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 6)
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on May 01, 2005
Updated..
on May 02, 2005

It has been 10 months for me, and I have no complaints.  With Proper lighting, I dont even need reading glasses, but I was warned about that as I am over 45.

And unless I think about Halos, I never notice them.  And when I do think about them, a blink gets rid of them.

on Jun 17, 2005
I had my Lasiks 2 1/2 weeks ago. I have had all of the same issues mentioned above - light sensitivity, tired/strained eyes, blurred vision, halos, fogginess, dryness etc. I had no idea all of these things would happen for weeks, even months afterwards. I had been wearing glasses/contacts since I was 5 years old and am certainly happy to be free of corrective lenses (I was -6.0 with astigmatisms). I wouldn't say that I regret it, but I have been dealing with a lot of discomfort and am anxious for the healing to pass. I envy those who gained percise vision, as words and numbers are still blurry for me weather up close or far away. I have achieved 20/25 in one eye and 20/30 in the other, which I know is pretty good, but it is definately not as clear as when I wore my glasses. I can only hope that things improve in time, as it is still pretty early I guess.
on Jul 05, 2005
I've primarily worn contacts since I was 19. I'm 32 now. I've never like wearing contacts or glasses. Glasses were just never comfortable to wear, and contacts dry up in the winter, stick to your eyes like their glued in on hot summer days, rip, fall out, you always have to carry an extra pair, etc...
I had my eyes done last Thursday. My right eye was -4.00, my left eye was -3.50 with no astigmatisms in either eye which surprised both my regular eye doctor and the surgeon who performed the procedure. They told me about 84% of the population has some sort of astigmatism in their eyes. They also told me that by not having astigmatism I could expect really good results.
Right after my procedure I could see really good in my left eye. My right eye had me a little nervous. It didnt even seem like they did anything to my right eye. I thought maybe the laser missed . But by the next day I could see clearer in my right eye but both eyes had halos. At night I see little starbursts, and halos but not bad where it's annoying. I do wish they would have stressed more the amount of time that it takes for Custom Lasik patients to heal. I guess I was expecting the immediate miracle but I have to give it time. Over the past couple days my vision has gone from extremely clear in my left eye and a little blurry in right eye, to very blurry in both eyes when looking at things at a distance. But this is to be expected, and as I read more here I see it will take some time, alot more time than I anticipated, which has calmed my nerves. You cant find too many boards where people talk about their CUSTOM LASIK experiences.
In my post-op check-up I had 20/20 vision in my left eye and 20/30 (probably closer to 20/40) in my right eye. My doctor told me that my vision would get better over time. He expects me to have 20/20 vision or better in my left eye and 20/20 vision in my right eye (20/20 overall). He did mention that about 12% of the people who get Custom Lasik need some sort of enhancement surgery but it's way too early to talk about enhancement surgery. It's only been 5 days. He said I wont really start to notice the full effects of my surgery for another month to 2 months.
I just have to learn to be patient.
I'll post my progress as it goes along...hopefully by the end of summer I'll be telling everyone how I can see the hair on a bugs butt )

on Jul 12, 2005
I'm so glad I found this site! It is incredibly difficult to find "real" testimonies which aren't always glowing. I'm glad everyone is so honest and upfront about their experiences. I'm currently 24 years old and -3.75 in both eyes with .25 Astigmatism. I'm planing on going for custom lasik on the 28th of this month (July). I'll update with my experiences if I notice people are still posting on this page. Thanks Again!
on Jul 14, 2005
I had RK done about 9 years ago. That was the surgery where they cut incisions in your eye using a diamond scaple. It really messed up my vision, So bad that they can't get a good focus on my left eve at the optomotrist to give me glasses. I barely passed the vison test to renew my license and I think the lady felt sorry for me and passed me after I explained why I was having a hard time. My left eye is almost usless and I have almost no night vision. My eyes always hurt and tired. I have been told that some people that have had this provedure are canidates for LASIK? Does anyone know about this or someone that had the RK procedure then LASIK? And what was their outcome. Please help! No Eyes, No Job!
on Jul 21, 2005
Three weeks since my surgery and my eyes feel like their getting better...slowly.
My vision comes and goes. Somedays my right eye has better vision than the left and vice versa. Most days my left eye is really good and the right eye is still fuzzy. My right eye was my weaker eye.
I'm down to taking steroid drops 3 times a day instead of 4 and have my next appointment with my eye doctor next Saturday. I went two weeks ago and I told him that my vision feels like it has hit a point where nothing has changed. He told me this is normal because my eyes are still really swollen. For anyone who hasnt had the surgery or is going for the surgery, when I say my eyes are still really swollen, dont worry, you wont be walking around looking bug-eyed. I cant even tell my eyes are swollen, they dont feel swollen and they dont hurt, but when I go to the eye doctor and he looks at my eyes with this bright light and microscope he can tell they are swollen...so dont worry, your not going to look freakish.
It's still too early to tell if I will need an enhancement done. I think it will all depend on how my right eye heals. I can deal with it for now, but if they told me that this was as good as it was going to get I would have an enhancement done, which my eye doctor has already said that if my right eye was that was it is now, three months from now he would also recommend it. But as I said...it's waaaaaaaaaaaaaaaaaaay to early to think about that. I could pass a driving test with no problem. I can drive fine, signs are a little fuzzy but for the most part it's no biggie. My night vision is really suprising. I see some little halo's and little starbursts around lights but nothing annoying. For the most part and from what I've heard from other people that symptom usually takes the longest to clear up.
I'll post again after my next visit and let everyone know how I'm doing...so far I'm happy with the results.
on Jul 22, 2005
Being that everyone's still sharing their stories here, I'll add mine. Just had my one week postop (although it's only been five days!) and I'm 20/20 - and it's still blurry with rainbow starbursts. They're expecting it to keep getting better, as already evidenced by the fact I could read the 20/13 line on the hand-held card and neeeearly up on the distance board. After only five days, I'm not exactly complaining. I was off the chart and into "how many fingers am I holding up?" without my glasses before this.

