Getting Laser Corrective Surgery (LASIK)

In March, I finally decided to pull the trigger and get laser corrective eye surgery (commonly known as LASIK).  I wore contacts for 13 years, and if you wear them, you know the daily struggles. From dry eyes to the lens falling out when you rub your eye, not being able to sleep in them, the cost, etc. I couldn’t really wear glasses because they would frustrate me after one to two hours of wear. I was on the fence about this surgery for years. Too scared.

I wore daily contacts, so it was costing me $60 per month! Plus, throw in the cost of seeing the eye doctor every year to renew my prescription when it hadn’t changed for years.

But what really put me over the fence, was all the backpacking trips I had planned for the summer. These trips were going to anywhere from a weekender to a week long, some solo, some not. I didn’t like the idea of having to take glasses, contacts, and extra “just in case mine fall out” contacts with me (extra weight). And I just didn’t feel comfortable knowing I would be hiking/camping solo and not having the ability to just wake up and see. I can’t sleep in contacts, and shuffling having to find glasses in the dark is never pleasant.

So, I did it, I scheduled my consultation at the UCLA Laser Refractive Center and then my surgery with Dr. Rex Hamilton (he is fantastic!). The pre-opt, operation, and the follow-up appointments cost me $2,500 per eye ($5,000 total), paid in full. My insurance did not offer coverage. This will pay for itself after 5 years.

They book out months in advance, I had originally booked an appointment for April, which I booked in February, I wanted to do it and have enough time to heal before my first trip in May. I called them regularly and was able to get a consultation appointment for March.

During the consultation (which is free at UCLA), they run you through a series of tests. They measure your corneal thickness, your prescription, the shape of your eye, your eye health, etc. Expect to be there for a couple hours, depending on how busy they are. After the consultation, the doctor will let you know if you are a good candidate for laser corrective surgery and what type of surgery they recommend.

UCLA offers 3 types of surgeries, LASIK, SMILE, and PRK. All have the same end result, but they differ in how they do the procedure. I was a good candidate for all 3, but I selected SMILE because I have dry eyes, and SMILE cuts less of the corneal nerves which is the suggested one for dry eyes (below I break down each surgery). When you go in for a consultation, the doctor will walk you through these depending on what you’re a candidate for and work with you to select the best operation for you.

After you’ve decided on your surgery, you do a pre-opt appointment where they check your eyes again. This is typically done the week of your surgery. I got lucky and someone canceled, so I was able to get my surgery that Friday. My consultation was on Monday. Also, since they weren’t too busy when I went in Monday morning, they were able to do my pre-op right after my consultation.

They do the surgery on Fridays, so you’ll have Saturday and Sunday to recover. They do both eyes at the same time, you need to have someone drive you and go home and sleep afterward.

When you come in for the surgery, you get an anesthetic in both eyes and medication to calm your nerves. You are awake for the procedure. No, you do not see what they’re doing and no it doesn’t hurt. This was my biggest fear, I didn’t want to see them poking around in my eye. It’s blurry when they do it, all you see is light. I also got a teddy bear to hug during the operation, I was extremely nervous.

The operation was done in about 20 min. I stood up and could see clearly. My eyes were extremely light sensitive right after, even with the sunglasses on. I put my jacket over my head while my grandfather walked me to the car and drove home.

You will have a burning sensation (the way your eyes feel when it’s dry and windy outside) and feel like something is in your eye. DO NOT rub your eyes, this only lasts a couple hours. Some people can sleep through it, but I was only able to sleep through half of the time. If you don’t sleep through it, it’s a bit miserable but manageable and it really does only last a few hours. My operation was at 1:00 pm, and by 5:00 - 6:00 pm the burning sensation passed and I was fine.

 Me in in the sleeping/showering goggles one day post-op.

Me in in the sleeping/showering goggles one day post-op.

You can’t shower that day or wash your face because you can’t get water in your eyes. You also have to be careful showering for the next week, and no hot tub or pool for the next two weeks. You have to sleep in goggles (they provide them) for about a week so you don’t accidentally rub your eyes. If you rub them, it can screw up the healing process. I also showered in the goggles just to be extra cautious about getting water in my eyes. Ladies, washing your hair with goggles is hard but manageable. They will also give you a directions sheet to follow, antibiotic drops, anti-inflammatory drops and preservative free lubricating eye drops. FOLLOW IT.

The next day, I woke up and I could see 20/20. It was weird after so many years of blurry vision to wake up and be able to see. Inside, without lights on, I could see without sunglasses. With the lights on, I needed to wear sunglasses. You need to wear sunglasses outside every time for at least 6 months post-op. Saturday morning my grandpa drove me in for the first post-opt, that afternoon I drove 40 min home from my grandparents’ house to mine. I could not text for the next 3 days because it’s hard to look at the small letters on your phone and the bright light. I only saw halos around lights for the first weekend.

Post-op appointments are the day after, at 1 month, 3 months, 6 months and 12 months. Afterward, you only go to your normal eye doctor every couple of years.

I went back to work on Monday, but I wore sunglasses indoors (including at work) until Wednesday. It makes for a great conversation starter in the office! If you can take Monday and maybe Tuesday off, do it. I could see 20/20, but it was hazy, like looking through very dirty glasses. Reading both online and in print was hard, and doing detailed work like on spreadsheets was also very difficult. The doctor said this is completely normal and just part of the healing process. Every day it got better and Friday, one-week post-op, it was gone!

 The preservative-free eye drops I use with added Omega-3's.

The preservative-free eye drops I use with added Omega-3's.

