The 20/20 Experience

I have recently undergone Lasik surgery. Just two days ago, in fact.

I know, there’re tons of arguments against or for Lasik, and I’ve read many of the different sides before making the decision. I’ve read horror stories of people with botched jobs, I’ve read the medical journals, the laymen’s experience, and still, I have made the decision.

Of course, I had some areas of particular concern, which I asked my eye surgeon and his clinic before I proceeded with the surgery:

1. Dry eyes. I’ve read many accounts  on the Internet of patients who have persistent and chronic dry eyes, to the point where it interferes with their quality of life. There were accounts of people whom, after almost 18 months post-surgery, experienced dryness to the point of debilitating pain everyday. That scared me. I’ve had my experience of dry eyes mainly due to hard contact lens use, after a whole long day. It was uncomfortable and made my eyes red at the end of the day. I didn’t want that to happen permanently everyday after Lasik. I asked my friends who’ve undergone Lasik before, and they also mentioned that they experienced dryness but it was usually temporary and didn’t last more than a few months. Further research into this showed that although you were more prone to dry eyes if you were Asian and female (amongst other risk factors) like me, but the length of dry eyes usually increased proportionately according to whether you were a contact lens wearer before, and for how long. As I hadn’t begun my contact lens journey more than 3 years ago, I hoped that wasn’t going to affect me much. Fingers crossed!

2. Starbursts/Night halos. This is a common side effect, I know. It’s meant to be transient and temporary, and should resolve within a week to a few months. I wouldn’t have worried so much about this if I hadn’t had a friend who has this side effect permanently. However, she did a procedure called “Wavefront Customised” where she was the unfortunate 5% who had aberrations on the retina. Nothing went wrong with her procedure, and all the results were absolutely great except for the fact that her night haloes never went away. The procedure I was looking at is called “Wavefront Guided”, which is supposedly far more accurate and safer for this night haloes effect than the other.

3. Influence on future eye surgery. My aunt was most worried about it having an effect in the future if you should ever need cataract surgery. I made sure to ask the clinic assistants about this, and they assured me that cataract and Lasik were operating on different parts of the eye, so there should be no interaction. You just needed to inform any future eye surgeons that you have had Lasik performed before. So far so good!

So with all these out of the way, I decided to go ahead with the procedure.

My appointment at the clinic was at 8.50am, so I showed up there on time. Nervous, but otherwise trying not to worry. The assistants there did the usual testing of my eyesight, with the machine that you have to look into. Next was the optical pressure testing machine, which I’ve never did before. It’s similar to the eyesight testing one, except they had a short but strong gust of air that blows into your eye. I wasn’t even ready for that! That optical pressure thing was really annoying but luckily I only had to do it once. Then they had to measure the topography of my cornea, which basically means how curved my eyeball is. You look into this really psychedelic swirly machine, it looks a bit like Willy Wonka glasses:

Image

After all this is done, you go into another room and test your eye sight with the usual Snellen charts, having to read out all the letters and having them put different pieces of glasses in front of your eyes, etc. I’m sure anyone who has or had myopia would be familiar with this procedure. After this, you go out and you wait somemore for the eye surgeon to see you. There’s generally a lot of waiting time throughout the day.

Finally, I went in to see my eye surgeon. He was recommended to me by my friend, the same who had night haloes when her Lasik was done by a different surgeon, but went to this one who told her that he could help her fix it, but needed to wait until her short-sightedness got worse first. Coincidentally, another unrelated friend also had her Lasik done with no problems by this surgeon. And thirdly, in a case a few years back where an acquaintance’s brother got his Lasik botched because he actually had retinal detachment but the surgeon somehow didn’t pick this up, they approached this surgeon for his comments and view. Having heard of him from 3 different places, I decided to go to him.

