Three months ago I got my eyes upgraded with refractive laser surgery. Two days afterwards, I wrote the following account so I could describe it to anyone who asked about it. In short, it is very safe compared to any other surgery and it does work very well, but the potential risks scared the bejeezus out of me and I'm not sure I'd do it again if I had to choose. Some of you have shown a little interest, so I'll post my recollection of it here.
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I have mixed feelings about this. I see it kind of like liposuction, an operation I have always held in great disdain, because it seems like a dangerous "easy way out" of a problem that should be treatable noninvasively with hard work and self-discipline. But I was tired of wearing optical aids and couldn't easily find something else that worked so I went and forked over a LOT of money to get my eyes' protective lenses blasted with laser beams and reshaped by vaporization into additional refractive lenses.
The following scenes describe a medical procedure (not surgery: "It's a procedure, deadly procedure") and may be mildly disturbing for some readers.
First they give you a foul-tasting Diazepam depressant pill to relax your muscles and calm you, and they drip local anesthesia into your eyes, which stings for a bit and is slightly disorienting. They drip more of that again on the surgical bed-thing. The pill didn't do a #### thing for my nerves (I read one of its effects is to induce amnesia of operations); I was very anxious that the surgeon refused to give straight answers to any of my questions. He overcorrected my myopia by a quarter of a diopter or so, saying that young people still have a better range of focus (amplitude of accommodation) and can work with that without any damage to near-vision, and it anticipates regression later on. I almost got into an argument with him when I asked him to explain it to me, and me with stuff in my blurry eyes already. That's probably the worst bit about the place where I did it: though highly skilled and with the best available equipment, even the doctors treat it like a "flap & zap, get out of here, NEXT!" mass product and forget they are performing surgery on human patients. An attitude suited perhaps to mechanics, but not to doctors. The medical technicians who operated the machinery actually had a much better "bedside manner."
During the surgery they use something like a little circular wire clothes-hanger to hold your eyelids open, which is kind of freaky but less than I expected. It would probably look worse if I could see it from above. Then they put this other circular thing which sucks your eyeball steady so that they can perforate bits of it with a laser to make the flap, sort of like a stamp. That takes about half a minute each eye. The doctor said I would feel like someone was pressing on my eye. That's like saying giving birth is pressure. It ####ing hurts. They slow-count the seconds and I counted faster in my head while I crossed my fingers at my side and held my breath the first eye to fight the pain. The pressure is so great that it burst a whole mess of blood vessels in my eyes (I lifted an eyelid yesterday and today and found that everything under it still looks bruised), and you can't see anything in that eye while they do it, which may be a good thing. They tell you that the room lights will go out and not to be alarmed, but as my other eye was open I could clearly see through the gauze bandage that they were bull####ing, and I didn't appreciate that. That's the worst part. Then they repeat it for the other eye. I breathed the second time, very deliberately.
Returning to the first eye (after the minute or so it takes for the holes to "set") they poke something that looks like a little metal dentist's hook into your eye to loosen and fold back the flap, while you stare at a very blurry orange light in the middle of a bright white circular lamp, which keeps moving around as part of your cornea is moved in the middle of your field of vision. You don't feel a thing. I don't remember being bound down; I think sheer terror is what they count on to keep you immobile. Keep staring at that now very blurry orange light for another half minute as it expands outwards leaving black in the middle, and you imagine that might be the excimer laser which vaporizes parts of your eyeball (it isn't, the laser's supposed to be invisible.) You can see, hear, and smell your eye burning away - thankfully you still don't feel a thing. Then the surgeon washes your eye and replaces the flap and you realize that the only reason everything was so blurred was because your vision was blocked by the ashes of your own cornea.
Immediately after the surgery everything remains blurred, but less blurred than without glasses before surgery. There was a halo in the center of my vision with eyes open or shut, probably left over from the lamp around the excimer laser. That disappeared in less than half an hour. They gave me ten minutes to rest, commanding me to keep my eyes shut, while a nurse explained to my mother, who'd escorted me, how to put my eye drops in. I told them to tell it to me because nobody else would do it, and the %+#*$ ignored me and kept saying "this one" and "that one" to my mother, who could see, while I listened carefully. The surgeon had a look at my eyes and decided nothing was ruined yet, and sent me home. In total, he can shuffle each patient through there in about half an hour.
