Friday, July 07, 2006

To Lasik or Not? That WAS the Question.

It’s been more than a year since I had Lasik surgery done on my peepers. I’d been considering having it done for years while I was still on active duty in the States, but it took my retirement and living here in the Philippines to finally put me over the edge.

A workmate’s wife underwent the procedure in New Jersey, and from the start I followed her progress with great interest. I wasn’t impressed. They found a cut-rate promotional offer – I think for less than a grand – and it seems they got what they paid for. One eye turned out okay, but the other eye did not. The vision in the unfortunate eye suffered from a shimmer or a halo effect, and it was severe enough that she had to wear a contact lens on it to read. She went in several times for follow-up procedures and treatments, but nothing helped. The purpose of the operation is to make it EASIER to see, NOT to make it more complicated. I felt terrible for her, and worse, HER experience scared me away from Lasik, for the time being anyway.

Not more than a year after I started living in the Philippines I started looking into Lasik again seriously, primarily because of my love of water sports, specifically snorkeling. My vision was so poor that swimming always used to be a mostly sightless experience. Unless a fish happened to swim directly in front of my face, all I was going to see of it was a flash and a blur. I had tried to use contacts along with a snug fitting mask, but usually, no matter how careful, I’d end up washing out a lens. It was frustrating.

After a lifetime of wearing corrective lenses I was tired of being, for all intents and purposes, blind. My visual acuity was 20/400, which means I could see at 20 feet what most people could see at 400. I could not drive or even safely walk around outside without my specs.

In fact, until I started wearing contacts in 1987, I never really knew what I actually looked like. It seems strange to say, but a thin length of plastic or metal framework wrapped around the front of your face, encircling your eyes, changes your look; it causes an entirely different aspect. Consider this – an imposing "tough" guy walks toward you with a neutral expression; some of us might feel uncomfortable with this fellow approaching, even if he’s completely benign. Now, put a pair of wire-rimmed glasses on his face, and now perhaps, in your mind, he goes from a possible threat to just another innocuous human being on the street. Appearance drives perception.

When I first got here, I spent some time relaxing around the pools of several of the local tourist hotels. I’d met several fellows who had come here specifically to have Lasik surgery – well anyway, MOSTLY for that. To a man, they raved about it, how fantastic it felt to be spectacle free. None had a bad experience; all, even after only a day or so after going under the laser, had perfect sight. They inspired me; like them, I wanted to get rid of MY glasses and contacts, and SEE, as barefaced as a baby!

My Internet research took me to Makati Eye Laser Center. I sent them an email asking about cost, credit cards, appointments and location. Their response convinced me to go in and get the exam. Two days after sending my initial inquiry, I was in their waiting room. I took a battery of eye tests designed to see if I was a candidate for the procedure. Was my cornea thick enough to shape down, how bad was my condition, was it correctable…stuff like that. The result, I was set to come back in three days for the full Monty. I was taking the plunge.

On the big day, I reported in and was shown into the operation anteroom. An assistant put numbing drops in my eyes, after which I kicked back in an overstuffed easy chair. I pulled the lever back to the full recline position, and proceeded to wait my turn. I zoned out on the soft cool leather, my legs all the way out and my head fully back. It was so comfortable I fell asleep. My wife had asked me in the waiting room if I wasn’t scared. What a question to ask someone huh? I didn’t care, I’m used to her . . . Once my mind is made up about something like this it’s never been my nature to question or to have second thoughts. I told her, no; I wasn’t the least bit concerned. I KNEW it would turn out just fine; why worry about it?

Aroused from my siesta, I was invited into the laser room. The doctor greeted me, and an unusual fellow he is, size-wise anyway, for a local. He’s a BIG boy, fairly tall and VERY “stout.” None of that made a difference though, because once I was in the chair with my head strapped tightly to prevent motion, I could no longer see him. For me, the good doctor became simply a voice, a soothing and self-assured one.

In the prologue of my decision-making process, one of the eye center’s young ophthalmologists had explained to me the wonders of the machine that was about to carve the surface of my eyeball. It was practically brand new, having been delivered to Manila from the U.S. just two months earlier. This advanced model’s computer “brain” would use the colored portion of my eye, the iris, as a lock-in reference. They had already captured both iris' image to memory, and the machine would follow any unintended movement of my eyes perfectly as it vaporized a precise layer off each cornea, in turn.

The older machine used the shape of the pupil for lock on, but evidently the pupil’s shape doesn’t provide as good a reference as the much more complicated iris. Of course, how am I to know what really goes on? Like most people, I just trust and let it happen. I can research it all I want, but in the end, when it comes to medical procedures of any kind, I simply take a leap of faith and let the doctor slice away.

After my head was made completely immobile in the full horizontal position, the doctor started talking to me like an air traffic controller calling a baseball game. He did a wonderful play-by-play, explaining everything he was going to do before he did it, and then describing what he was doing while doing so. He taped my lower and upper eyelids so that my eyes were stuck in the wide-open position, a very weird feeling.

A device was placed over my entrapped right eye and the doctor centered it over my pupil. He told me to keep my eye as still as I possibly could. There was a bright orange point of light for me to stare at and to concentrate on for a reference point. I relaxed and did exactly as I was told.

The weirdest part of the procedure happened next – he put a suction cup directly over my pupil. Thank goodness it was numb, otherwise I’m sure it would have stung like crazy. The purpose? To hold everything still while the laser cut a flap in the outer lens to gain access to the cornea below. It took no time at all. The doc remarked how perfect the flap looked as he laid it over, and then got the exposed surface ready for the laser to do its thing.