He was very confident about himself, he summarised the procedures of Lasik, and talked about how his machines are the safest and most advanced types you can find in Singapore or in Asia. It sounds a bit like selling, but heck, when you’re about to do a surgery like this, you’re not going to want to hear half-assed remarks from any surgeon, right? He examined my eye again under a bright light, and pronounced that I was a suitable candidate for Lasik (I read that about 10% of people who consulted for Lasik are turned away because they aren’t suitable). I told him I was currently taking Roaccutane, a drug now commonly prescribed for acne which could potentially dry your eyes (since it essentially dries up your oil-producing glands in your face), and he re-examined my eyes again just to make sure I had a good enough tear film that doesn’t increase my risk of having debilitating dry eyes after the procedure. He said again that I was suitable, and after I asked him my questions, the first consultation was over.

The time was around 11am. Throughout the morning, the assistants had dripped eyedrops into my eye (didn’t get a good look at what they were, but I think it probably was atropine) that dilated my pupils. It was a weird experience, because I had to take off my glasses to do close-up reading. It wasn’t like I had good vision already, but wearing glasses and doing close-up reading was somehow more blurry now. They said it was normal, so I let it be. I suppose they had to dilate my pupils so they could get a better look into my eye and so the surgeon could see the retina better when he examined it. Now they had to constrict it back to normal size before they could proceed with the procedure, but even with constricting eyedrops, it normally doesn’t go back until a few hours later, so they told me I could go out for lunch and to come back at 1.30pm.

More waiting! I honestly don’t know how I whiled away those few hours, but I wasn’t really in the mood for lunch though I did grab a bite. I was bored but nervous at the same time, not really sure what to expect and how everything was going to go.

When I got back, again – more waiting. The assistants looked at my eyes and said one pupil was bigger than the other so I had to wait till they were both at normal size again. When that was finally done, they began to prepare for surgery. I can’t tell you how nervous it was to see the assistants suiting up in the blue surgery gown, and getting me to put on one too. They sat me in a dim room and put on the gowns for me, then they cleaned my eyes with an antiseptic eye kit. More waiting. Finally, they led me into this bright, white room with big white machines in it. It looked rather futuristic but also kinda scary because you know those machines are going to get into your eyes. Don’t think about it!

They got me to lie down on the reclining seat and positioned me underneath this metal thing. It was not a needle or a spike or anything scary, it just looked more like a cone with a blunt tip. The surgeon came in and greeted me cheerfully. I could feel that he was trying to sound as warm and friendly as possible to relax me, which I appreciated. They dripped anaesthetic eyedrops in my eyes and although I could still blink, I could slowly feel the numbing effect kick in. The surgeon explained that he would be putting a suction ring onto my eyes and that I needed to relax. I already read about this in the consent form, but it was still pretty darn scary. It looked something like one side of a contact lens stuck onto a plastic handle, and when it goes onto your eye, the surgeon goes, “Suction on!” and there’s a lot of pressure on that eye and your vision in that eye blacks out (also read about that in the procedure form).

He kept repeating “Suction on!” but it seemed like my right eye was really resisting it, so they had to release me and let me rest for a while. The machine also had to recalibrate itself. I guess I was way too nervous! They brought me back to the dim room to rest (now for a longer time) and finally when the machine was done recalibrating, they brought me back in and repeated the whole process.

What the suction ring does is basically to hold your eye in place so that the femtosecond laser is able to cut the corneal flap, which is Stage 1 of Lasik. This is the easier way of cutting the corneal flap (the other one involves blades – NO WAY IN HELL am I letting blades near my eye), and apparently with lesser complications. Yes, it was scary to have your vision black out and feel all the pressure on your eye but honestly, I was slightly glad for it because I wouldn’t want to be looking straight into that laser that’s so close to the cornea anyway. I couldn’t see a thing in that right eye and all I felt was something like someone lightly blowing into my eye (the optical pressure measuring machine I mentioned above was much worse in that aspect). They released the pressure and your vision comes back really fast, except now everything’s kinda milky and weird (but still visible), but you try not to think about it. It’s like looking at the world through a piece of very dirty glass. Now the process is repeated in the left eye, but I think my left eye was either more compliant or just less responsive because I clearly did not resist or struggle as much with that one.

Now they go on to Stage 2 of Lasik. This is the main bit, but really, the most difficult part (suction ring) is over. The corneal flap has been cut, so now all they need to do is open it:

Image

In the above image, ‘microkeratome’ refers to the other way of creating the corneal flap – the bladed way. It has its pros and cons but, ugh. I didn’t do it so I’m not going to get into that.

