My Lasik Experience

[swerveut]

I am a 26 years old male and had myopia and astigmatism with 4.75 S, 1.75 Cyl, and 10 axial in my right eye and 4.50 S, 2.25 Cyl and 165 axial in my left eye. I underwent Lasik surgery two days ago (22nd Dec 2009) and I will use this thread to record my Lasik and post op experience. Hope you can find it of benefit.

My Lasik correction was undertaken with the Bausch & Lomb Zyoptix machine and was a standard Lasik with the Tissue saving function.

Let me describe my Lasik experience 2 days ago:

Clinic arrival:
I was asked to go to the theatre prep room where I was given some anesthetic eye drops. The area around my eyes was cleaned with povidone Iodine and I was given a gown to wear and a cap to cover my hair. I was also given a valium to calm my nerves.

Operating room:
The theatre was a clean room with a big machine with a pivoting bed (B&L Zyoptix). I was asked to lay down on the bed and it was pivoted under a projecting microscope-like device with three lights shining from above (felt like I was under a scanner).

Surgery:
The surgeon covered me with a sheet with only one eye hole and asked me to look at the lights above. Then he taped my upper and lower eyelids out of the way. At this point I had difficulty blinking which was a little uncomfortable and made me a little apprehensive. I was asked to fold my arms on my chest, and for me, folding them tightly gave more re-assurance when required. I was given more anesthetic drops and then a device was put on my eyelids which really forced them open. This device can be a little uncomfortable as it stretches your eyelids out so they may hurt a little.
The surgeon poked my eye with few instruments but I did not feel them, so I guess i was numb. I asked him to keep talking with me and tell me every step of the procedure so I was aware of what was happening next.
He told me he was about to cut the corneal flap and whether I was ready for it. This was the scariest part for me so I asked him to give me more anesthesia first and waited for about a minute to gain my composure. Then it was either do it or not, so I asked him to go for it.
A suction ring was applied on my eyes, and at this point you start feeling that something is pressing on your eye hard. If it gets too hard, tell the doctor. Then a whirring noise, and something comes in front of your eyes so you cannot see anything. Then when its removed, the pressure is lessened a little. The doctor may wash or clean your eye now.
My flap was held to the side and the doctor told me the laser was starting. I was asked to look at a red dot on the scanner with three lights above. The laser then started ticking and flashing and I could smell something like burning flesh (which is your cornea being ablated). This was not painful at all, and rather interesting. It lasted only about 30 seconds to a minute. Afterwards, the flap was replaced, the eye was washed with water which felt really really cold and smoothed, then the doctor put in some eye drops which stung a LOT. He then removed the device forcing my eyes open and removed the tapes on my eyelids. My eye was closed with a surgical tape and it felt good and relaxing.
Next, the cover with the eye hole was moved over to my left eye and the same procedure was repeated.

The trick is to maintain communication with your surgeon and take some time to calm your nerves. Ask him to let you tell him when you are ready. The procedure is not very bad and only discomfort is when the microkeratome presses on your eye and is creating the flap. This may be avoided with Intralase procedures, however, I preferred the microkeratome method.

After surgery, it is good to go to sleep for about two to three hours to allow your eyes to heal

[swerveut]

Post-op Same day:

When I got home from surgery, I had extreme urge to sleep due to the Valium that was given to me prior to surgery. I slept for about two to three hours. On waking up, I could see the clock on the wall with ease... something I havent been able to do since I was age six. Exhilerating, however the image was blurry in places. My eyes felt really tired and I could not make out much detail. Vision = 50%.

I have been given a strict regimen of eye drops, an antibiotic - Vigamox, 4 times a day, a steroid - Tobradex 6 times a day, and a lubricant/hydrant - Systane 6 times daily or as required.

In my 50% vision, I took a big sheet of paper and wrote down times when I should be taking each medicine in bold letters. Took off the clock and placed it by my bed. Its better to sleep much on the first day.

I have been given eye shields which resemble small plastic eye tubs. I have to wear them while sleeping so I dont accidentally touch or hurt my eyes in sleep. Also, I have been asked to take a valium before sleep too. Wikipedia says that Valium also supresses REM sleep so that should also be good to avoid any chance of flap displacement.

[swerveut]

Day 1 Post op:

In the morning when I woke up, my eyes were seemed full of pasty gunk and I could not see very well. I used systane to wash them off, then applied my first daily dose of all the different eye drops. After about 10 minutes, my vision seemed to be back to normal. Can see up to 90% today, however there is a haze surrounding everything. Hopefully it will get better with time.