He explained that the program called for just over 30 seconds to burn away the necessary layer of cornea. Calmly, as always, he asked me to concentrate on the light, to keep my eyes as still as I could. He counted down and started the laser. I forced myself to relax and let the laser do its thing. It hummed a little and I think it sizzled some, the doctor continually spoke to me, always reassuring and descriptive. I felt complete confidence in both him and his machine as he counted down the seconds.

When the first eye was complete, he smoothed the flap back nicely into place with a brush-like instrument, and of course, detailed how perfect it looked. Then, we repeated the whole process again with the left eye. From start to finish, I was in and out of the chair in about 20 minutes, maybe less. A shielding blindfold was placed over both my eyes, and I kept them closed and still under it as the assistant led me back out to the anteroom. Once again, I fell asleep on the recliner, waking up only after they told me it was okay to take off.

For the next few days, I took it easy on my baby blues, well I was supposed to anyway. In reality, I did nothing of the sort. I was on the computer, watched TV, and rode my scooter. I did wear protective glasses all the time though, to keep the flaps from being disturbed by chance while they healed.

I went back the next day for a postoperative exam and the doctor was amazed. I felt no irritation, dryness, pain, nothing; it all felt completely normal, EXCEPT that I could now see without glasses. He checked my new vision and I was 20/15. They had overcorrected me; now I could see at 20 feet what most people could see at 15, quite a change from 20/400!

The only negative consequence: now I need reading glasses. No problem, they are just 1.5 in strength, and I have about 6 pair of lightweight plastic ones that go for about $4 a pair. That’s a far cry from the $200 I used to pay for my old super costly wire rimmed eyeglasses.

Even after a year, when I awake, out of habit, I'll grab for my nonexistent glasses where I used to keep them just under the edge of the bed on the floor. Or, I’ll be watching TV and instinctively push my “phantom specs” back up the bridge of my nose. It's funny, because after wearing them for most of my life, I’m still amazed at my “new look;” in my mind’s eye, I still see myself as I was before, wearing glasses. To me, my face looks kind of naked without them.

Just the same, how wonderful to wake up now and see crystal clear everything in the room. It’s great to be able to put my head down in my arms and not have to take my glasses off first. And unless you’ve worn glasses, you don’t know how annoying it is to have to keep taking them off to wipe sweat and dust off the lenses.

There’s no doubt that having to wear glasses is a total pain. I remember first reading about the Russians experimenting with corrective eye surgery and thinking, ‘yeah right; no way!’ But then continuing hopefully, ‘wouldn’t that be cool though?’

For just $1400 my life changed; that’s all I paid for the perfect vision I now enjoy, not to mention the wondrous freedom from the tyranny of wearing and caring for my glasses. I used to have nightmares about losing or breaking them, and I’d always carry a spare just in case.

And then there is the water: I was allowed to swim after 30 days; on the 31st day I was at the beach and snorkeling. What a treat! Now that I’ve had it done, I don’t know how I ever managed with my old eyes. If I had to do it again, I would, and for three times what I paid.

It is amazing how quickly we accept miracles, and it’s kind of pathetic how soon we start to forget how things USED to be BEFORE the miracle. When I think about it, I feel like a miserable ingrate, for slowly but surely, I am beginning to take all this for granted; and I didn’t realize it, UNTIL I started writing this post about my Lasik experience. Well, it IS a miracle, a miracle of science; it reminds me that we live in wondrous times. Now, if we could just fix this terrorist thing... Unfortunately, it's going to take more than some Lasik surgery to get THESE sickos to see the light!


Anonymous said...

Technology has indeed come a long way. Even the blind can now see and the deaf can hear through the wonders of science and medicine. I agree that you could call it a miracle.

Kevin said...

I had it done in 2000. Life changing. I am also 20/15. I was 20/400 before, just like you. Another cool thing is being able to wake up in the middle of the night and see what time it is. Also, falling asleep watching TV is kinda novel. You don't have to wake up and take off your bent or broken glasses, or dig the gellified contacts out of your eyes. The list of cool chanes is endless.

Ed said...

Excellent post on something I have thought a lot about. I've worn glasses since I was perhaps eight or nine. In my case, I have stigmatisms and I don't know if lasik can fix that or not. I need to do some research but have always thought of it being to cost prohibitive here in the U.S. to do so. I never thought about doing it in the RP.

I remember the day I tried on my first pair of contacts. It was like you said, a new me staring back and a life changing experience. Unfortunately, it ends every evening when I take them out and go back to glasses. Maybe one of these days I should undergo the procedure. It didn't sound as bad as I had imagined.

PhilippinesPhil said...

I would only say to do what I did and understand the risks. I have no idea what it costs in the US; it's probably not much more than here. As a technology becomes more available, the market drives the cost down.

The benefits are immediate. I can't say enough for how much it means to me to be able to just get up and go, no glasses to find and clean, no contacts to wear and worry about. It's the best money I've ever spent, for sure.

I think that if you follow the doctor's instructions and you stay as still as possible, concentrating on keeping your stare fixed at the light while they shape, as well as following all the orders about after care, there is virtually no pain or discomfort hardly at all. Some people experience some dryness and soreness, but I felt normal from the moment I stepped out of the chair. The doctor told me though that I was one for the books. He'd never seen anyone adjust so well to the procedure. As the church lady used to say on Saturday Night Live: "Well, isn't that speeecial!"

Vision Experts said...

there are a lot of new method nowadays to help improve eye sight, but if your eyes are still good, don't take if for granted, visit your eye doctor regularly