Went to Boling Laser Center in Mishawaka, IN - after researching, reading and finding out everything I could, it was a no-brainer - Richard Boling II is one of the most experienced LASIK doctors in the area and they keep detailed notes on every single patient, so they can compare your proposed treatment with every other one they've done and fine tune accordingly. I know you're not supposed to expect perfect vision with LASIK, but I couldn't help but feel pretty confident.

I went for the full, expensive package with all the modern technology. The Intralase laser creates the corneal flap without a blade at an incredibly uniform thickness, following the curve of the eye and resulting in better healing after. The laser is so accurate, it even bevels the edges of the flap so it fits snugly back into place! Then the VISX laser does the actual corneal bed sculpting using the CustomVue waveprint map taken during my pre-lasik prep work. Supposedly, this added gizmo actually measures the refraction your cornea/lens achieves at multiple different points, instead of the plain ol' wall chart giving you an overall estimate, and the VISX laser can perform more precise sculpting over thousands of points, turning your eyeball into a "perfect" sphere. Well, adjusting the focus so it fakes it, anyway. I'm told this results in better contrast and better focus on fine detail over the regular "average it all out" lenses.

To top it all off, the laser had a pupil tracking device so if I were unable to keep my eyes precisely focussed on that red blinking dot (say for example, after my flap was sliced off and it turned into a fairly good impersonation of a blurry dodgeball) the laser would automatically follow my eye movements, as long as I didn't decide to look at the doctor halfway through.

I had no pain whatsoever, probably helped by the fact that I slept the advised six hours as soon as I got home, then immediately tagged another 14 hours onto it (hey, it was late, what was the point in getting up for an hour or two?). Dry eyes for sure - I was told today this is because the cornea is unable to send the necessary signals to the tear glands because of the nerves severed during the flap creation, and as they regenerate, it'll all go back to normal.

The only part of the procedure that was a little discomforting was the intralase flap creation. After /thoroughly/ numbing my eyes (the doctor wiped his gloved finger across my eyeball to check - I thought he was waving his finger in front of my eye!) they attach a little cone like suction device directly onto your eyeball to increase the pressure slightly, and hold the eye completely still. So far, so good. As they put that little bit of suction in, your vision goes dark as the blood flow changes. Still okay. Then they lower the laser and try and force the suction cone out the back of your head. Well, that's what it felt like, anyway. Having two doctors paying very close attention to me meant I was sure everything was okay (I turned down the offered valium - no fear!) but it was a minute or two of "Bah, I wish they'd pull it back already". I don't recommend it, but if you're worried about this, you can preview the feeling by pushing the heel of your palm hard into your eye for a few seconds (no more!) and imagine it lasting a minute or so.

And yes, a minor burning smell when the VISX machine actually sculpts your corneal bed, but it didn't really bother me that much.

Monovision - different focus lengths in each eye to preempt the need for reading glasses - wasn't an option for me, I'm a pilot and the FAA don't allow it. I've got a ways to go before I need reading glasses anyway (touch wood) so I'm good for now.

