Laser Eye Surgery

[docblackrock]

I talked to the surgeon I was assigned at Optimax and asked how long he's been doing this and so on. Seems good.

Seems good? That's the problem, are you in any way qualified to judge that? Oooh, that Dr Shipman, he seemd like such a caring GP always taking an interest in the elderly. Poor taste example perhaps for which I apologise but proving a point. With any elective surgery, I'd ALWAYS recommend asking for a personal referral from someone (or several) you know. If I or my own have ever needed something done, do you think I just pull out the nearest yellow pages? Of course, I have the advantage of professional courtesy and getting preferential treatment but I still speak to someone, who speaks to someone, who gets me a name, who I then vet to the point I know what he likes for breakfast before surgery, who I then arrange a referral, and speak to personally before even letting anyone get their hands on my nearest and dearest. Gerco has the right attitude, take a leaf out of his book...

I may give it some more time though, especially as my money at work is cut quite a bit...

Good idea, take your time, there is no rush, nothing is dropping off or causing you any distress remember.

[Chronus]

Time is still being taken....

The way things are going, a new watch will pop up that I just have to have and then no money!

Or I will find out about these non-surgical methods of improving eyesight. If there's anything to that, it's definitely worth a look.

[hu12]

Only do it when you feel comfortable. Its a common procedure nowadays and affordable (compared to years past). Of course, once you do the procedure you'll wonder why you hadn't done it sooner.

Best whishes on the new sight!

edit:spelling

Edited August 23, 2006 by hu12

[kegra]

Before some years i have heard of a new method using ultrasonic (something) not laser and brings great results, try to find something towards this direction it might help you ...

John

[hottoddy]

Have you ever noticed that none of the ophthalmologists have had this proceedure done on themselves?

Yeah, I've been to three or four different eye docs (including an ophthalmologist) over the past decade and all were hesitant to get it for themselves. They say there's still not enough long-term data, and the technology is getting much better (so they'll wait). What's going to happen when these early adopters get old? Other major considerations beside astigmatism are pupil size (mine are huge), and prescription stability (mine always gets worse). Many "successful" data patients still require corrective lenses - just less strength.

Personally, I'm afraid of the permanent halo effect which seems to afflict those with large pupils. A friend of mine was an early lasik patient and can't drive at night because every light become Saturn.

[cwai02]

I don't have any advice, but you may check these threads at fatwallet. I am sure you ll get a lot of information.

http://www.fatwallet.com/forums/messagevie...threadid=630182

http://www.fatwallet.com/forums/arcmessage...threadid=208902

http://www.fatwallet.com/forums/arcmessage...threadid=152637

[Esmarc]

I would have been on this one like white on rice, but I've been MIA for a bit. All is well with me, and if you want any info that you haven't already gotten from a reliable source, PM me.

Esmarc, the Eye

[Chronus]

Any advice is welcome... you can post it on here or email me (PMs are full again!).

Thanks for all the help everyone.

[watchski]

Any advice is welcome... you can post it on here or email me (PMs are full again!).

Thanks for all the help everyone.

Again, i recommend the new bausch and laumbe equipment...it's a guarantee 20/20 deal where i come from!!!

[efnstefn]

Thought my two cents here are worth a little more......

I was -8/-9 and had surgery 5 years ago. Had the surgery done at Yale University in New Haven, CT. I decided to go to a high end provider since I was at the outer end of the spectrum for what could be done at the time. I'm glad that I did since I had to have two surgeries on one eye due to some complications. I don't know if the procedure/brand is still around, but it was called LADAR.

Pros: went from god-awful thick glasses to being able to get by without any! it's a change of life. absolutely.

Cons: left me with a stigmatism in one eye, but the other is near perfect. my vision is 20/25 w/stigmatism in one eye and 20/20 in the other. I've always had starburst issues, but they've become much worse. I do wear glasses with a super AR coating and a slight prescription to help the stigmatism in the one eye.

Overall, not perfect, but an amazing difference. Hope that helps out.

[Chronus]

Thanks for all the replies. I'm still debating it, but the current situation is I am very low on money so it will have to wait a while. Maybe after Xmas if I'm lucky and do decide to go ahead with it. I'm still undecided.

[sharon]

hi! i can't speak from personal experience, but a friend of mine had the surgery. all went perfectly. she did buy the insurance so that any future adjustments were done for free and she did need adjustment not too long after. i don't remember what the period of time was or how much additional the insurance was, but it sounded like it was definitely worth purchasing it.