So Stage 2 is Step 2-4 in the above image. The surgeon pasted these transparent film things over my eye. I think it’s meant to cover every part of my eye except the corneal flap which is the only bit he needs to operate on. I was positioned under another machine (the reclining seat swings there and back like a revolving chair lol) and there it was – the infamous orange blinking light! I wasn’t really scared by the orange blinking light, I was actually glad to have something to focus on at least. The surgeon kept saying, “Look at the orange blinking light~ Just look at it~” and I remember thinking, “I can’t goddamn see the orange blinking light.” because it really was kind of hazy to me. I saw the surgeon’s metal forceps and tweezers above my eye, and he sort of moved them in a rubbing motion. I honestly don’t know what he was doing, but after a while I could see something being lifted off my eye and everything becomes blobs.

Yes, my corneal flap was folded back from my eye.

It really sounds much scarier than it feels. Because I honestly felt nothing during the whole procedure. The orange blinking light became a very big orange blinking blob. The lights in the room were just really big white blobs of glowing things. The surgeon continued to ask me to focus on the orange blinking light but I don’t think I could look anywhere else even if I tried. The laser is switched on, I suppose. My vivid imagination had braced me to see some sort of sharp laser searing into my eye like some kind of horror movie, but if you were excited to see that, you would be sorely disappointed. It basically looked like camera flashes going off around the orange blinking blob, and the sound the machine made didn’t even sound like the typical laser sound that you’d expect. Not even like a lightsaber. It sounded more like softer, duller firecrackers. I was hugely relieved for that though, at least it didn’t make me more nervous than I already was.

After the laser goes on for about half a minute or less, the procedure is done and the surgeon starts to reposition my corneal flap back over my eye. I saw the metal tweezers again, a white spatula and more rubbing motions. Then, he made a downward sweeping motion with his white spatula, and everything comes back into focus, albeit a little watery and blurry, but at least the blob is no longer a blob. More rubbing motions, and I still remember him having two white spatulas on both sides of the flap and carefully positioning it. It felt like a position I should be seeing when someone is making arts and craft, not above my eye. But what the hey, careful repositioning of the corneal flap is important and essential for successful and rapid recovery.

Same thing with the other eye now, except now I’m less nervous and more prepared for what’s going to happen. I even took some time to admire the orange blinking blob. I was still a little edgy when it came to the surgeon’s tweezers and spatula so near my eye because I just really hate things being put near my eyes. It took me years just to put on contact lenses, and even then I still could never put on the soft ones because I couldn’t bear the idea of pinching them off my eyeball. Anyway – after all this was done, everything’s over. The procedure took less than 10 minutes.

The nurses led me out of the room. My vision was slightly milky but otherwise everything was looking in focus for the first time ever. I felt great! I went back to the dim room to take off the surgical gowns and to call my dad to pick me up. The surgeon saw me once more in his room just to make absolutely sure the corneal flap was positioned correctly. He shone bright light into my eyes, and I still felt nothing. He was very satisfied with the result and sent me on my way. They pasted these really ugly plastic shields over my eyes and I asked if it was truly necessary because they really looked hideous. I looked like a monster or someone who just got into a bad accident, but they said I had to. The assistant offered to bring me downstairs, but I thought, what for? I can see now! But I humbly accepted her help anyway.

When I got downstairs, I fully understood why the assistant needed to come downstairs with me now. It wasn’t the sunlight, I was fine with that as well – at first. It was when the anaesthetic kicked up its feet and said adios – dear Lord! It was as if my eyelids went on “Override All Orders, Auto-Shutdown” mode. I absolutely could not open them at all. The assistant was reminding me about my eyedrops regimen that I needed to do that day, but I wasn’t really paying attention. My dad could not come fast enough. I kept my eyes shut during the whole drive home but even then, there was just a lot of discomfort. Even in the darkness of my room, it was super uncomfortable. My curtains don’t block out 100% of the sunlight, but they are darker than most curtains. Even then, I couldn’t handle it. I couldn’t even sleep well because I had to wake up every hour to drip the eyedrops.

