Wednesday, June 20, 2007

Vision Quest: To Quote Roy Batty...

"...oh, if you could only see what I have seen with your eyes."

A lot of folks (yes, I said "folks") out there are pretty damn curious about this. I've gotten more email about this operation than from all the other posts combined (I apologize for not writing more about this in the wrap up with the video, but I've been busy looking at stuff with my new eyes! Very novel - I like it.)

So, let's see if I can answer all of the questions from the emails in one shot....

What did I experience before/during/after?

  • When I was planning this procedure, I scoped out the doctors and found who I wanted to do it very early - last fall, as a matter of fact. I went in for the pre-op check in November of '06 to see if I qualified (I did, obviously). I subsequently went through a scheduled-canceled-scheduled cycle a few times, until I wound up at last week (June '07.) This was mostly due to work commitments...they were very flexible about rescheduling.
  • I didn't actually get nervous (I am not a nervous or squeamish person by nature - and operations of any sort tend to interest me on a technical level) until just after the pre-op procedure (called the "C2") just a few days before the operation. That night I didn't really sleep as I had visions of losing my eyes in a freak lasik accident. (A friend of mine said "the problem is you know too much" about how it all goes down. Probably right.)
  • During the C2, they took the final measurements of my eye (the cornea, the lens, the vitreous humour density - and then the surgeon ran the algorithms required for the LASIK machine to autoshape my lens to approach 20/20 vision. After a few decades of work in the software industry, I briefly wondered how much it would suck if - after I was underneath the laser - someone's else's file was loaded in by mistake...but, uh, I assumed they must have had some safeguards in place. (He did, actually - apparently, the level of safeguard was so intense, that if they put the machine over the right eye when it was programmed for the left eye, the machine wouldn't work. Cool.)
  • The morning of the operation, I was sorta ridiculously calm. I was driven in, had the pre-op conversation, signed the little form that acknowledged the risks of this, listened patiently (haha..get it?) as they, once again, explained the problems that could results, took a Xanax, and went into the room.
  • If you check out the video I posted on the previous article, you will see exactly what I experienced. From "my end of the eyeball" it was a very strange experience. Because the surgeon knew that I understood the optics and the tech involved, he described exactly what he was doing at every step of the operation. (I heard one of the nurses ask if that was a good idea - and he said "He requested that I tell him what I am doing." So, that was good...)
  • When the first corneal flap was removed (all together now: EW!), I saw my vision completely cloud over - I just let it happen and trusted the doctor and the tech, I had no choice. This was done by the first "intralasik" laser - it made no noise at all.
  • I saw a blinking, red alignment light. You need to try to keep that light in your central field of vision at all times.
  • I saw the doctor swab my lens with a cotton swab. That was bizarre - I felt nothing.
  • I saw a field of red pixels - which I assumed was the laser alignment grid - and then I heard the tat-tat-tat of the shaping laser come on. (Every time the beam fired, it made a loud TAT noise - the effect would have been disturbing if it wasn't for the Xanax.)
  • If you are squeamish, don't read this bullet: I could smell the burned lens tissue as the laser turned it to plasma.
  • The laser stopped, and he swabbed my lens again.
  • He manually positioned the corneal flap back into place, and swabbed it down. (I immediately could see a poster that they had taped to the ceiling. Not completely clearly, but clearer than I would have with contacts or glasses.
  • The procedure was repeated for the second eye. Total time for both eyes was about 20-25 minutes.
  • When done, they sat me in a dark room and let me put on my iPod. They would check in on me to make sure I was awake, and as I sat there in the dim light, I could see an eye chart on the far wall. At some point during that few hours in the dim light, I became aware that I could read the chart - I had no idea when that happened.
  • I was brought home - I expected to be convalescing that whole night - in fact, I set my weekend up in a way where I didn't have to do anything, but by 6 or 7pm, I was watching a movie on my television.
  • The next morning, I woke up with 20/25 vision. I drove myself back to the doctor's office for a post-op exam. Despite the dire warnings, the operation had gone better than everyone expected:
    • The reading glasses I used when I had contacts were no longer necessary, despite hearing that I still would need that after the operation.
    • My distance vision was not as sharp as with contacts, but was visibly getting sharper by the hour. (I am told by the doctor that it will continue to improve as the weeks go on - and it seems to be true.)
    • My night vision is just as good as it was with contacts.
    • What about the "prism" effects people complain about? I have put my night vision to the test several times over the last week - and small points of light appear as, well, small points of light. I do see the prism effect, but very faintly - and only on sodium arc lamps. (The low-power, orange hued overhead street lamps that are common on city streets and major highways.) The prism shows up only when I look directly at the lamp, and then only faintly. The prism pattern occurs as a straight line "rainbow" at the 0, 90, 180, 270 degree marks at a distance of about 22 degrees from the light source. For the curious - the prisming is caused by the pixel banding patterns that the laser cuts into your lens to shape it - essentially, the laser turns your lens into a Fresnel lens, just like the kind that used to make the baby Jesus disappear and reappear in those freaky catholic handout things. The distance between the banding is obvious very small (measured in angstroms), and my speculation about why I only see these sometimes is that the distance between the bands must be close to the frequency of the sodium lights.

Ok, so here's the deal for a successful LASIK:
  • Do your homework. There are a lot of quacks out their that you can get involved with that will do a sloppy or bad job on your eyes. (You don't want to wind up dictating a blog entry on, do you?) I came away with the metric: if the doctor has done less than 5,000 successful ops in a row, I wouldn't use him/her. Also, nothing is better than finding a reliable reference.
  • Do not bargain hunt. Dicker your heart out when you are negotiating a price for a car or jacket or something, not on your freakin eyes, dude.
  • Do what they tell you - both pre- and post-op, not just during the operation. If they want you to wear the goofy goggles for 2 weeks, even if your eyes feel fine, do it. Take the meds, the drops, the vitamin C, the whole deal.
  • Bring your iPod (or iRiver, or whatever) for post-op recovery. The hardest part about this whole procedure was staying awake in a darkened room for 3 hours while zoned out on Xanax. (If you fall asleep: rapid eye movement kicks in...uh, you don't want that...but you do want the Xanax, trust me.)
  • Get someone to drive you - I almost stupidly took a cab to/from the place-o-cutting....not a good idea, you will be VERY zoned out at the end of the day when you have to go home.
Throughout the whole process, there was no pain and no panic. I have been asked over and over if I would do it again - the answer is unequivocally yes, without any hesitation. My vision became impaired when I was a kid - I had mumps when I was 6 years old, and my vision deteriorated rapidly after that. (That was one of the effects of that virus - it moves from the saliva glands into other soft tissue fairly easily. Be glad that it has been virtually wiped out, kids.) So, for 4 decades I have donned spectacles or placed little pieces of vinyl on my corneas every morning - so, after the LASIK was the first time in my adult life that I have seen unaided.

So, yes. Absolutely. Without any hestitation I would do this again. Science wins this round.

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