LASIK
Note: I am not a doctor, and I am not offering medical advice. I am only sharing my experience for anyone who may be interested in pursing LASIK. Anyone pursuing LASIK or any other medical procedure should seek the advice of a medical professional.
When I think of June 13, 2009, I think of “Amazing Grace.” Specifically, I think of the line about being “blind but now I see.” At 8:45 that morning, I took off my glasses, took one last look at a blurry world, and a few zaps of a laser later, I gazed at details I never thought my eyes would see again.
LASIK (laser-assisted in situ keratomileusis) is one of the most common elective procedures performed in the United States. According to the American Academy of Ophthalmology and the International Society of Refractive Surgery, approximately 700,000 Americans undergo the procedure each year. The procedure is quick and generally painless, requiring no extended monitoring or overnight hospital stays.
Nevertheless, it is surgery and, for that matter, surgery on the eye, an organ most human beings rely heavily on for our day to day existence. Determining if you are a good candidate for LASIK and finding the right doctor is critical in attempting to ensure the best possible outcome. And as with any major elective procedure or major expense, it is important to give a lot of thought over a period of time to LASIK.
I had wanted visual corrective surgery for at least a decade. Ten years ago, a co-worker had her vision corrected through PRK (photorefractive keratectomy), the then-current technology. PRK, which is still performed today, primarily on patients who do not qualify for LASIK because of thin corneas, has a longer and more uncomfortable recovery period than LASIK. As far as I was concerned, it was cutting-edge technology, and I was enamored with the idea of being able to see without the contact lenses I’d worn since I was fourteen years old. Unfortunately, at the time, I didn’t have the financial resources for a procedure that wasn’t covered by insurance. Ultimately, it didn’t matter—I would not have qualified because my prescription was still changing, and a stable prescription is a prerequisite to visual enhancement surgery.
Five years later, my vision and financial situation had stabilized. Another co-worker had his vision corrected—this one through LASIK. He was extremely pleased with the outcome and talked with me about his experience. He got as far as saying, “First the surgeon cuts the cornea…” Cuts? Like with a knife? I couldn’t believe what I was hearing—I thought the procedure was all-laser. It wasn’t. Five years ago, the general practice was to cut a corneal flap with a knife and then reshape the cornea with a laser. Cut first, then zap. That was enough for me. No one was getting near my eyes with a knife.
Fortunately, no one had to. The practice and technology have advanced to where the laser both cuts the corneal flap and reshapes the cornea. No knives involved. (The procedure can still be performed using a blade, though I don’t know why anyone would choose this option.) When I learned this, I had my cue to go forward. Ten years of mulling it over had finally come to a close.
Even without a blade, eye surgery is no small matter. We rely on our vision for almost everything—even things we don’t think about like making sure we get change for a $20 bill instead of a $10 bill, choosing our floor on an elevator, or balancing while we stand or walk. So before forging full speed ahead toward a procedure whose worst-case-scenario is blindness, I did my research. I tried to stay with neutral sources such as the National Library of Medicine, the Food and Drug Administration, and professional organizations, and was careful to avoid websites owned, operated, or sponsored by LASIK surgeons where I would be more likely to get a sales pitch than an unbiased preview of risks and benefits.
There are risks. Major complications can arise from LASIK surgery, but they occur in a very small percentage of patients. One of the most serious risks is keratectasia, an irregular thinning or weakening of the cornea, which, in the worst case scenario, can require a corneal transplant to correct. It is exceedingly rare, in part because reputable surgeons screen out people with thin corneas who are at greater risk of developing this condition if they have LASIK.
More common risks include impaired night driving, dry eyes, and the possibility that the surgery will not result in 20/20 vision. Some people who have LASIK report having difficulties driving at night, often due to “halos” around headlights and streetlights. This is actually one of the more common side effects of LASIK, and it is usually temporary. Dry eyes are another common side effect that is also usually temporary. In addition, as there is the possibility that LASIK may not correct vision to the point where glasses or contacts are no longer needed. Depending on the reason, an additional procedure may be performed to further correct vision, and depending on the surgeon’s policy, this additional policy may or may not be free of charge.
Despite the array of risks, I formed the opinion that my chances of experiencing one of these complications was extremely low. Your individual physiology and health history, combined with your individual risk tolerance, will help you make the decision as to whether it’s worth the risk.
When selecting a surgeon, I scheduled consultations only with practices that came recommended by former or current patients. I have the luxury of living in a mid-size metropolitan area, so there are a number of surgeons and many patients. I visited three practices and asked the doctors a number of questions. More importantly, I listened. I had been told by two optometrists that I was a good candidate for LASIK. I wanted to know if the LASIK doctors would offer the same diagnosis. They did.
Ultimately, I chose the LASIK center where I felt most comfortable. My surgeon was very reputable and came highly recommended. In addition, he worked with my eye doctor on my pre- and post-operative care. Some surgeons prefer to handle the pre-operative diagnostics and the post-operative check-ups themselves. The logic is compelling: end-to-end care by the surgeon who will perform and has performed the procedure. On the other hand, there is equally compelling logic for a partnership with the patient’s eye doctor. I’ve been seeing my eye doctor for several years and I intend to continue seeing her in the future. She knows my eyes better than any other doctor and I feel comfortable with her. That was a deciding factor and I chose the arrangement that made the most sense for me.
In the days leading up to the procedure, I was consciously very excited. Unconsciously, I suspect I was more nervous than I was willing to admit because I didn’t sleep well the week before the surgery. Otherwise, the only frustration about the pre-operative period was having to wear glasses for two months. Having worn contacts since I was fourteen years old, I was used to having peripheral vision and not having to deal with glare from headlights hitting the smudges on my lenses. I also found that, after a day of sitting on my nose, my glasses started to hurt me. I counted down the days.
Copyright Julie Nisley. Published 1 September 2009 in The Zone.
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