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 5)
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on Nov 17, 2004
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 know that Adrian had a different procedure than you did, but even now, 8 months later, he still feels like there is always something in his eyes, just like you do with your right eye. I'm curious to hear what your doctor says about that problem.
on Nov 18, 2004
I'm going in on Friday so I'll find out more then.  I did an eye test today here at home. I see slightly better than my wife does (who doesn't wear glasses).  I'd guestimate around 20/25 overall. 20/30 in left and 20/50 in right.
on Nov 18, 2004

I'm going in on Friday so I'll find out more then.  I did an eye test today here at home. I see slightly better than my wife does (who doesn't wear glasses).  I'd guestimate around 20/25 overall. 20/30 in left and 20/50 in right.

They say, and I see it, that I have better with both eyes than with either.  I wonder why that is?  Might want to ask them when you go as I would be very interested in knowing, just for curiosity sake.

on Dec 12, 2004
Updated.
on Dec 13, 2004

Ok, I gotta ask.  What is Custom Lasik?  How is it different from regular old lasik?  I did not know there was more than one kind (other than different kinds of procedures using different laser techniques).

And Lasik is like Christmas to a kid.  We know the end results are coming, we just want to jump over the intervening days and have it come now!  Glad you are progressing well!

on Dec 24, 2004
Hi Guys and Gals,

I have read all the scary stories of LASIK including this one. I finally decided to go for it.
I had my surgery yesterday afternoon (5.30pm). Trust me...I never had any of the stuff that is mentioned in this article. I spent about 30 mins in the surgery in which 7 mins was spend under the laser. It costed me $6000 (Australian Dollars).

After I came home I was given sleeping pills to sleep over and this morning everything was great!!! I could see well. I actually drove to the hospital this morning (about 1 hour drive from home). I also went to the transport authority and got my license changed to "No need to have glasses or Contacts" after passing my eye test.

Here are a few things that I came to know from questioning my doctor about everyones unpleasent experiences.
Halo/Starburst - It is natural as your eye is not accustomed to lasered eye yet.
Gritty feeling/Something in the eye feeling - This should never happen. This happens when the eye surgeon does not put back the flap of the cornea properly. If you get someone say that then DO NOT GO TO THAT surgeon.

Today after 2 hours drive am still feeling good. Touch wood things will go on well for me.

Will keep you guys posted on my recovery too. Pls post your comments if someone actually reads this.

Abhinav

on Dec 24, 2004

Will keep you guys posted on my recovery too. Pls post your comments if someone actually reads this.

Actually, I had it done 6 months ago. on the Halo vision, the Doc told me it was due to the flap taking time to seal (I had it with glasses - somthing to do with 2 focal points).

The Gritty was only for a few hours afterwards hence the sleeping part.  By 4 hours Post OP, it was gone!  My Halo is almost completely gone and I really have to be thinking about it to notice I have any.  And then with a blink of my eyes, it is gone!

After wearing glasses for 40 years, I am very satisfied with it!  As for the warnings and such, they are required here to tell you all the dirty, no matter how slight the chances (when my youngest daughter went in for eye surgery, they told us horror stories because they were required to by insurance, but it went flawlessly!).

I know several people personally that have had it.  I have yet to meet anyone that has had a bad experience, other than perhaps some less than hoped for expectations.

If you can afford it, go for it!

on Dec 27, 2004
Hi Everyone,

Up until now there has been no problems for me with LASIK. I have no idea if it is standard or custom. Since it is Christmas I can not call up and find out.
I went out for a drive last night for the first time (3 days post-op) and found that I have a slight problem where I get a glow around a light object (Street lights, head lights of cars)
Other than that things are normal. I have started work again (20 hours in front of the computer everyday).

Does any one know how many days it takes for the glow to go? Also when is the final day to say that the surgery was success. What I mean is that after how many days/months/years can I say that this is what I got as the result from surgery?

Most articles here say that even after 6 months they are still healing....
on Dec 27, 2004

went out for a drive last night for the first time (3 days post-op) and found that I have a slight problem where I get a glow around a light object (Street lights, head lights of cars)

That is the Halo.  For me, it took about 5 months to finally go away.  But then I had it with glasses, so it was not a problem!.

