Brad Wardell's views about technology, politics, religion, world affairs, and all sorts of politically incorrect topics.
A LASIK Diary Report
Published on May 1, 2005 By Draginol In Surgery

I finally bit the bullet and had custom LASIK done to both my eyes. The procedure was performed by Dr. D.C. Fiander of the Farmington Laser Eye Center.

It was not an easy decision to have this procedure done. I had spent a great deal of time researching the pros and cons on LASIK, PRK, Custom LASIK along with other methods to improve vision. 

Since I work in front of the computer all day, my eyes are very important to me so weighing the potential side effects from such a procedure was key in my decision. For the past near 20 years, I've been wearing contacts.  And glasses for years before that. My vision was bad. Very bad.  6.5 in my right eye and 5.25 in my left. I also have some astigmatism.  For those of you who aren't familiar with these numbers it means that without glasses and contacts that am disabled.  I couldn't function without glasses or contacts because my vision was so bad that I could only make out shapes.

For years I've hesitated in having this sort of thing done on my eyes. I didn't like glasses and contacts but I just don't like the idea of people messing with my eyes. And let's face it, as annoying as those things are, they are preferable to taking a chance on permanently damaging ones vision.

So I did a lot of research.  The Usenet news groups weren't helpful because the main group seems to be populated by a handful of kooks telling horror stories that just didn't match up with anything I'd read elsewhere (and it was only a couple of people who seemed to have some agenda).  There were numerous websites that gave clinical information on it and told me of the benefits and potential pitfalls of the procedure.

But I learned the most from talking to other people who had had the procedure and all were very happy with it. But still, I was just not willing to go in and have someone do things to my eyes. I was just too squeamish.

But then this summer I was at a wedding reception on the other side of the state when I got something in my eye while there.  I was wearing contacts so this was a big deal. Taking them out meant being basically blind.  That was my turning point. I travel a great deal and I'd reached a point where I simply didn't want to mess around with contacts and glasses knowing that if something unforseen happened that I could be left totally helpless. Whether it be a business trip or vacation or whatever, the idea that I could be left essentially disabled due to a lost contact or broken glasses became unacceptable. The logistics train of having to bring extra everything "just in case" exceeded my tolerance threshold.

So I made an appointment at Dr. Fiander's. He was someone that some friends had recommended and went for an evaluation. There are two types of LASIK available these days. The regular LASIK and Custom LASIK which uses Wavefront technology to have the changes be more customized to your eyes.

The Custom LASIK costs more and is somewhat more invasive, has a slightly longer recovery time.  But it has a higher statistical likelihood of giving good results.

My vision with glasses and contacts wasn't particularly good. In my case, I saw 20/40 with glasses and 20/60 with contacts.  So anything that equaled that or bettered it was an improvement.

The first step was the consultation.  I did that about a month ago. In that, they do a great deal of measurements on ones eye. It was like an optometrist appointment but much more intense. In hindsight, I wish I had asked more questions and received more information from this.  For instance, most LASIK centers offer free enhancements for up to a year.  I don't know if this is covered or not (and hopefully it won't be relevant to me either way).  The price range was on the high side compared to other places I went to but results were my overriding concern. Still, I would expect to be "taken care of" in the event that I do need further enhancements later on.

I also would have liked to find out things like my Corneal thickness, corneal steepness, pupil's in dim light,, tear break up, and other pupil measurements.  Essentially, for helping my research for myself after the consultation it would have been nice to be given a copy of the results so that I could assure myself that I was a good candidate for this procedure.  I am confident of Dr. Flander's view on this but it would have been handy to have this information for my own peace of mind.  I'll probably mention this to him on my next appointment as a suggestion.

Another suggestion I would have would have been to receive a print out on all the equipment. There are several different types of lasers and several different wavefront systems available. I recall hearing that they use the Excimer laser with LadarWave which would make it Alcon's "LADARVision CustomCornea". My right eye is at around 6.5 to 7 so it was at the very edge of what this system can correct (according to the FDA).  But I could be wrong on this (hence why it would have been handy to receive a bit more data on this).  Because it could also be the Technolas 217 Excimer laser with add-ons that supposedly give better results. I will ask more on this in follow-up exams.

So about a month after the consultation (October 22) I went in the Custom LASIK.

It took about 2 hours from the time I went in. Most of that time is in preparation.  They take close up topical pictures of your eye. This was not pleasant because with custom LASIK they have to take a picture of the entire eye ball which involves having a nurse holding your eye lids open just right (which took awhile to get right). 