The pain wasn’t a sort of sharp stinging pain like you just want to gouge out your eyeballs. Rather, it’s more of a nagging sort of strong discomfort which isn’t even relieved when you close your eyes. You can even feel what shape your eyeball is in because when you tense them, the pain is there, but when you relax them, it’s much more relieved. Unfortunately, for most of us, it’s difficult to fully relax your eyeballs even when you close your eyes, until you’re on the verge of sleeping. That was me for the rest of that day. I was even thankful for the plastic shields cos the rest of my household didn’t have to see how ugly my eyes were. They were not exactly swollen, just a little bit puffy but quite bloodshot. Opening my eyes was a huge difficulty, and I’d rather have done everything with my eyes closed. I felt that sitting up and opening my eyes was slightly easier than lying down and opening them.

Throughout all this, I kept reminding myself that it was only for today. The day of the surgery is typically the worst and most uncomfortable day for most Lasik patients, and according to what my friends told me as well. I couldn’t look at any form of light at all. I felt like a vampire, waiting for darkness to fall. It was relief when the sun set and my room was plunged into absolute darkness. Opening my eyes was still difficult, but less so than earlier. Everywhere I went in the house, I shielded my eyes while I found the switch to switch off the lights. I had my dinner in the dark (my appetite is notoriously tenacious), I bathed in the dark (no washing of face or hair though). I couldn’t look at screens very much but I managed to reply some messages here and there. Things did get better as the day went by, I managed to keep my eyes open for more and more. Bathing wasn’t a chore, especially if it was in the dark. I went to bed really early at 9pm+ more because I had nothing better to do and I knew everything would be better the next day.

They were right. The next day, everything went back to normal. Sure, my right eye is still scarily bloodshot (it still is when I’m writing this), but my left eye looks almost completely normal now. I visited the surgeon again for my 1 day post-op follow up and he said I now had perfect 20/20 vision, that the bloodshot-ness was normal but he did increase my eyedrops regime to try and decrease the inflammation as quickly as possible. He also said I would no longer need glasses or contact lenses for life, because everything was “healing fabulously”. He did warn me about the risks that some patients do have to undergo a second surgery for corrections, or that they might develop a degree later on etc. which you need to correct with glasses etc but these were only about 1-3% of his patients, so a very small percentage. So I was really happy with his.I’d rather have a bloodshot eye that only looked scary but otherwise functions normally with no strangeness in vision, rather than a normal-looking eye that had a messed-up vision like if the surgery wasn’t done well. Anyway, the bloodshot eye is probably due to some blood vessels that burst when I resisted the suction ring too much. I’m not too worried about it because I’ve seen this happen randomly in people due to such reasons like air pressure during flights, and it’s harmless and usually resolves within a few days, like a bruise (which also involves burst blood vessels).

I feel great, no pain, not much soreness (only when I try look to my extreme sides) and yes, it is extremely liberating to be able to see everything without glasses or contacts now. The day after the surgery, sunlight and LCD screens were no longer an issue for me, although I know for some people, photosensitivity does take a bit longer to go away. Dry eyes, surprisingly, are not yet a problem. I’m not sure if it’s because I’m habitually dripping all those antibiotic and anti-inflammatory eyedrops which may also moisturise my eyes at the same time, but right now, I have no pressing need to use those lubricating eyedrops they gave me (although I do use them from time to time just to feel safe). Yes, I do experience night haloes and starbursts, but as I’m only Day 2 post-op, I’m giving it a bit of time for them to go away and I’m pretty confident that they will. I’m not sure how troubling these night haloes would be, as I haven’t ventured out of my house at night to see how bad they’ll get if I tried to drive at night. Luckily, I have no pressing need to drive at night either. 🙂

So here’s to a rapid and successful recovery! I was just sitting on the couch this afternoon and looking at the rustling leaves on the trees faraway and thinking – this is how my eyes should’ve been all along, if I hadn’t sadly developed myopia when I was 7-8 years old. Life is much better enjoyed in 1080p!

P.S. Kinda really wish I didn’t buy that new bottle of contact lens solution. And I’m thinking of getting an optical shop to take out the lenses of my glasses so I can still wear them as frames.

Advertisements