Friday, January 26, 2001

Laser Eye Surgery - the blog

Yesterday I had LASIK laser eye surgery. In short, this is where they take the front part of your eye off, burn a pattern on the surface of the underlying cornea, and put the front bit back on again.

In long...

You have a consultation where your prescription, your pupil size and the shape of your cornea is measured, and they work out if the treatment is possible. Although they can correct myopia and astigmatism, they can't correct everything, such as keratoconus. They also measure the thickness of your cornea to ensure there's enough material to work on. Presumably this is to avoid burning right through your eyeball and making a mess of their shiny new laser by covering it with whatever fluid that might erupt henceforth. Yum.

Having passed over those hurdles, I returned yesterday for the treatment itself. I decided to go to Boots in Regent St., London, on the basis that I'd have easier access to lawyers and a support environment in the UK if something went wrong, than I would in the USA. Also, Nadine works at Boots so it must be good. It was about 50% more expensive than in New York, but then Nadine does get to drive a nice car, and you don't have to tip the surgery when you leave. I was escorted there by the lovely Nurse Melanie. Those of you who know her will not be surprised by the fact that one of the nurses had to explain to Mel, after I'd returned from the Abyss (more below), "you're not meant to be laughing, you know".

Having arrived for the treatment, I sat done with Mel to eat lunch. Shortly thereafter I was rudely interrupted from a rather tasty chicken and mozarella sandwich by the need for yet more tests. They re-checked the measurements and explained that my left eye would be corrected to perfect vision, and my right would be left with about .25 dioptres of myopia. This was to leave a little bit more thickness in the cornea (they wanted to keep their laser clean) and might even delay the need for reading glasses in later life.

The next bit was the though bit. You lie flat on a couch. They produce a clamp that they insert into your eye to hold your eye open. Then a vacuum clamp sucks itself onto your eye. A knife appears and they slice into the top of the eye. Of course, it's your eye, so you get to see this happening. Then the laser comes. Someone explained that I'll probably smell a strange smell. I jokingly said "you mean like the smell of burning flesh?". There was no reply.

And then there was this funny smell of burning flesh.

The main problem was I'd been told the procedure would last 20 minutes. So I thought I would be lasered for 20 minutes. Actually, you're only lasered for 90 seconds. Nevertheless that expectation, plus the thought of what they were actually doing, added up to a very grim time. The guy was saying "stop rolling your eyes!" and I tried to explain, through my hyper-ventilating, that I was unable to control them. Shortly after I realised that backing out wasn't an option. All you want to do is close your eyes and get away, but you can't. Anyway, somehow it all worked out, eventually, and it was over.

But of course, the basic human model comes with two eyes.

So it was on to the next one. This time it wasn't half as bad, as I knew what to expect. Uncomfortable, but ok. I left the room and my eyesight seemed much the same. Over the next few minutes, I tried squinting through my (strong) glasses and realised that they actually made my eyesight worse. So I was now unable to see properly at all, without or without my glasses. What a bargain.

The surgeon came in a few moments later and explained that altough I'd had a "very unusual reaction" (I didn't realise most of the population didn't mind having a vacuum pump clamped to their eyeball) and that I was the most difficult patient he'd had, he was very pleased to say that the machine had done everything it needed to and he thought that I was going to be fine. Mel and I had a nice cup of tea and found plenty to laugh at, non of which I can remember now.

All I had to do then was pay. Funny how they wait until you can't see before asking you to sign the Visa slip...

I was a bit embarrassed for being so squeamish in the theatre, but they were all very nice about it. Two female nurses had been holding me down, it turns out - one with a rubber glove on too. I left before they decided to charge extra for that bit.

I noticed all sorts of things that blind people must live by - the beeps in the underground for when the doors open, the annoucements over the tannoy saying what station you're at, the rough parts of the street where the crossings are. Thankfully Nurse Mel led me back to college.

The next 20 hours or so I spent in the dark. The treatment requires a dilating fluid in the eye which renders the patient photosensitive. I just kept my eyes closed. Other than that I felt fine. My eyes stung a little but nothing too serious. I talked to Mel and called home, but I could only call people who's number I knew off by heart because I couldn't read my address book.

Today, my eyesight has been getting better and better by the minute. I learned to point my eyes in the same direction at about 11am, to read at about 11:30am, to read number plates at a distance about noon, and so on. I cancelled my direct debit for my contact lenses at 12:30. Never imagined I'd be able to do that. Focus is still a bit hazy for reading. I'm writing this because it's easier than reading. I guess it's silly to strain too much today. I get to have a checkup tomorrow.

So, did it work? The objective is to avoid carrying around glasses and contact lenses, and avoid sore dry eyes after transatlantic flights or after sleeping in contact lenses overnight. At this point, I don't know if it worked. My sight isn't as good as it was with glasses, and that wasn't as good as it was with contacts. Hopefully it'll continue to get better. If not, I'll need a new pair of glasses/contacts.

Lessons learned - 1) go with someone. But for Mel and Ma offering, I would have gone on my own without even asking someone to come along, and I'd have had to spend the night outside the clinic on Regent St. 2) it's not the painless, quick operation some of the advertising would let you believe. It's not that it hurts, particularly, so much as the thought of what's going on. Also, it takes a while to recover use of your eyes. Take two days off. 3) Contact lenses are more trouble than you realise, once you don't have to wear them. They're not perfect all the time, they can get a little dirty or dry. Even now, before my eyesight has settled down, it seems to be one of those Change Your Life things, worth every penny.