Then they dilate your eyes. Once your eyes are dilated, they come in and put some numbing drops and use a special pen to draw dots on your eyes (very weird stuff).  A few minutes after that they took me in and had me lay down on this table where you rest your head under this machine.  It seems to be totally computerized -- complete with computerized voice telling you what % of the procedure is complete.

They started with my right eye and I won't lie, I experienced quite a bit of discomfort. About the same level as getting a shot for getting a cavity filled (not excruciating but not comfortable).  You hear the computer say "acquired" and then apparently a little blade comes and slices a very thin flap of your eye surface that is pealed back for the laser machine to do its thing.  For the next minute and a half, the laser does its thing while you stare at a red blinking light.  I didn't really feel pain but the longer it did its thing the more heat I could feel in my right eye. I did feel a distinct burning sensation when the right eye was being worked on.

A minute later they did the same to my left eye which was easier for some reason.  When they were done they put some anti-biotic drops in my eyes, some steroid compound drops and gave me some drugs to make me go to sleep and sent me home (my wife drove me home).

When I went home, I went to bad and slept for about 10 hours.  I got up the next day and I can instantly see the massive improvement.  It's not yet nearly as good as glasses or contacts but that is to be expected they say as my eye has to heal. Mostly it has to do with fluid in my eye and such that should go away over the coming weeks.

So am I glad I did this? The jury is out. It depends on how recovery goes. I expect in the next couple of days I'll have a pretty good idea. There's no doubt in my mind that my vision is far better than it was. But as the literature said, for the first 72 hours after the procedure I can expect halos and other light refraction issues which I am experiencing.  It is also hard to read close up things right now which I am told is normal and will work itself out in the next 72 hours.

Day 2: The glare has gotten considerably better. So I can read pretty well at this point.  My first concern that's come up though is that my right eye's vision is significantly less defined than my left.  I don't know if this is something I can expect to change or not.

Basically my right eye's vision is slightly garbled.  Imagine the letter S where a second letter S is superimposed on top of the first S but just a few milimeters above the lower S so that you have an almost double letter S going.   The left eye is completely sharp.

I've not found very good resources on the net yet to find out whether this is normal or not. After all, it's only been 48 hours. I won't worry too much for another week or so. But right now, while my left eye is basically perfect, my right isn't so great. Reading text and such, distance or near, is very indistinct.

Day 3: Halos and glare decrease. My eyes are fairly comfortable at this point. I'm quite pleased with my left eye but my right eye isn't quite as good. It seems to have a moderate case of monocular diplopia. I am hopeful that over the coming weeks as it heals that this will clear up.  I'm currently seeing about 20/30 in my left eye and 20/50 in my right eye. This is still better than contacts and once the "glow" effects from light and such dissipate over the coming weeks I expect to be quite happy. Though I am hopeful that my right eye will improve as it heals (I am left eye dominate fortunately).

Week 1: Still have some halos. The world is still vaguely like looking at the Sky Captain and the World of tomorrow. Left eye feels good. Right eye still feels a little tender. Vision in left eye is about 20/25. Vision in right eye has improved to probably 20/45 at this point. It's still noticeably less clear than my left eye. I'm not sure if that's due to it being less fully healed or what. Eyes do get fatigued quite easily. But overall, I'm still pretty happy about things. Not having to wear contacts or glasses is very nice. I expect the halos and overall glowy effect of everything to subside (basically with every light source big or small giving a glow effect it does make the world look a bit odd).

I'm having to put various drops into my eyes. Anti-biotics and steroid drops 4 times per day and about the same # of times for "refresher" (wettening) drops. The left eye needs it a lot less than my right eye.  I don't get star bursts which was one side effect I read others having on the net. So I'm happy about that.

Will keep reporting.

Week 3:  Night vision is still problematic because light sources give of a large halo (glow around the light source). My vision is about 20/30 overall at this point.  But it's 20/50 in my right eye. Overall, i don't see as well as I did with my glasses but I see better than I did with my contacts.

Eyes do get dry quite a bit but it's getting better.  There is still a significant haze in my vision largely due to the reflection of light off of surfaces.  I have not found that to have improved yet. 

Overall, I'm pleased with the results but I am thinking I may need them to tweak it.

2 Months:
I've become more pleased with the results over time.  I see about 20/20 out of my left and 20/25 out of my right. Overall I see 20/20 at this point.

One of the things that I've been told is that CUSTOM LASIK, as opposed to regular LASIK does have a longer recovery time. I wish this had been stressed to me at the time as I wouldn't have been as concerned with the results early on. Most of the articles I've read on-line deal with plain old LASIK.

