Laser eye surgery – the before

This is my experience – the specifics will differ by clinic so it’s only here to give you a rough idea of what you might expect and clearly I’m not a doctor, so blah blah blah, warning warning warning.

Step 1: Research. Start with Google as an appetizer, followed by healthy helpings of PubMed/Google Scholar for the hearty stuff. This is not essential but it helped me understand the procedure and risks better, ask the right questions, and know what to expect. You’re reading this so yay, you’ve already started!

Step 2: If you haven’t seen your optometrist for a couple of years, go see them. They’ll check your prescription to make sure it is stable enough for you to be a candidate (very roughly speaking they don’t want to see more than 1 D of change in the past couple of years). They are also a great resource for information: they know your eyes, they know the procedure, they know the local clinics and surgeons. I felt a whole lot more confident going forward after seeing my optometrist, asking lots of questions, and walking away with a clinic recommendation.

Step 3: Book a consultation at a laser eye surgery clinic. It was free and in my very limited experience, pressure free. The appointment consisted of technicians taking various measurements of my eye, a corny video showing smiling patients and diagrams of eyeballs, and then a question-answer period with a ‘patient advisor’ who appeared to know less about the surgery than I did.

Finally I met with the actual surgeon, which by this point felt a bit like meeting a celebrity. He went through my file with me, confirmed I was eligible, and made a recommendation on the type of surgery I should have. Because my cornea is on the thinner side, he recommended PRK for me.

In brief, this is what that means:

The objective of all laser surgery is to remove microscopic layers of your cornea (the lens) so that light going through it will focus correctly on your retina (the back wall) and this can be done one of two main ways (though variations exist):

(click for source)

LASIK (the ninja method)

A tiny flap is made on the top surface of your cornea, the laser zaps underneath to reshape your eye, and then the tiny flap gets put back in place, much like a bandage.
Pros: Much quicker healing time – your vision will be shiny and new within a few days so you only need a couple of days off work and eye drops for a week or two.
Cons: Due to flap-making, it is a more complicated surgery so it’s extra important you pick skilled surgeons. You have to be careful not to rub your eyes for a few months afterwards because the flap could dislodge and I don’t think I have to tell you that would be non-ideal.

PRK (the action hero method)

They just shoot a laser at your cornea. That’s it. Since there is no corneal flap to act as a bandage, they put contact lenses on your eyes for the first 4 days instead.
Pros: The safer (and sometimes only) option for the thin cornea-ed, less risk of experiencing dry-eye afterwards, and no flap-related complications to worry about.
Cons: Longer recovery – your vision will take 1-2 weeks to sort itself out and as a result you need about a week off work, there might be more pain involved for the first 1-4 days, and you’ll be on a strict regimen of eye drops for 3-4 months.

Besides those differences, the risks and success rates of the procedures are basically the same.

At the very end of the appointment, they gave me a price estimate and an idea of their next available surgery dates, but no one pressured me to book. I was happy with the clinic I first went to but if you weren’t you could very easily go have a consultation elsewhere.

Step 4 (a couple of weeks before surgery): Back to the optometrist. This appointment was to thoroughly examine my retinas to make sure there is absolutely nothing funky going on that would interfere with the success of the laser-ing.

In order to get an unobstructed view of my retinas, they put dilating drops into my eyes that caused me to look like this for the next 6 hours:

Also, my optometrist showed me pictures of my retinas! Mine are apparently quite dark – which is a good thing – and look more Mediterranean than Finnish (I thank the mixing of Lappi blood into my gene pool for that).

Step 5 (one week before surgery): Stop wearing contacts because they tweak your eye shape slightly. Get nervous and re-read all the statistics* again to convince yourself you’re not nuts. Buy audio books that will be essential to entertaining yourself while your eyes are healing (turns out 90% of my usual activities are eye-ball dependent). Finally, make plans for someone to take you home from the clinic as YOU WILL HAVE HAD LASERS SHOT INTO YOUR EYES!!

I’ll be going under the laser Monday morning – wish me luck!!

*This article is not available without a subscription to the Lancet so if you are interested contact me.

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Posted on February 23, 2012, in Health, Life and tagged , . Bookmark the permalink. 11 Comments.

  1. Oooh thanks – I didn’t know there was an alternative to LASIK – I’m very prone to dry eyes…and also, intrigued because my new job has health insurance and if it covers eye surgery at all, I may pursue it.

    • Yes! Apparently when make the flap for LASIK it severs the corneal nerves and somehow that makes it worse for dry eyes. The risk is there with PRK as well, just less. The details elude me, but good to know!

  2. Fingers crossed. This is very exciting, can’t wait to hear that it goes well.

  3. And deep breathing. I am very excited for you.

  4. Yippee!! Several of my good friends have had PRK or Lasik done in the past few years and they LOVE it. I’m really jazzed for you!!

    Also, this was ridiculously informative and helpful.

  5. Ahh good luck! Since it is now Monday morning (and I’m just getting around to catching up on blogs), I hope things are going well!

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