[gioarmani]

As an ex ABO certified optician, I can tell you it's well worth it. Judging by your prescription, your myopia isn't too far advanced by any means-- a negative 3 diopter with moderate astigmatism isn't too bad--I've seen "legally" blind patients regain quite a bit of sight from a negative 10 in both eyes; I suggest looking at it as a worthwhile investment. Regardless of how clear your contacts/glasses were, nothing beats having the correct refraction & focusing of light taking place in your eye itself rather than on a piece of plastic, before it even enters the eye and is then directed to the retina; it's a completely different quality of visual experience. At most, it will take 2 (maybe 3) days to fully recover to normal functionality & operability. However, contrary to popular belief, the procedure is not permanent but is for the better. At a certain age your crystalline lens (located behind the cornea) will inevitably "short out" and you will require reading glasses; usually only a +1 diopter or so, tops. This generally occurs with the myopic at 40+ years of age, or at 45+ for the hyperopic. You will also notice a definite change for the better in your depth perception--making it easier to spot those fakes. Hope this helps.

Edited September 17, 2006 by gioarmani

[omd]

Any advice is welcome... you can post it on here or email me (PMs are full again!).

Thanks for all the help everyone.

Hi Chronus

Im an Ophthalmologist with a cornea and anterior segment sub, Im been doing excimer laser surgery since 1994 (before it was FDA approved).

My best advice is find a cornea surgeon in your area and get a good advice.

Laser surgery isnt for anyone, it depends a lot on what you are expecting

For example:

If you require perfect vision (airline pilot) you should stick to eyeglasses or contacts

If you dont want to use glasses for 95% of your activity, then do the surgery.

There are other variables like age, and your ocupation, that can weight on the decision, and as with any other medical procedure there is some risk involved.

If you decide to do it, then dont use a discount lasik center, find yourself a center that provides you with epilasik or aqualase and a excimer laser machine tha can offer you wavefront tecnology.

If you need more advice you can PM me

Regards

[RedHerring]

I had -9 in both eyes, no astigmatism. I got ICL ( implant ) surgery and I can now see 20/15 in both eyes from within minutes of getting the surgery. I have had IOP ( intra ocular pressure ) issues, and had to have multiple iridotomies ( YAG laser to punch invisible holes in the iris to allow pressure to equalize ( sounds worse than it is ) ).

The lenses are also UV filters which tightens up outdoor vision. Amazing difference in vision. Razor sharp. No halos or light sensitivity. I have had dry eye issues and use NATURES TEARS spray which feels great. I am over 40 so I do have to wear reading glasses in some situations, but I had to do that before the surgery anyway.

The ICLs can be removed leaving your eyes in stock condition. There was no way to get this kind of vision with any of the laser procedures. It was 6 grand for both eyes.

[supermanx]

Have you ever noticed that none of the ophthalmologists have had this proceedure done on themselves?

I had it done three years ago and couldn't be happier. and 3 Years without designer glasses, antiglare, scratch resistant, tinted lenses it had paid for itself.

[Chronus]

Thanks again for all the info.

I have heard professional sportsmen (eg. footballers) are not supposed to have this procedure done. I'm wondering why, as I play 5-a-side football up to 3 times a week.

[crick0234]

I'm not an expert, but i did attend optometry school for a year before i left to pursue a career in something else...

so far there's 3 types of visual correction surgery i'm aware of. Please forgive spelling: Radio-archae, lasik, and the non-bladed lasik.

Radio archae is pretty much obsolete and has longterm visual side effects. it's the procedure where i believe 8 cuts are made into the cornea... this unfortunately leaves scarring. i heard from teachers that if done incorrectly (like... VERY incorrectly) it leaves potential for your eye to just pop if hit (like a leaky water balloon!)

lasik creates a cutted flap, laser burns the middle endothelial cells, and the flap is flipped back. heals pretty fast. most common. still waiting for the 20 year side effects to show.

laser without the flap i would have to assume it burns right throw the epithelial tissue (surface of your cornea - basically the flap?) to create corrections? I think in certain states, optometrists can do this operation because by medical law, optometrists cannot perform any form of surgery. Surgery is defined as a tool coming into contact with you (ie: if i remove an eyelash that got stuck in your eye, that's considered a surgery!). However, since laser is not a physical metal tool, it circumvents that law in some states - this is the newest procedure and as such, still waiting for the 20 year side effects

i would opt with the lasik as it's a proven method done for years. The other procedure i would worry about longterm stuff (of course doctors would argue about that).

anyways, if there's an Opthomologist or Optometrist on this board, or if i'm just blatantly wrong, please please please correct me

OH... and that blade that is used to cut that flap? they call it the MicroGuilletine... nice name.

Edited November 3, 2006 by crick0234

[rasputin]

I've entertained the lasik procedure but have decided against it. As someone going into radiology, my eyesight is paramount. First of all, the complication rate is still substantial even for fellowship-trained physicians performing the procedure. I haven't researched the most recent numbers, but even a complication rate of 1:1000 is enough to dissuade me from the procedure because my eyesight is too important. The issues with glare and dry eyes may be prominent and can take months to years to resolve...if at all. Furthermore, the procedure is irreversible. There is no undo button to restore your pre-op state of vision. In addition, the new "implantation" procedures to correct vision are in the near future and these promise the benefit of reversibility. That is, if your vision changes or if you are unsatisfied, you can theoretically return your vision to a prior state or revise your procedure.