I still experience dry eyes, something I didn't before. But it seems to get better by the day.  I am still getting a significant halo affect but that too is improving over time.  I think I'll have a better idea in another month or so.  Overall, I'm quite pleased with the results at this point.

6 Months later:
Very pleased with the results.  The halos are gone or at least so much subdued that I can't notice it.  My eyes do get dry sometimes so I carry some re-wetting drops with me. But it's pretty minor. 

We recently went on a trip to Disney and it was wonderful because I didn't have to lug around contact stuff or glasses (or both). And I can definitely see better than I did with glasses/contacts so I could definitely appreciate the difference.


Comments (Page 4)
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on Oct 26, 2004
I had PRK done on both my eyes about 3 years ago. I couldn't have LASIK done because I had too big pupils, the doctor told me, and I was afraid of the surgery aspect of LASIK. I couldn't stand whenever something touched my eyes - up to the point to not being able to wear contacts, not even being able to put them in once, because I was so uncomfortable with that thing. My eyesight was really bad before this, -7 on my right eye and -10 on my left eye! another thing that made me feel better about PRK is that the do one eye first and then the other eye 6 months after when the first eye has healed. So I figured that if something goes wrong, I will still have one at least.

The entire procedure was a lot like when you have LASIK done but without the actual surgery, only lasering directly onto the eye. It took about a minute, I think. Afterwards I got pills for the pain and was sent home. The pain was quite bad, sort of like having crushed glass under your eye lid, and I also had a bandage over the eye so I couldn't see anything with it. That was just as good as I preferred to have both eyes closed to avoid additional discomfort. Also, I didn't take all the painkillers since they made me feel dizzy so I guess it's partly my own fault that I experienced so much pain. However, it was managable. Since I really dislike people messing with my eyes, I was so happy it was over and only the healing left that the pain was no big deal. After a few days, the bandage could be taken off and although it was a little strange to have perfect vision on my right eye and still have -10 on my left eye (so I saw a little strange, with double images), this corrected itself after one day or so and I could see perfectly! Even better than my friends who have never had glasses. I was told by the doctor that it would take a few months until my vision had improved and the healing was done, it seemed like it only took a week. I had to take eyedrops for a month or so after the surgery aswell to avoid swelling.

The PRK on the other eye was about the same, but my vision didn't turn out perfect, probably because of my terrible eyesight before the procedure. I'm not sure how good my eye sight is on that eye right now but not bad enough to bother me at least, and I've never wore glasses even once after the procedure on my first eye. It's possible to get the left eye redone since it wasn't perfected for free but I prefer not to have this done since of the discomfort from the actual procedure.

It cost about 1000 US dollar for me for each eye, but I live in Sweden so it might be cheaper because of that. The only problems I've had after the procedure is worse nightvision which I don't really mind because I couldn't see a thing when waking up in the middle of the night before I had it done anyway , aswell as a burning sensation whenever my eye is touched quite hard on the pupil (with the lids closed). I had this done when I was 21 yrs old, the minimum age to do it here is 20 yrs.
on Oct 27, 2004
I was told that the have LASIK that can accomodate larger pupils now , as a friend of mine wanted to ahve it done a few years ago but that was his problem , and he finally had it done not too long ago.
on Oct 27, 2004

Brad, how goes the progress?

I forgot my drops for a few days and noticed my far vision getting kind of misty.  Started using them again, and things are clearing up!

They did not tell me how long I had to be on the Liquid tears, but I guess it is a long time.  Small price to pay for no glasses!

Questess:  I dont know the minimum down here, but they really were putting off anyone under 25.  Due to the eyes still changing.  If they change that in the next few years, I may just get my son a nice Birthday present when he turns 21!  His is not nearly as bad as mine, but I know he hates glasses!

on Oct 28, 2004

Brad, an update so you can look forward. After about 1-2 weeks, sunglasses were optional, and while I bought my self a snazzy new pair (first time I could do that instead of looking for clipons!), I only use them when the sun is shining right in my face.

On the Halos, well, since winter is approaching, I drive to work in the dark. And I realized this morning (I dont know when it happened) that the Halos are almost gone! 100%^ better than with glasses, as I always had them with glasses. Now they are very faint, and I have to think about them before I notice them!

In some cases 3+ months sounds like a long time, but trust me, it will go very fast for you! Enjoy the new sight. It will only get better over the coming weeks!
on Oct 28, 2004
That's encouragig. The halos are going away a little but I'm not totally satisfied yet iwth the quality of my vision. It's all still a bit fuzzy still.
on Oct 29, 2004
(grin) I think most of us could honestly say that we want your eyesight to keep getting better, Brad. Your eyes see Stardock's content before it gets out to the rest of us, and I think we all want to see your vision doing just fine in that regard.

