What really happens after LASIK - my experience

If you are thinking about having Lasik, IntraLasik, PRK, LASEK, Epi-Lasik, RLE, or P-IOL eye surgery, this is the forum to research your concerns or ask your questions.

What really happens after LASIK - my experience

Postby Mike_in_VT » Tue Sep 16, 2008 6:41 pm

Hi all, I've been posting in the "just had it" forum and was thinking I was posting to the wrong group. It seems like most of the "thinking about it" questions are about the pros/cons of the different procedures rather than any assessment of what happens after they burn away part of your eyes.

It reminds me a bit of the product reviews you see on internet shopping sites. They're often written by folks considering buying something , but what you really want to know is how a product performs long after you've made your purchase. With that in mind, I give you my thoughts as someone who had the surgery 9 months ago.

The text below is from my "just had it" posting on 9/16/08:

****

It's now been 9 months since my LASIK surgery. After many ups and downs (as evidenced by this thread) I feel like I can draw some conclusions on my experience. They are:

1. The eye doctor tests show healthy eyes with 20/20 vision and no astigmatism. This definitely puts me into the "success" category as far as the LASIK industry is concerned.

HOWEVER, if given the chance to do it all over again, I probably wouldn't do it because:

1. My vision in low light has definitely been compromised. I find myself turning on lights earlier in the day and requiring more light to do basic tasks like reading or cooking.

2. In spite of what the LASIK people tell you, the surgery definitely compromised my reading vision. I know that most people will need reading glasses once they hit their 40s (I'm 39), but I went from crystal clear reading vision to occasionally blurry reading vision, especially in low light. I'm not wearing reading glasses just yet, but I sure spend a lot more time focusing when I'm looking at things close up. I can't not believe this wasn't a result of the surgery and not my age.

3. Nine months out I'm still using drops almost daily, especially at night. By 9 pm or so I'm definitely reaching for the bottle (of drops, that is).

4. The comfort level of my eyes is approaching what it feels like to have comfortable contacts (sometimes blurry, sometimes scratchy) but it's nothing like the comfort I had when I wore glasses. Prior to LASIK I never thought about my eyes much. Even though I wore glasses, they just "worked," much like a person with good hearing doesn't think about their ears. Not anymore.

5. I don't feel especially liberated by NOT wearing glasses. I had worn glasses for over 30 years, and I thought it would be a great relief to not wear them, especially running and in the pool. But compared to the discomforts I have now with no glasses (see 1-4, above) I'd much rather wear glasses knowing my eyes were comfortable and healthy.

The punchline here? If you want perfect vision and expect to have no side effects, chances are that's not going to happen with LASIK. If you're even remotely hesitant about getting the procedure done, then my advice would be to save your money and keep your glasses.
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Re: What really happens after LASIK - my experience

Postby LasikExpert » Wed Sep 17, 2008 6:12 pm

Mike_in_VT wrote:...assessment of what happens after they burn away part of your eyes.


The excimer laser does not burn the cornea or use heat at all. The laser energy causes the molecules that hold together the corneal cells to be disrupted. This causes the cells to escape at high speed from the cornea. Heat can be generated by the escaping cells banging into each other and creating friction, but the temperature rise is about 11 degrees F. Certainly not enough of a change to cause burning. See Lasik Burning Smell for details.

Mike_in_VT wrote:...but what you really want to know is how a product performs long after you've made your purchase.


Absolutely, but our forum presents a skewed view of Lasik results. People who received what they expected have little motivation to search the internet for answers to questions or concerns, therefore it is much more likely that the people who participate in forums like ours have complications. The successes just go on about their business and we seldom hear about it. See Nothing but Complications for details.

Mike_in_VT wrote:1. The eye doctor tests show healthy eyes with 20/20 vision and no astigmatism. This definitely puts me into the "success" category as far as the LASIK industry is concerned.


The Snellen 20/Whatever test is valid, but it is not the only test to determine vision quality and is sometimes one of the worst. Sharp edged black known letters on a white background in a controlled lighting environment is not the real world. Just because you know the only letter that is shaped like a fuzzy pyramid is the letter "A" and can guess it correctly does not mean you actually see normally.

This is why our system of evaluating Lasik doctors' outcomes has moved from chart data (Snellen) to patient opinion survey. See Lasik Results.

Mike_in_VT wrote:1. My vision in low light has definitely been compromised. I find myself turning on lights earlier in the day and requiring more light to do basic tasks like reading or cooking.


Bright light reduces the size of your pupil and creates a "pinhole effect" that can increase your depth of field and quality of vision by reducing aberrations found in the periphery of the cornea. See Lasik night vision problems for details.

Mike_in_VT wrote:2. In spite of what the LASIK people tell you, the surgery definitely compromised my reading vision.


We have been trying to inform the public about this for years. See our article about Reading Glasses After Lasik.

Mike_in_VT wrote:3. Nine months out I'm still using drops almost daily, especially at night. By 9 pm or so I'm definitely reaching for the bottle (of drops, that is).


Dry eye symptoms after Lasik are the most common complaint both short-term and long-term. A question that should be asked of all pre-Lasik patients if they would be comfortable with a trade-off of putting on glasses/contacts or using eye drops daily. Not everyone has your dry eye difficulty, but it would be good for the patient to consider that as a possibility.

Mike_in_VT wrote:4. The comfort level of my eyes is approaching what it feels like to have comfortable contacts (sometimes blurry, sometimes scratchy) but it's nothing like the comfort I had when I wore glasses.


This sounds very much like dry eye symptoms.

Mike_in_VT wrote:5. I don't feel especially liberated by NOT wearing glasses. I had worn glasses for over 30 years, and I thought it would be a great relief to not wear them, especially running and in the pool. But compared to the discomforts I have now with no glasses (see 1-4, above) I'd much rather wear glasses knowing my eyes were comfortable and healthy.


I often say that the most Lasik can provide is the convenience of a reduced need for corrective lenses. If that convenience is not all that important, then the risk of surgery does not seem worth the limited reward, especially if there is long-term discomfort like yours.

Mike_in_VT wrote:The punchline here? If you want perfect vision and expect to have no side effects, chances are that's not going to happen with LASIK.


Actually, the chances of being satisfied with Lasik are pretty good (see Lasik Results), but statistics mean little when you are on the wrong side of them.

Mike_in_VT wrote:If you're even remotely hesitant about getting the procedure done, then my advice would be to save your money and keep your glasses.


Absolutely. Patients need to become informed about what they are considering and only proceed if they are comfortable with the potential risk compared with the potential benefit.
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