Post op appointment:

I drove myself to the doctor for the post op appointment. The doctor examined me with a slit-lamp scope and told me I was healing fine. A quick eye exam showed my number to be 0 in one eye and 0.25 in the other. Very exhilerating news. Its amazing that I can see things without glasses now. A little bit unbelievable.

I am using wrap-around sunglasses all day long to help protect my eyes from any dust, accident, and of course, bright lights.

Night-time vision quality is very bad. I can see intense halos and haze around every bright light. Makes it difficult to register detail. Hopefully it will go away with time.

[swerveut]

Day 2 Post-op:

In the morning again, my eyes seemed almost stuck with gunk. After removing the plastic shields, I washed them again with systane. In the morning, vision seemed very bad - more like 80%. I was worried about my eyes having been undercorrected. However, after I allowed some time for hydration, vision got back to normal. Used the normal cocktail of eyedrops.

As the day progresses, I am testing my vision against everything. It seems like it has become much better now in midday. Vision quality ~ 97%. Haze has been reduced by 60%. Eyes are somewhat dry. I need to apply systane roughly every hour. Still using wrap-around shades roughly 90% of the time in order to avoid accidental inury, dust and light. My eyes hurt a little in bright sunlight, however, I have had some photophobia even prior to surgery so it isnt that bad.

I can read smaller fonts on the computer now as well with little difficulty. Earlier I was magnifying the font size on the computer 6-10 times.

At night, tried my vision on the moon. I remember as a kid, when I started developing astigmatism and myopia, I would look at the moon and see two intersecting crescents and then the whole thing slowly became blurry with time. This time, I saw a clean half moon with both eyes by the grace of God. Only slight halo around it which should hopefully go away with time. Night vision quality = 70%

[LasikExpert]

Keep the hydration as this promotes healing. It sounds like you are doing the "Lasik Salute" of covering one eye, looking, covering the other eye, looking, back and forth. People become very vision aware after Lasik.

Thanks for all the excellent information about your experience. Keep us informed.

[swerveut]

Day 3 Post-op:

No gunk in the eye today in the morning. Maybe because I hydrated them a lot more yesterday night before sleeping. Vision = 95% right from the time of waking up. Remaining haze = 5%. I am sleeping these days with the plastic eye shields taped to my face in order to still avoid accidental rubbing (I read about someone who did this while sleeping and damaged their eyes). I also take a valium before sleeping to reduce REM sleep. Should I be doing this? Maybe I am being a little too cautious. But I guess no precaution hurts when its your vision that counts.

The bruises around my Iris are still pretty much there (caused by the suction ring). However today will start to wean off the steroid drops. Will go to one drop instead of two, six times a day. Both eyes feel like there is something in them at times, however when I hydrate them, the feeling lessens.

[swerveut]

Day 4 Post-op:

Vision = 97%
Haze = 15% daytime, 25% night time.
Thing in the eye feeling : Dust particle
Bruising = 90% still there.
Cool experience of the day = I could actually see how my hair was being cut at the barber's today! Cheers to Lasik.

From today will be decreasing frequency of Tobradex (steroid drops) from 6 to four times a day.
Just noticed today... I have lost most of my eyelashes of the lower lids because of the tape that was used to keep my eyes open during surgery.

[swerveut]

1 week Post-op:

Vision = 98% (fluctuating at times) distance vision, 95% close-up vision (for reading). Reading or computer work is still causing me some eye strain.
Haze = 5% daytime, 15-20% night time. At night vision sensitivity is still poorer because all lights have halos around them and brighter lights have starbursts. However nighttime vision is steadily improving.
Thing in the eye feeling : Sometimes a dust particle
Bruising = 85% still there. I hope it goes away soon because it is very visible.

Overall, I am happy so far with my treatment. Seems to have gone well by the grace of God.

Question for the experts here: Why are steroid drops prescribed after Lasik (eg. Tobradex)? What benefit do they have and if they are discontinued what can be the downside? I have read numerous stories about steroids causing complications. Even in the drug information leaflet, the mentioned side effects seem very severe.

[LasikExpert]

Why are steroid drops prescribed after Lasik (eg. Tobradex)? What benefit do they have and if they are discontinued what can be the downside? I have read numerous stories about steroids causing complications. Even in the drug information leaflet, the mentioned side effects seem very severe.

Corticosteroids applied as an eye drop after Lasik are used to control the wound response, including reducing inflammation. Without the steroids significant corneal edema would likely occur, vision would be poor, pain may be present, and generally you would not have a very pleasant experience.

There are very rare side-effects of some steroids including allergy, but the most common side effect is an increase of intraocular pressure (IOP). Long-term high IOP can lead to vision loss, but we are talking days, weeks, months. During recovery your doctor will monitor IOP and respond accordingly. Some people do not have an IOP spike with steroids.