It is fortunate that I've practiced moving and doing things with eyes closed (always thought it was a weakness to rely entirely on one sense) so I was able to pretty confidently locate objects in my pack and lead the way out of there by opening a crack in one eye every few seconds. For six hours or so afterwards you can't open your eyes all the way (one side effect of the anesthesia), and they hurt a lot. It's supposed to be an irritation but it got worse, and really hurt. I took a painkiller, but it didn't help much. About two to four hours after the operation I felt as though something must be sealing my eyelid shut, like swelling as the cornea healed. I had trouble opening enough of a crack in my eyelids to drip the antibiotic drops into them even pulling an eyelid down with a gauze pad, and couldn't even do it myself the first few times. For the first few hours tears leaked like a flood intermittently out of my left eye and down my face, but it still felt dry. I felt my eyelids pulled awkwardly by the device they use to hold them open, maybe that was left over from that. I think I eventually figured out how to close it tight enough that they'd wash the eye instead.
Those things burn too. It feels like they're burning even worse every day and every time I put them in. You have to put in two sets of antibiotic drops every two hours with an offset of three minutes between them, followed after 15 minutes by two drops of lubricant in each eye (the only drops that don't burn,) for three days following the surgery, and keep your eyes closed for about minute after each drop. Following those first three days, the dosage drops to four times a day for the next week. You have to keep using the artificial tears for a good while - I think I might buy some more.
I wrote most of this with translucent eye-guards taped over my eyes, so please forgive typos until I properly edit. You have to wear these funny-looking bug-eyed-alien plastic guards over your eyes for the first day and the first three nights at least, to keep you from touching your eyes. Contamination and infection is the greatest risk, they told me. So I had to avoid dust, washing (tap water is very dangerous,) and especially my beloved Ragnarok the Destroyer, whom I was assured was "a certain contamination hazard." I was advised not to leave the house for the whole weekend, but yesterday I had to go for a day-after examination. They checked that I can see pretty well... my left eye still doesn't see as well as my right eye, and right now I see noticeably worse than I did yesterday, and my vision will continue to fluctuate for months after the surgery... but I can read most road signs from over 15 meters away, and they had a quick look at my eyes to see that I haven't managed to infect them yet in that critical 24 hours.
I haven't showered in three days (I'm allowed to bathe up to my neck with the eye-guards but decided not to bother yet.) My eyelashes look long and pointed, stuck solid together with residues from frequent eye-drops and stuff from my eyes. Yesterday an eyelash fell into my eye and I was faced with the dilemma of whether I would contaminate my eye worse by leaving the lash in there, or cleaning my finger and sticking it in there to remove it. I settled on flooding the eye with artificial tears and when that wasn't effective enough, I washed my little finger in the stuff and carefully used it to remove the offending hair.
If anyone is considering this operation, I would advise very careful and serious deliberation. Everything went absolutely perfectly for me (so far! *knock on wood*) and I'm still feeling queasy about it and wondering whether it was worth it. I wish I'd done my research better when I had the chance, even if it might have scared me out of it. Ask yourself why you want to undergo such surgery and what you reasonably expect to achieve. Chances are you do not really need this. It may be one of the safest operations in all medical history, but it's still a very new surgery, not a harmless product. The only other surgery I'd ever undergone was because I would have certainly died otherwise, and I practically did it under protest.
If you are thinking about it, do your research first and ask your doctors many of these questions. You should be aware that the healing process is several weeks, of which the first week or so involve extreme caution - all the stories you hear about people driving to work immediately afterwards are either cowpoop or dangerously reckless irresponsibility. Until the day after, you may feel like utter ####, as you should after surgery. Until a week after you need to use aggressive treatment of potentially painful eye-drops and avoid sweating, or anything coming into contact with your eyes. And for Random's sake don't let anybody poke you in the eye! This is if everything works great. Ask yourself if you are prepared to take the [even very minor] risk of not only possibly losing your vision, but having visual artifacts like "forks" at the ends of objects, halos around lights, astigmatism or other abnormalities that weren't there before? Nobody cares that it's only a 3% chance of complications when they fall within that 3%. Are you prepared to risk that the surgery may fail to correct to optimal vision but make it impossible for you to ever wear contacts again, binding you to eyeglasses for life? Are you prepared to repeat it if needed to correct problems introduced the first time? How about having to regularly use eye-drops for months or years after having your tear system crippled? Make no mistake: compared to other surgeries the chance of complications is extremely low and it is getting safer all the time, but this procedure hasn't been around for a decade so there is no long-term data on it. If everyone who did it were to go blind after 25 years, nobody would yet know. So yeah, that's how I'm doing and I would recommend being less hasty than me and keeping an eye on the technology for another few years, if you're thinking about it.
and I am not exaggerating.
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