedness has to be 0 or under a quarter.
Well, as expected, the optometrist appointment the next day showed that right
eye now only had a quarter of astigmatism and was seing 15/20.
And just a week later, the followup check showed that even the quarter of
astigmatism was gone and that I had more than perfect version in my right
eye.
Simply amazing...
Well, there is nothing to say except that the whole procedure was a complete
success. While I wasn't aiming for that good, I have more than perfect
uncorrected vision now
Sure, it'd have been better if I hadn't had to go back for an enhancement,
but this isn't exact science, when you deal with living tissue, you get as
close as you can, but you can't always be perfect the first time.
I'm really impressed that the current technology and Dr Hyver, were actually
able to improve on .75 astigmatism.
Today, with wavefront technology, you can most likely only get better results
than I already got, but in the meantime, two and half years later, as I write
this, I still have perfect vision in both eyes, and I can happily read my
small fonts that most other people can't see without squinting
Email
2002/02/12 (21:38) Version 1.0
2002/02/13 (10:19) Version 1.1. Filled in the blanks, page made live
2002/02/13 (20:01) Version 1.2. Added preliminary vision results
2002/02/21 (11:48) Version 1.3. Added 1 week vision results
2002/06/11 (22:02) Version 1.4. Enhancement report
2002/06/18 (09:42) Version 1.5. Enhancement + 1 week report
2004/09/28 (11:46) Version 1.6. Update 2.5Y later