My Doc told me about 3 months for most of the side effects (which were very mild for me) to go away.  The Halo did take a little longer.  I figure I got about 20/20-20/30 right now.  DUe to my age, I also my presbyopia, so I do need reading glasses for small print (they told me that too).

Mine wants me to get it checked by an independant Optometrist. If the says it is not at least 20/30, I can get a touch up.

I will do that in the new year.  But it sure is great not worring about glasses now!

on Dec 29, 2004
Six days after custom lasik, and the vision is getting better all the time. My doc used a laser to cut the flap, which is supposed to cause less discomfort. After the flap is cut, they led me back to a prep room, where I waited for several minutes before having the actual procedure. My doc came out and spent several minutes with me, answering questions and explaining the next phase.

Having the actual procedure was weird. After putting a spreader to keep the eye open (which was only slightly uncomfortable), I was told to look at the red light. Then the flap was lifted and the dot turned into a kaleidiscope of red and green lights for about a minute. As the laser did its thing the doctor explained what he was doing, and a tech counted down. On the second eye, they had a little problem lifting the flap and the tech chuckled that I was a squinter! But that was the only hitch.

Went home and slept for the next 4-5 hours, woke up to a semi-blurry world with a lot of haze. Sat with the family to watch a movie, but mostly kept my eyes closed. Every time I dozed off, my vision was noticably better each time I woke up. At the 24-hour check, one eye was 20/20, the other was 20/40. A few minutes later they switched, which has been my experience over the first week. The vision is clear for a while, then drifts out of crisp focus, and back. They told me to expect this fluctuation over the first 7-10 days, and then it will start to stablize as the eyes heal. Had a real "wow" moment yesterday afternoon when the computer screen snapped into crisp focus, and I could clearly read the papers on my desk (I'm 48 and expect to need reading glasses now instead of bifocals). After an hour or so, things drifted back to a soft focus.

Halo is not a real problem, but I now have a really cool rainbow effect

Right now I am putting liquid tears in about every 2 hours, plus the steriod drops 4 times a day. It is amazing how hard it is to hit my eyes with the first drop! ;>) According to the doc, I'll probably have to use drops for the first 3 months and then the need for drops will taper off. It will be nice when I can sleep more than 2-3 hours without having to get up and put more drops in. I'll ask my doc about this at the one-week check tomorrow.

BTW - I am using a co-managed system. I live about 300 miles from Denver, where the procedure was done. My local eye doc will take care of the post-op checkups (unless a problem develops), which saves a lot of time and cost. And when I am in Denver I can schedule a checkup at the laser clinic if I want.

This all started after a camping trip this summer when I told my wife I wanted to see the stars without fumbling for the glasses. When I saw the stars and full moon on Christmas night, the smile on my face simply would not go away!
on Jan 06, 2005
I got custom lasik 4 weeks ago today. I am seeing better, but the improvements are slower than they were early on. Most signage when driving is blurred and I people's faces are blurred if they are 20 yds. away or more. The dry air this winter is not helping, since my eyes seem to get worse throughout the day. When I wake up in the morning, I see pretty well.

After reading all the comments about having "patience", it reassures me. Overall, I'm happy. If I have to, at some point, I will just get an enhancement done.

on Jan 18, 2005
I had the laser procedure done in the right eye in 1995. It did not go well, and there is a scar in the middle of the cornea. It sees better than it did, but I will likely never read clearly with that eye again.
on Jan 25, 2005
I want to thank all the posters.

I am going for custom lasik in 48 hours. From what I've read here, and from personal discussions with those who've had 'normal' Lasik and PRK, it appears to be money well spent.

If it doesn't work out well, at least it will be a reason to get a dog.

I'll let you know how it goes...
on Feb 15, 2005
Are you a lasik surgeon?
on Feb 20, 2005
i got my custom lasiks here in LA at UCLA Stein eye clinic 3 days ago, and it's AMAZING! at my 24 hour post-op, i had 20/15 vision w/both eyes and 20/20 on each. my site wasn't too bad to begin with, but now it's PERFECT. my astygmatisms are gone, and i feel so happy that i'm terrified of loosing this site! i will like to be able to properly was my face and put make up on again....they said to avoid that for 4 days.
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