Laser Eye Surgery

Why 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.

Before Day of Surgery

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.

Day of Surgery (2002/02/12)

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.

The Hyver Laser Institute

Outside of my optometrist referral, I picked the place for the following reasons:

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.

After Surgery

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.

Surgery + 2H

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.

Surgery + 3H

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) :-)

Surgery + 5H

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

Surgery + 8H

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)

Surgery + 10H

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.

Surgery + 12H

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)

Surgery + 1 day

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.

Surgery + 4 days

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.

Surgery + 9 days

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

Surgery + 3 month

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.

Enhancement Surgery

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.

After Enhancement Surgery

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.

Enhancement Surgery + 2H

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.

Enhancement Surgery + 6H

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.

Enhancement Surgery + 1 day

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.

Enhancement Surgery + 8 days

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 :-)


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