My Experience

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My Experience

Postby goldbug » Mon Jun 18, 2007 7:42 pm

I’ve thought about getting laser eye surgery since 2000, with the wait primarily due to my concerns about night vision and flap creation complications. I was convinced to finally undergo the procedure by the wider adoption of the custom wavefront and Intralase technologies. The following are my experiences:

Prior Existing Prescription: –1.75 right eye, -1.50 left eye. I had a minor amount of astigmatism in each eye.

Pre-surgery: I was excited for the procedure until about three days before surgery. At which point, I became more nervous than excited. Finally, once at the clinic the day of the surgery, I was nothing but nervous, with thoughts about backing-out crossing my mind. I took the Valium they offered, of course, given my nerves. Within 5 minutes, I felt like I had a few beers and was very relaxed. However, as soon as they called me into the surgery room, my adrenaline was so high that I no longer noticed the Valium buzz.

The Procedure: The room was chillingly cold, sterile and dim, however, the chair was rather comfortable. In fact, I remember thinking that I should get one of these chairs for my house, but that may have been the Valium talking. The actual procedure was very quick and not painful. Basically, you can’t feel anything on account of the numbing drops, and you can’t see much due to the suction rings dimming your vision and blocking your view. The amount of pressure from the Intralase device was a bit of a surprise, but I didn’t mind, possibly because either I was expecting it or some combination of the Valium and adrenaline effects. Looking at the laser’s light and when the doctor peeled back the flap was like a “Close Encounters of the Third Kind” experience. Overall, the anticipation was more difficult to deal with than the actual procedure.

Immediately After: Right when I sat up from the surgery chair I could see extremely well in my left eye, albeit with a little haze, but the right was fairly blurry. On the way out of the clinic, though numerous eye drops, pouring tears, clear plastic eye shields and dark sunglasses, I could see the light shimmering though the waves on the pond outside the building with an amazing clarity. On the drive home I could read street signs farther away then I ever remember being able. That is until the numbing drop wore off about ten minutes into the drive and I could no longer take the brightness outside, even with my hands over my eyes. Which is when the burning sensation began. I still managed to sneak a few peaks through the pain at the trees and road signs along the way home, however, just because it was so amazing to see that well without glasses.

Fist Night: The burning sensation increased and was fairly intense for the first 4 hours post-op. I couldn’t bear to open my eyes due to this pain and the incredible sensitivity to light. Unfortunately, the Tylenol didn’t seem to have much affect on the pain. The burning and light sensitivity finally subsided around 10pm at night, and I could open my eyes long enough to really look around again. Things were still very clear with my left eye and fairly blurry with my right. The only visual complication I noticed were somewhat minor halos around objects emitting light.

Next Day: My left eye continued to feel great, and see with exceptional clarity. My right eye felt sore, like it got poked in the eye with a thumb, and was a bit blurry both for near and far distance, though it had better clarity than before surgery. I had a little dry-eye, which I found Refresh brand no preservatives type drops worked the best to treat. Also, I had a circular ring of blood around both eyes where the suction rings were attached. At my first post-op check-up I easily saw 20/15 in my left eye, and 20/25 in my right eye. The doctor said my right eye only “seems” blurry because of how clear my left eye was. He said that both eyes would fluctuate over the next several weeks.

Today (1.5 weeks post-op): I went to a baseball game yesterday, and I was astounded how clear my overall vision was. I’ve never seen this clear in my life. My left eye continues to be excellent and problem-free. My right eye is still a little blurry both near and far, but could probably pass 20/20 on the chart, and tends to get an eye strain type soreness near the end of the day or after reading for a while. It also feels physically larger than my left eye, possibly due to swelling? My right eye also takes a second to focus in on close objects. I’m trying not to do the left-eye right-eye comparisons too much and patiently waiting for my right eye to catch up with my left eye. I’m very happy overall with the surgery and the results.
goldbug
 
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Postby LasikExpert » Tue Jun 19, 2007 12:31 am

Thank you for the excellent report of your personal experience!
Glenn Hagele
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USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
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Postby goldbug » Sat Jun 30, 2007 6:51 pm

3.5 Week Update: My left eye continues to be perfect and my right eye is ok, but a little blurry still at all distances.

I got my medical records in the mail a week ago. I was wondering about how they calculated my treatment. In the records they show

OD (right)
PRE-OP
Manifest Refraction: -1.75
WaveScan Refraction: -1.24
TREATMENT
Desired Correction: -1.24
Physician Adjustment: -0.53
Adjusted Correction: -1.75