Many of my physician colleagues have undergone the procedure with varied results. The major problems are as outlined above and include dry eyes and glare. One had a serious complication of a corneal flap which is still giving him issues. These were done by fellowship-trained ophthalmologists from major academic institutions in the US. Other providers may not have the training to deal with these complications.

In summary, lasik is a good option if you require vision correction and the risk/benefit analysis is favorable for you particular situation. Complications are not overwhelmingly common but they do occur. The cost/benefit is not worthwhile for me but it may be for others. My best advice is to research your surgeon carefully because it may all be up to him/her in the end. Caveat Emptor.

[Chronus]

Thanks to everyone who has contributed.

There are new developments coming along, but it will take years for them to be accepted. Lasik is around 20 years old, and as this thread demonstrates, it does not have universal acceptance yet.

I am still undecided but go for a consultation on Monday. Should be straightforward, and this company offers 3 years interest free credit which will help, but is also the most expensive of the 4 I am looking at (by almost $2000)!

[Chronus]

OH... and that blade that is used to cut that flap? they call it the MicroGuilletine... nice name.

I think here in England, it's called a micro-keratame.

Also there is an IntraLase method which uses a laser to cut the flap. I would think this is more accurate than a blade which may not be perfectly smooth at that low a level. I'm more interested in the IntraLase method as it renders the whole procedure bladeless (and I don't mean RWG1!).

[docblackrock]

Chronus, just get your bloody four-eyes zapped already and give us all a break, ha ha

You probably know more than the experts now. FWIW this late in the day, I'd say go Intralase if you can afford it (my advice is never skimp on paying for healthcare ) but equally traditional LASIK despite the horror stories you read in the media has a fairly robust long-term safety profile, and there's no published clinical data saying otherwise.

Your question relating to why pro sports players are advised against I believe is related to the fact that these same people are infinitely more prone to eye trauma anyway, and any procedure that can affect vision significantly, for example during a period of adjustment, can leave that person at risk of more severe ocular traume such as detached retina etc. Look what happened to poor Momo (Sissoko) for example

Just out of interest, is your desire for spectacle-free life anything to do with image/appearance and the fairer sex? (damn, what ever happened to the poke-with-stick smilie?!)

[docblackrock]

Five year follow up of laser in situ keratomileusis for all levels of myopia.

Br J Ophthalmol. 2006; 90(1):20-3

O'Doherty M; O'Keeffe M; Kelleher C

National University of Ireland, Mater Private Hospital, Dublin 7, Republic of Ireland.

AIMS: To assess the long term refractive and visual outcome of patients who have laser in situ keratomileusis (LASIK) surgery. METHODS: This was a retrospective study of visual and refractive outcome of patients who had LASIK surgery performed in 1998 and 1999. All levels of myopia were included in the study. 49 patients attended for follow up. The main outcome measures were safety, predictability, efficacy, and stability. Postoperative complications and aberrations were also recorded. The mean preoperative spherical equivalent was -4.85. RESULTS: At 2 months postoperatively 67% of eyes were within plus or minus 0.5D of attempted correction with 81% within plus or minus 1.0D. At 5 years postoperatively 60% of eyes were within plus or minus 0.5D of attempted correction with 83% within plus or minus 1.0D. 88% of eyes had a vision of 6/12 or better at 2 months compared to 89% of eyes at 5 years. Best spectacle corrected visual acuity (BSCVA) was unchanged or improved in 51%. No eye lost more than one line of BSCVA. Overall, there was regression towards myopia with a mean change in refraction of -0.5D over the 5 years. As expected, severely myopic patients regressed more with a mean change of -1.06D. However, there was a high level of patient satisfaction with the surgery. CONCLUSION: LASIK surgery offers predictable results in terms of refractive and visual outcome with mild regression in refraction over time.

[Davey]

Anyone thinking of Lasik surgery you have to watch this:

[Chronus]

Just out of interest, is your desire for spectacle-free life anything to do with image/appearance and the fairer sex? (damn, what ever happened to the poke-with-stick smilie?!)

That's part of it, of course, but their are other reasons.

Assuming I won't need contact lenses or glasses for the next 15 years, I will save money (paying GBP300 per year just for contact lenses and solutions at the moment).

As some may have picked up I get allergic reactions to metals with nickle which has caused bad problems in the past due to glasses.

I also play a bit of sport, and it is much better in that regard. also want to sart swimming, but that is not a good idea with contact lenses.

Other things are pure laziness - sometimes if i've come home and taken out the contact lenses, I won't go out again because I can't be bothered to put the lenses back in, and I don't really like wearing glasses, and rarely outside of home.

There are other considerations, going out to clubs etc and wearing contacts all day make them get dry towards the end of the day, and staying over someone's place without preparation means sleeping with contact lenses in; definitely not a fun experience. I remember once falling asleep at a Greyhound bus station in mid-west America and waking up being unable to see, contact lenses had dried out in my eyes and I kept blinking rapidly. I took them out without washing my hands that time- not a good thing!