Sunday, March 22, 2009

Lasik - Postop

After the surgery, I opened my eyes now and again, but everything was really pretty blurry and very, very bright, so mostly I tried to keep them closed. I think I really didn't want to know, at that point, whether my vision was any better than it had been before -- either it was or it wasn't, and I knew it would take some time to settle in, so I didn't want to start overanalyzing.

They had me wait a bit, then the doctor looked in my eyes to make sure everything looked OK, which it did. That was it -- I was free to go. (I'd already made my one-day and two-week followup appointments.) We stopped at a drive-through and I ate in the car on the way home with my eyes mostly closed (the light was *really* blinding now that we were outside, even with the super-dark sunglasses they'd given me).

When I got home, I pretty much went straight to bed, as they had told me. The directions were to take a three-hour nap, which I did, more or less, except that I woke up and staggered to the bathroom a few times. It's not like real surgery, where you've had anesthetic and are still out of it from the drugs, but I think just because my eyes *so* didn't want to be open, and because of the huge adrenaline rush of the surgery, I was really groggy and out of it.

Once I woke up, I put in the antibiotic and steroid drops as directed. (I did forget that I was supposed to use the steroid drops every hour that day, and only used them every 4 hours with the antibiotic. Oops.) Then I pretty much tried to not look around too much and again, not to think too much about how my vision was. (Answer: Still kinda blurry and hazy; certainly less nearsighted than before, but hard to tell, really.) I figured reading was hopeless, but that I could kind of half-watch TV, which is what I spent the rest of the afternoon/evening doing. I had forgotten how mind-numbing it is to watch TV all afternoon and evening.

By late that evening, I decided I could definitely see pretty well, but was still trying not to make any assessment until the morning, since there was still a bit of haziness. I checked my email (but only very briefly, especially since John scolded me when I opened the computer). I did do one crossword puzzle before bed, just to prove that I could still read.

I slept pretty well, despite the goofy goggles, and when I woke up -- well, I looked outside, and it was still a bit too bright for me, but I could *definitely* see with more or less normal vision -- the buds are coming into bloom on the maple outside our window, and I could see each and every one! Weird. Amazing and weird.

I drove myself (wearing the super-dark sunglasses) to the postop exam. Not a problem at all. The monovision is definitely going to take some getting used to, but it doesn't affect most activities. If I am trying to focus on something specific, at whatever distance, I'm very aware that one of my eyes is working better than the other, and sometimes it's a little disorienting. Like when you're wearing contact lenses and one of them is really dry and blurry, or you need a new prescription in one eye. I wonder whether I'll always be as conscious of it as I am now -- hopefully not.

The postop exam took a long time (they really kept me waiting -- I was there for an hour and a half, for two 5-minute checks -- one of my actual vision, and one to look inside my eyes). The vision check was just as they'd aimed for -- 20/20 in my left (dominant) eye and 20/40 in my right eye, and no problem reading close up (as long as I can use my right eye!) When they looked in my eyes, the doctor told me that I had a little inflammation under the flap in my right eye. So she told me to use the steroids more often (every 2 hours) for the next 2 days, and to come in on Monday to make sure it's not getting worse. Other than that, everything looks perfect.

It really is incredible that with a 10-minute operation, a lifetime of myopia is just... gone. Poof. I can see like a normal person. (well, except for the funky weird monovision thing.)

Last night, as I was getting ready for bed, the blurriness of the monovision caught my attention, and my immediate reaction was to think, "Oh, I should take my contacts out." Very disconcerting. Good, but disconcerting.

At the moment, I'm not experiencing any bothersome symptoms whatsoever except for the adjustment to the monovision. There's maybe a tiny bit of ghosting around bright lights, but it's not nearly as bad as the glare that I would get off my glasses (and forget about scratches and dirt!) So far I haven't tried to drive at night, but it doesn't seem likely that it will be a problem. My eyes aren't even particularly scratchy or dry. I think I'm like a poster child for Lasik. :-)

More posts to follow if there are any interesting developments to report. Otherwise I guess you can all count me as a satisfied customer!!

Saturday, March 21, 2009

Lasik - The Surgery

I went for my Lasik surgery on Friday, March 20, 2009, at LasikPlus in Rockville, Maryland. My surgeon was Dr. Jay Lustbader (who's done 10,000+ Lasik surgeries and is also the Chair of the Department of Opthalmology and Director of Cornea Service at Georgetown).

Before the surgery, they checked me in (and collected my payment of course! - for the record, with a discount they gave me for my insurance plan, I paid $3390 total for both eyes, with a year of postop exams and lifetime "enhancements" (touch-up surgeries if I have any problems) - the "standard" price is $2099/eye). Somebody examined my eyes to make sure the corrections they'd recorded earlier were still accurate, and I met with somebody else who gave me the post-surgery care instructions.