[swerveut]

Thank you Glenn for the information.

Ten day Post-op: Follow-up visit

I went for a follow-up appointment with my surgeon today.
Had been having some minor headache lately and eye strain in my right eye. Also some difficulty using the computer. At the check-up it turns out that I have been slightly overcorrected in my left (non-dominant) eye. It now has a +0.25 D number whereas the right dominant eye is exactly zero. I sustained a minor injury to my right eye when a baby cousin inadvertantly hit me on the eye on the 9th day after surgery. Luckily I closed my eyes in time, however it led to some swelling and minor aberration of vision in my right eye. It is healing well now however, and I hope the swelling will be gone soon as well. Using zero prescription spectacles for guarding my eyes from accidental injury now, till they are completely healed.
I have heard that during the healing process, the eyes can undergo minor shifts in visual acuity. I hope that both my eyes stabilize to the same number after complete healing, whatever it is, so I can still remain without glasses.

Current visual outlook:
Vision = 98% (fluctuating between 99% and 94% lately at times)
Haze = 5% daytime, 10% night time.
Night-time vision = not very good in the dark yet (as opposed to pre-Lasik vision). However I can see some steady progress on daily basis.
Thing in the eye feeling : none, however some pain in my right eye due to swelling.
Dry eyes = little. Am using Systane generously and genteal gel at night. However I notice I have better vision when I am not stuffing my eyes with drops and letting them get a little drier.
Bruising = 80% still there. My face probably looks the same with or without glasses, so people don't seem to notice at first that I am not wearing glasses. They only say - "why do you have blood in your eyes?" then I have to tell them I had surgery and they're like "aaaaah".

Cheers!

[LasikExpert]

Keep the posts coming. This journal is invaluable to those considering Lasik.

[swerveut]

~ 1 month post-op:

Current visual outlook:
Vision = 99% (fluctuating between 97% and 99% - usually improves as the day wears out)
Haze = 5% daytime, 10% night time. It is continually improving.
Night-time vision = Night time vision is good, however, generally in dark environments resolution is not very good as yet. Sometimes causes trouble reading things at a distance. Sometimes it gets a little distorted due to starburst-like effect. I see a steady improvement however.
Thing in the eye feeling : None.
Dry eyes = Not very much. Systane was proving to be a little too heavy for me so I have switched over to Genteal drops in the daytime, and the gel at nighttime.
Bruising = 75% still there. My eyes are also still very red and that has been causing me much embarrassment lately as everyone who I talk to is staring at the red in my eyes and I notice all sorts of reactions. Because of this, I have started wearing no-number spectacles with somewhat reflective glasses so people dont notice the redness first thing in the conversation. At post-op appointment today, my surgeon said that I was healing very well (by the grace of God), and he prescribed me Maxitrol eye ointment for nighttime use to lessen the redness. Its a steroid ointment however, and I am a little apprehensive about its use. He measured my IOP as well, and said it was normal. Next appointment in two weeks time and thats when I will update again. Cheers!

[swerveut]

Question for Glenn / any other experienced person:

I am looking for some sort of an eye wash or an eye bath for washing my eyes out in the morning, since when I wake up, they tend to be very sticky and gunky. If I use water, it leaves my eyes stinging and very very red. Would you advise any eye wash containing witch hazel? I found one by Optrex, however it uses Benzalkonium Chloride as a preservative and I have heard all sort of bad things about this compound. Any other advice on good eye washes available?

Cheers!

[swerveut]

Yup. Knew steroids were horrible. In my right eye again, i had severe visual distortion yesterday and today (progressively worse) and had really bad headaches all day today... coupled with horrible vision. I am quitting the steroid ointment. Will go talk to the doctor on Saturday.

[swerveut]

Update:

So I told my doctor about the visual error I was getting on using dexamethasone containing medicine in my right eye, and he said that I was right in stopping to use it. He gave me FML drops to use for 4-5 days since my eyes were very red. He said this was a much weaker form of a steroid so it would not have that severe an effect. I was to use it 2-3 times daily. I think my eyes tolerated FML very well, and my redness really went away much faster with them. Now my bruising is diminished easily by 50% in both eyes. Vision is also becoming normal now in both eyes, and is easily 98-99% in both eyes. I have a severe problem with dry eyes however currently. Oftentimes, my eyes seem so dry that it seems like they are going to crack off like dry mud. And literally it looks almost parched if I look in the mirror up close. It also is causing me eye distress and headache. I am using Genteal almost every hour, and the genteal gel at night, however it is not offering much help. Am going to try various combinations of drops to see which one suits me best. I used to have a really good tear film before surgery, but now I have almost no natural tearing right now. I hope it starts to come back.

Cheers!