Besides, I've been wearing glasses for over 20 years, and I come away from this blog wanting LASIK, I won't complain.
on Oct 30, 2004
My wife had the Custom Cornea procedure 1 year ago. Her eyesight was -7.15 L and -7.25 r with 8% astigmatism.
We did it through a local opthemologist by the name of Dr. Mitchell Wong and my wife had the same squenching problem as well as not liking people touching her eyes.

20mg of Valium later that went away.

The procedure took about 70 seconds for each eye, with them using one laser to create the flap and another to do the Custom Cornea procedure.

My wifes only problem with the procedure was she was squenching her eyes so hard, she looked like she had been in a fight for the first 12 hours afterwards.

One year later the halo's have gone away completely and she has 20/20 in boths eyes.

Cost wise, it was $4900 at the time but that price has come down and they also have something new called Crystal Eye.
Outside the dry eyes for the first 3 months, no problems have occurred at all.

She is a bit more light sensitive now but that takes care of the Night Blindness she had when wearing glasses.

Also, just as an FYI, the reason she got the procedure to begin with, the doctor was recommending bi-focals, and with the thickness of her glasses and weight of the frames, we started looking at titanium frames with ultra-thin polycarbonite lens with scratch resistant coating etc etc. They would have cost us $1,100 so the jump to the custom cornea was quite easy.

Go to someone that uses the laser to make the flap. It is much less damaging to the eye and they can make the flap 2.5 mm larger than they can with the mechanical device, keeping the halo down to a minimum.
on Oct 30, 2004

Yea, I had the mechanical thing for the flaps. I have halos but they're getting better by the day.

I am just wonderig how fast the vision gets better. It's been 10 days and while I am able to work without glasses or contacts, my right eye is significantly less clear than my left.

on Nov 06, 2004

Ok, Brad.  It is 2 weeks later.  How goes the vision?  As for me, 4 months later (as of Tomorrow), my Halo is almost non-existant!  My Night vision (now that we are off DST) is so much better as to be eerie (they never told me about that!).

I hope yours is coming along great.  But they can do fine tuning if they did not get it right the first time. I dont think I need it.  just some eyedrops!

on Nov 10, 2004

Vision still gets a little better but it's stil not quite as good as I would like it. I still feel like there's a haze given off by reflections from light sources. And I'm still seeing around 20/30.

I see roughly as well as I did with contacts but not as well as I did with glasses.

on Nov 10, 2004

If you dont get 20/20, they can fine tune it.  Mine still dry out easy and then my vision gets hazy.  But when I keep it lubricated, they are as good as with any glasses or contacts I have ever had!

Look at it this way.  It has been 2 weeks, you no longer wear glasses and the vision is improving daily!  it does take time as impatient as we are!  But it sure is great!

on Nov 15, 2004
My dad got it done about 2 1/2 weeks ago and his vision was restored to his glasses from 20 years ago, the docotors said with two cuts they can restore 20/20. He had his Cartiacts removed.
on Nov 16, 2004
I had mine in April of this year and I went from 20/400 to 20/15. However, I developed diabetes this last October and the medicine the doctor prescribed screwed my vision royally. So I stopped the med's and am controlling the diabetes via diet and my eyesight has restored to normal, 20/15. Best money ever spent.
on Nov 17, 2004

Well it's been about a month. And here's where I'm at:

1) Vision is much improved over glasses of course.  But it's still a solid 20/30.  At the doctor's office they show 20/20 (or did when I was there) but I think their chart is a bit too close. I have a chart here at home that is measured out to 20 feet.

2) Eyes still dry out very easily but this has improved a lot since I first got it.

3) Night driving is very problematic. The halos don't seem to be getting better. This has me quite concerned as I used to have excellent night vision (with glasses or contacts).  The halos are really quite severe around light sources.

4) There is still quite a bit of haze but I think it's getting better (or I'm getting used to it).

BUT..

The thing I'm most concerned with is that I cannot currently sleep on my right side. My right eye feels like it has a piece of sand in it. Which is normal (I'm told) at first but after a month? That doesn't seem right. My eye looks fine on inspection but my right eye has quite a bit of discomfort to it (enough to keep me awake). I go in for my checkup next Tuesday so I'll hopefully have a better idea then.

on Nov 17, 2004

My discomfort only lasted a day.  You are right, that does not sound normal.  But the Halos will disappear.  Like I said, after about 3 months, they were almost completely gone and get better every day.<BR>

<BR>

Good luck with the Visit.

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