Finally I was called in by Dr. Lustbader, who I liked -- he was very relaxed but professional, explained the surgery, and asked me if I had any questions. They sent me back out to wait for a short while, then brought me into the operating suite (which is partitioned from the waiting area by a glass wall, so you can watch the surgeries, including a TV camera showing the eye as the operation proceeds).

They gave me "squeezy balls" to squeeze (and telling me to squeeze those, *not* my eyes!), then put numbing drops in my eyes, and a patch over my right eye. Then Dr. Lustbader inserted a lid holder into the left eye, which wasn't exactly painful but was *really* uncomfortable. After that I couldn't really see very well. Then he put some sort of cup device over my eye, at which point I basically couldn't see anything (but he had warned me about that). Then they cut the flap (I have no idea how that went, since I couldn't see or feel it!) Same thing on the other eye.

Then I had to get up (with my corneas cut away) and walk across the room to the other table, which was a little weird and disorienting. That's where they did the actual surgery on the cornea itself. Again with the lid holder, and this time they also taped my eyelashes down -- again, not painful, but very uncomfortable and not at all pleasant. The weirdest thing was when I could see the doctor's hand coming at me with a pair of tweezers to peel back the corneal flap (which took a few tries).

Then there's a flashing red (now very blurry) light you have to look at, and the laser makes these funky clicking noises, and you are very aware that your cornea is being reshaped, which is quite disturbing and sends an adrenaline rush through you like you wouldn't believe. The squeezy balls turn out to be quite useful at this point.

They were great about telling me exactly what they were doing and how long it would take. Then I was done, and that was it - the nurse walked me out to the lobby and told me to wait with my eyes closed for a few minutes.

More in the next post...

Lasik - The Decision

I thought I'd write and share my (ongoing) story about getting Lasik surgery.

I first thought about Lasik maybe 5-10 years ago, but when I looked into it, it seemed that there was a fairly high rate of complications (especially halos and glare), which made me nervous. I just didn't think it had been tested enough back then. Then as I got older, I thought, well, what's the point now? Sure, if I was 25, it would be worth doing it, but not now.

A few years ago, though, I started to develop presbyopia, and more people I knew were having Lasik surgery, even people in their 40s, 50s -- this year I found out that a 72-year-old I know just had Lasik! And the rate of complications seemed much lower. Looking around on the Internet, it wasn't that easy to find people who were unhappy -- and most of them seemed to actually have relatively mild complications (e.g., they would complain that they still had to wear glasses -- well, I have to wear glasses *now*, so that doesn't seem like a tragic outcome). My biggest concern had been major loss of eyesight, but I really couldn't find *any* stories with extreme outcomes like blindness. Given that millions of people have Lasik every year, it seemed like it had gotten pretty safe and straightforward.

I went to the LasikPlus in Columbia (recommended by a friend who had had the surgery) for an evaluation in September 2007, and they said that I was a candidate. But they also told me that I had presbyopia (which I knew) and that I'd need reading glasses after the surgery. Trading one kind of glasses for another didn't seem all that appealing. They mentioned monovision, but I didn't think I could get used to being severely nearsighted in one eye and fairly farsighted in the other eye.

Fast-forward a year and a half, to late 2008, and my presbyopia was clearly getting bad enough that I was going to need bifocals pretty soon. (I couldn't just take my glasses off to read; I actually had to replace the regular glasses with reading glasses, especially if it was dark or my eyes were tired.) So I thought, OK, now the tradeoff seems worthwhile.

I made another appointment at LasikPlus (this time in Rockville, because the appointment times were more convenient) in February 2009. Again, they told me that I was a good candidate (pupils not too large, correction not too extreme (-3.75 diopters with mild astigmatism in one eye, -4 in the other)). They also told me more about monovision -- I had gotten the impression that the "close vision" eye wouldn't be corrected at all, or very little, but they told me that I could expect to have 20/20 vision in the distance-adjusted eye and 20/40 in the close-adjusted eye. They gave me some of those goofy insert-a-lens glasses with the monovision correction to wear while my eyes adjusted. It seemed like something that I could probably adapt to, and they also told me that if I didn't like it, I could come back after my eyes healed to change the close-adjusted eye to distance vision at no charge. (Of course, then I *would* have to wear reading glasses.)

I was also somewhat worried about glare and night vision, but it seemed that with the new laser technology, fewer people had long-term problems with these issues than even a few years ago -- and the night vision problems that can be caused by monovision (extra glare/halo from the blurry distance vision in the close-vision eye) can generally be fixed by wearing night glasses (that give you that extra bump in distance correction to even out the eyes).

I also talked to several friends who have had Lasik and are wildly satisfied with it, including a student who has monovision. I decided that the risks are small enough (possibility of still needing glasses, now or in the future; possibility of night glare or blurry vision, especially during healing) that I was going to do it.

I scheduled my surgery on Friday, March 20, 2009. I'm planning to post a series on the surgery and healing process, so stay tuned!