At almost 6 months post-op, I have dry eyes, which aren’t any worse than they were before. I still use preservative free eye drops a couple times a week. I also take Omega-3 supplements for my dry eyes which was recommended by the doctor. They make your tears thicker and help keep the lipid layer on your eye which keeps the moisture. Omega-3’s have made a HUGE difference with my dry eyes. I also have some light sensitivity occasionally and always wear sunglasses outside.

If you’re scared, do it! 100% worth it!

Last but not least, as promised, here’s the breakdown of each type of operation from UCLA’s website -

SMILE:

Small incision lenticule extraction (SMILE) is an outpatient procedure that changes the shape of the cornea to correct refractive errors. It is FDA-approved only for the treatment of Myopia at this time.

In SMILE, topical anesthesia is applied to the surface of the eye. Next, a femtosecond laser cuts a small lens-shaped disc or lenticule of tissue within the cornea. The shape of this lenticule is calibrated to match the refractive error of the eye precisely. The surgeon then extracts the lenticule through a separate cut-down incision, also made by the laser, to produce a shape change in the cornea.

Your surgeon can explain the limits of Myopia that can be treated by SMILE. Treatments for Astigmatism, and Hyperopia are not yet approved.

Not every patient is a candidate for SMILE. Patients with thin corneas, progressive ectasia, scars, irregular astigmatism, and a few other pathologies are ineligible. Your surgeon, or one of the optometrists in his or her practice, can determine if you are a suitable candidate during a free screening examination.

SMILE typically takes about 20 minutes to perform per eye and both eyes are usually treated during the same session. SMILE is associated with minimal to mild discomfort while it is being performed. When the topical anesthesia wears off, however, the level of discomfort increases. Most patients develop redness and tearing. There is often stinging and a gritty sensation that lasts 6 to 12 hours. Visual recovery is slower than laser-assisted in situ keratomileusis (LASIK), typically taking 2 to 7 days.

As with any procedure, there is a risk of complications with SMILE, including the possibility of an under correction or over correction. The risks should be discussed with your doctor before you undergo the procedure.

Enhancements are usually performed by photorefractive keratectomy (PRK).

LASIK:

Laser-assisted in situ keratomileusis (LASIK) is an outpatient procedure that changes the shape of the cornea to correct refractive errors such as Myopia, Hyperopia, and Astigmatism.

In LASIK, topical anesthesia is applied to the surface of the eye. Next, the surgeon makes a thin, tangential cut through the cornea using a femtosecond laser or mechanical microkeratome. The corneal tissue flap that results from this cut, which looks like a contact lens, is hinged on one side. The surgeon retracts the flap and then uses an excimer laser to treat the exposed corneal tissue beneath the flap, thereby changing its shape in a very precise manner. Once this has been accomplished, the flap is placed back into position where it seals down over the next 12 to 24 hours.

Your surgeon can explain the limits of refractive errors that can be treated by LASIK.

Not every patient is a candidate for LASIK. Patients with thin corneas, progressive ectasia, scars, irregular astigmatism, and a few other pathologies are ineligible. Your surgeon, or one of the optometrists in his or her practice, can determine if you are a suitable candidate during a free screening examination.

LASIK typically takes about 20 minutes to perform per eye and both eyes are usually treated during the same session. LASIK is associated with minimal to mild discomfort while it is being performed. When the topical anesthesia wears off, however, the level of discomfort increases. Most patients develop redness and tearing. There is often stinging and a gritty sensation that lasts 6 to 12 hours. Visual recovery is fast. Most patients see fairly well the next day.

As with any procedure, there is a risk of complications with LASIK, including the possibility of an under correction or over correction. The risks should be discussed with your doctor before you undergo the procedure.

Enhancements are usually performed during the early postoperative period by lifting the flap and applying additional excimer laser treatment to the cornea. Late enhancements can be performed by lifting or re-cutting the flap or by photorefractive keratectomy (PRK).

PRK:

Photorefractive keratectomy (PRK) is an outpatient procedure that changes the shape of the cornea to correct refractive errors such as Myopia, Hyperopia, and Astigmatism.

In PRK, topical anesthesia is applied to the surface of the eye. Next, the surgeon removes the central epithelium of the cornea by one of a variety of different means. Then, the surgeon uses an excimer laser to treat the exposed corneal tissue, thereby changing its shape in a very precise manner to correct the refractive error. Once this is accomplished, the surgeon places a bandage contact lens on the cornea and the epithelium heals under it over the next 2 to 4 days.

Your surgeon can explain the limits of refractive errors that can be treated by PRK.

Not every patient is a candidate for PRK. Patients with thin corneas, progressive ectasia, scars, irregular astigmatism, and a few other pathologies are ineligible. Your surgeon, or one of the optometrists in his or her practice, can determine if you are a suitable candidate during a free screening examination.

PRK typically takes 10 to 15 minutes to perform and usually only one eye undergoes surgery at a time, although there are exceptions. PRK is associated with minimal to mild discomfort while it is being performed. When the topical anesthesia wears off, however, the level of discomfort increases significantly. Most patients develop redness and tearing. There is often stinging and a gritty sensation that lasts 3 to 4 days. The bandage contact lens is removed following corneal epithelial recovery. Visual recovery takes 3 to 4 weeks.

As with any procedure, there is a risk of complications with PRK, including the possibility of an under correction or over correction. The risks should be discussed with your doctor before you undergo the procedure.

Enhancements are usually performed by additional PRK. LASIK and SMILE are potential alternatives.

 

**I am not a doctor. This post is based on my experience, my conversations with my doctor and information from UCLA's website. Consult a doctor for further information to see if you're a good candidate.

Jenny KotlyarComment