Boling offers enhancements for two years at no charge, unless a new piece of technology comes out with an associated royalty fee - at which point, you'll pay that royalty. This is one of the reasons using all this new tech is so expensive, every time they fire the laser at your eye, they have to pay the manufacturer a royalty fee - on top of the outright purchase of the VISX laser at a half-million.

But seriously, you get what you pay for. There are leaflets coming through the door advertising lasik from $299 - and sure, you may get a good deal. You'll probably end up half blind, though. If you take the time to research your doctor and ask a whole load of nasty questions - and they don't get annoyed but give good answers - the technology nowadays can /almost/ guarantee you amazing vision.

The level of technology is just about at it's peak right now, there's not really much more they can do at this point to improve the chances of great vision. From what I'm told, they're trying to work on a laser that can sculpt the corneal bed without needing the flap (kinda like the intralase technology) but they're having problems getting rid of the burned waste and aren't anywhere near a solution yet.

As a final note, after all this, they won't let you drive home afterwards, but I was fully capable of driving to the one day postop the next morning. There's a huge eyedrop regimine you're supposed to stick to, no rubbing of the eyes for four weeks (and /that/ can get hard if you get gunk in your eyes) so there's definately some work involved, but everyone else said it, and I'll say it too. Waking up in the middle of the night and being able to see the alarm clock is barely short of a miracle.
on Aug 30, 2005
I have two questions: forgive me if they've been answered in the sea of replies above, but reading does not come easy to me.

1. Why did you opt to have both eyes worked on at the same time? Is this not a big risk?
-- or --
Is there any truth to (or logic behind) the claim that you should work on one eye at a time?


2. My father had this newfangled cateract operation done, and is as pleased as punch. I'm currently saving up a small basket of money in case I decide to have it done myself. (Being disabled, I have Medicare, but it won't pay for the operation unless I've been diagnosed with cateracts -- but my problem is lens-related and removing it or replacing it would be the way to go, here.)

Many of his friends are having this operation done as *elective surgery* because those who have had it done are so impressed with the results!

Some of his friends have had one eye fixed for reading and have left the other eye as-is for distance. (Or is it the other way around?)

Would you ask the doc to explain this operation for me? All I have is what Dad has told me.

Thank you

The Cliff Walking Fool
aka The Zero Card

(It's Tarot imagery, not self-depreciating humor, okay?)
on Sep 05, 2005
H there. I am from new Zealand. I had Lasik 4 days ago. I have dry eyes, especially at night. I am having to get up twice during the night to put lubricating drops in. Last night, my eyes were so dry that my eye was stuck to my eye lid. It was scary and I amworried I will damage the flap. Has anyone had this and if so, how long did it last. Other than that, I am happy with the results (so far).
on Sep 05, 2005
H there. I am from new Zealand. I had Lasik 4 days ago. I have dry eyes, especially at night. I am having to get up twice during the night to put lubricating drops in. Last night, my eyes were so dry that my eye was stuck to my eye lid. It was scary and I amworried I will damage the flap. Has anyone had this and if so, how long did it last. Other than that, I am happy with the results (so far).
on Sep 05, 2005
H there. I am from new Zealand. I had Lasik 4 days ago. I have dry eyes, especially at night. I am having to get up twice during the night to put lubricating drops in. Last night, my eyes were so dry that my eye was stuck to my eye lid. It was scary and I amworried I will damage the flap. Has anyone had this and if so, how long did it last. Other than that, I am happy with the results (so far).
on Sep 06, 2005
Dry eyes are pretty normal.  Mine are getting a bit better each month.  But they are still dryer than they used to be.
on Sep 13, 2005
I had my lasik procedure done 5 days ago and still have some blurry vision both far and near (not sharp vision)....is this normal? How long will this last? Also, Close up vision is very blurry, like the numbers on the dash board of the car I can't see them clearly....does this clear up? Thanks!
on Oct 04, 2005
I read your LASIK Diary Report yesterday before going in for Custom LASIK myself. It has now been 16 hours since surgery. My left eye feels a little better than my right. I had more of an astigmatism in my right eye so it is most likely because the laser was required to burn off more. Just a guess, though. With both eyes, however, I see pretty clearly. The left only slightly better than my right. Discomfort is next to nothing. The only distortions in vision I have noticed is from my peripheral vision. It appears that the light entering my eyes where the flap was cut is distorted/refracted irregularly. I did see some halos around light sources as you described, but I saw them with my glasses as well. I have my follow up appointment in one hour so I should know what my vision is then. I can already tell that it is better than it was with my glasses. I'll post when I return from the doc's. I feel comfortable driving there on my own...without glasses. This is weird.
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