OS (left)
PRE-OP
Manifest Refraction: -1.50
WaveScan Refraction: -1.11
TREATMENT
Desired Correction: -1.11
Physician Adjustment: -0.14
Adjusted Correction: -1.23


They have calculations on one chart where it looks like they were trying to over-correct by 18% of -1.25 on my left eye and -1.5 on my right eye. They used this over-correction value as the amount of physician adjustment. However, it looks like they did the calculation wrong for the left eye and actually over-corrected my right eye by 43%. (My Wavescan refraction on differs by 0.13 between both eyes, but they over-corrected one eye by 0.39 more than the other.)

What is the industry standard for calculating the amount of over-correction? And, do they typically try to correct based on the manifest or Wavescan refraction values?
goldbug
 
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Postby LasikExpert » Sat Jun 30, 2007 7:06 pm

Different doctors have different opinions about which is best, wavefront autorefraction or manifest refraction. Much depends upon the circumstances of the patient and which way the difference indicates (over or under).

As a general rule the manifest is better because it is based upon what the patient perceives as best. In many circumstances the patient perceives an over or undercorrection as best. A part of the equation is patent age and ability to accommodate. A cycloplegic refraction may provide yet another refractive error. All of these, and other, factors need to be considered. Sometimes what the patient currently perceives as best is not what will be best after surgery or with time.

The percentages are not nearly so important as the targeted correction. In this case your doctor targeted full correction in your right eye and a 0.25 diopter undercorrection in the left. There are many legitimate reasons why your doctor would have made this treatment plan, but you really need to ask your doctor what was the reason in this case.

Refractive surgery is not so simple as taking a measurement and plugging in a number. There is much, much more to consider.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
Site Admin
 
Posts: 3309
Joined: Fri May 12, 2006 6:43 am
Location: California

Postby Remander » Sun Jul 08, 2007 6:27 am

Overall, the anticipation was more difficult to deal with than the actual procedure.


Amen. I had the same experience on that issue.

I also had the extreme light sensitivity issues on the way home from my enhancement (went home in the dark after first surgery, so it was not an issue) so I recommend bringing a dark/thick towel to throw over your head on the way home. I thought to do this and was glad I did.

Congrats on what sounds like good results so far.
Remander
 
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Postby goldbug » Tue Jul 10, 2007 6:07 pm

1 Month Update: I had my one month check-up yesterday. My left eye sees 20/15 easily, and my right eye sees 20/20. The manifest refraction showed that I am +0.25 in my right eye. The doctor said that it’s better that I’m +0.25 instead of –0.25 because there is still a chance that I’ll regress back to Plano. I still see starbursts and halos with my right eye but not my left, so I’m hoping that my right eye is still healing and will improve back to Plano.

Again, the doctor told me that my right eye only “seems” blurry because my left eye is so good. I don’t necessarily like hearing that because it seems like they are just trying to minimize less than ideal results. And also, because it feels like something other than “ordinary” refraction error is causing my right eye’s vision to be slightly off.

Finally, the doctor said they targeted my correction to achieve Plano in both eyes. And, that they treat people based on correction tables that were developed experimentally by testing people of similar age, sex and prescription.

Overall, things are still going well and I continue to hope that my right eye heals back to Plano.
goldbug
 
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Postby goldbug » Tue Aug 07, 2007 5:57 pm

2 Month Update: My left eye continues to be great and about 20/15.

My right eye slowly came into good focus over just the last week. I think my right eye is now 20/15 or darn close to it. Occasionally, my right eye does get a little bit blurry when I haven’t had a drop in several hours or have been staring at a computer monitor for some time. However, this blurriness is happening less and less often each day.

I do have a dry eye when I wake up, but during the day it’s only a minor issue. I use Refresh Plus drops about six times a day, but more often if I’m working on the computer a lot. In fact, I can feel my own tears starting to well up and come back once in a while.

I’m very happy with my results and I’m glad I had it done. It was a little dodgy for a while with my right eye early on, but thanks to this website I knew I had to be patient for my eyes to fully recover before getting too concerned. I don’t plan on posting more updates unless I run into some issues later on.
goldbug
 
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Postby goldbug » Tue Jun 10, 2008 6:53 pm

I just had my one year checkup.

I now have no refractive error in either eye and I can see 20/15. Things turned out very well once the healing process completed itself and I'm glad I had the proceedure done.
goldbug
 
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