My changed view of the world..!

How I see the world seems to have changed for good since last week obviating the need for corrections. I mean it literally since I underwent Lasik (laser-assisted in situ keratomileusis) eye surgery one week back. :-) No more contacts or glasses based vision correction, at least for few years.

As few friends interested in the procedure were asking about how it went, thought will send out a mail. There is a simple explanation of the procedure posted at https://acuitylaservision.com/vision-correction/ which is the center where I got my corrective procedure done. There is a long write up at the Wikipedia site http://en.wikipedia.org/wiki/Lasik describing the procedure's origin, efficacy, side effects, etc. if you are interested.

While the initial idea of surgically correcting the cornea to fix vision related issues came from Columbia circa 1950, there are contributions from allover the world ranging from Soviet Union, Europe, an Indian American (who developed the Excimer laser used in the process) and North America that have improved existing procedures or developed better ones ranging from RK, PRK, Lasik, etc. over the last several decades.

The routine to get this procedure done seems to be going in for an initial test that lasts about 3 hours where your eyes get checked & measured to see if you are a good candidate. You pay couple of hundred dollars deposit that you get back if you are not a good candidate. If you are a candidate and you decide to go through the procedure, the deposit gets deducted from the final fee. Though the surgeon has an economic incentive to approve everyone and perform the procedure, factors like is the cornea thick enough to undergo the procedure, sometimes makes one not fit. I had spherical power of -3.75 on R and -4 on L. When the cornea shape/size were mapped, the surgeon felt that I may not have enough tissue on the left to undergo the procedure, in which case I could possibly get PRK on left (since it does not involve creation of a flap as in Lasik) and Lasik on the right or PRK on both eyes. But some more testing confirmed that I was ok for Lasik on both eyes. As you might have read from the URLs above, Lasik is the preferred procedure in general since the recovery is faster and more comfortable.

Since I was wearing soft daily wear, I had to give up wearing contacts (and switch to glasses) for a week before the exam so that cornea will return to normal shape/form losing any deformation caused by contacts constantly pressing over the eyes. This was a pain since my glasses were a bit old and I was using them normally only for an hour or two before I go to bed everyday. If you wear hard lenses you had to fore go the contacts for longer period of time. If you only wear glasses, you can get it done immediately. In addition, had to take flax-seed oil tablets twice a day, clean eyelids with baby shampoo couple of times a day, etc. during that week.

Medical insurance does not cover this procedure since this is considered an optional one (i.e. not a must). Once I was cleared in December, I decided to get the procedure done in January so that I can use the new year's medical savings account funds to pay for the procedure. In U.S. this gives us income tax deduction for the money we pay, thus saving us about 25% of the cost. Later came to know that a large percentage of people getting this surgery think along the same lines and so usually the first quarter of every year is the busiest season for these centers..! :-)

On the day of the surgery I was asked to sign waivers that were a bit disconcerting as they absolve the surgeon of any wrong doing claiming so many things can potentially go wrong. Even Maya wasn't too thrilled about me getting this done. But both statistical and anecdotal evidence convinced me that over the years it has been proven to be very safe. It is even performed on walk-in patients in some malls..! So, I decided to go ahead.

Surgery itself was straight forward. Just couple of drops of local anesthesia in each eye. Few minutes of rest with eyes closed followed by lying on a sofa under the Excimer laser equipment. One eye gets patched, while the other eye's lids gets taped to keep them open. With a small amount of suction the eye is held (no pain but minor discomfort) while the flap is created. With the flap open everything looks very blurry and you can only make out the orange/red laser light. Laser is triggered just for about 5 seconds with a small whirring noise. As a colleague of mine stated, the weird smell of your own eye tissue getting vaporized gets permanently etched in your mind..! :-) After that, the flap is placed back followed by a quick check to make sure there are no bubbles/wrinkles/debris underneath the flap. Procedure is repeated for the other eye. Total time taken is about 5 minutes for each eye. You are back in the waiting room with eyes closed for few more minutes and you are done. You immediately see the difference but since there is some itchiness/irritation, you are asked not to drive back but get someone else to drive you home and immediately get some sleep.

For the next one week you are advised to sleep with protective goggles on so that you don't accidentally rub your eyes in sleep dislodging or pulling out the flap that is still healing. Whenever you are outside, you are asked to wear sun glasses they provide that covers the whole eye area well. 4 times a day I had to keep putting on an antibiotic eye drop to prevent infections, a steroid drop to suppress itch/irritation and artificial tears to keep the eyes moist. You are also asked to continue cleaning the eyelids (to lower the possibility of any infection) and do warm compress by placing hot/wet towel over your eyes couple of times a day (to help eyes rest/rejuvenate to speed up recovery).

If you are willing to spend a lot of money, there are several additional options available:

- You can get the laser firing customized further to correct higher order aberrations (such as star/halo you may see at night around light sources) though there is no clear evidence or guarantee that it works. I said no.

- You can get punctal plugs placed in your tear ducts to block tears from draining helping you keep the eyes moist. Cheap removable for $200, or automatically dissolving ones for $300 or permanent ones for $500. When I understood that even with the plugs you still need to use the artificial tears (though less frequently), I opted out.

- You can get an "extended warranty" on the procedure for 6 months, 1, 3, 5 years or life time so that in case if any additional "touch up" is required you don't have to pay for the surgery again. Since I know a colleague who had to undergo the procedure twice (he went to a different surgeon the second time and paid again since he wasn't happy with the first one), I chose to get 1 year additional coverage.

Testing conducted one day after the procedure showed everything is going well. Yesterday went for the next check up that is one week post-op. So far so good. I seem to have 20/15 vision on the right and 20/20 vision on the left..! One possible side effect I read/heard about is slight deterioration of short sightwhile distant vision becomes perfect. Thus, you may not be able to read fine print text as well as before. But so far I don't see any such deterioration as I am able to see everything clearly.

Of course this does not guarantee that I will never need glasses ever since only the power I had last week has been corrected. So, after a few years just like someone who had zero power developing short/long sight needing glasses/contacts, I may also need correction again. But hopefully not for a long while.

Next checkup is after a month, followed by another one after 6 months. Will see how things go.

A subconjunctival hemorrhage is a listed, common and minor post-LASIK complication. You can see a picture of this hemorrhage in the wiki page. I have this on my left eye. But as predicted, it has regressed considerably since the procedure during the last one week and is expected to go away fully in couple of weeks.

After 8 days, I still have some dryness and itchiness. But once I put the drops in, don't feel anything for the next few hours. I am hoping that in the next month or so both eyes will completely heal improving vision and decreasing the discomfort further. Not having to ask Maya for the time displayed on the digital clock sitting on the bedside table when I wake up in the middle of the night is indeed nice. :-)

As usual yesterday night with the bedroom lights off, I was watching TV lying on the bed for few minutes before going to sleep. Finally when I switched off the TV, the room turned dark. Following my old routine, my left hand automatically went to my face to take out the glasses to put them under the cot before going to sleep. I smiled at myself in the dark realizing that I can get rid of that unconscious routine & muscle memory as that task is no longer needed. :-)

-sundar.