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Holy Crap my Eyes are Smoking!

I started wearing eye glasses to correct my short sightedness when I was 7 years old. Oh yeah! I have heard all the stupid childhood jokes about wearing glasses. The first day I produced my glasses at “show and tell”  was rather traumatic.

Thirty years ago I watched a documentary on TV about pioneering Russian corrective eye surgery. The procedure involved cutting the cornea off the patient, freezing the cornea then shaping it in a computer controlled milling machine. Once the cornea was the correct shape it was thawed out before sewing it back on the guinea pig – I mean patient. My reaction to watching this was ” I think I will wait and see if corrective eye surgery improves any before I give it a whirl!

Fast forward to January 25 th 2012, I was laying on my back on a gurney with the smell of  burnt hair filling the room as a laser  zapped my eyes! Holy Crap my Eyes are Smoking!

When we made the decision to travel full time again I made up my mind to get laser corrective surgery performed on my eyes.  I did not want to deal with glasses or contacts anymore. When scuba diving there was always the thought running in the back of my mind – what if my contacts blow out at 100 feet depth – wouldn’t be cool. I had spoken with my optometrist and he said I was a candidate for the surgery.

The are basically two types of corrective procedures available:

1. Lasik  where a thin flap of cornea is first created, with a sharp blade. The flap is then lifted and the underlying tissue is sculpted by the laser for the desired correction.  The flap is repositioned without sutures.

2. PRK (Photorefractive Keratectomy) First, the surgeon scrapes off the outer layer of the cornea (epithelium), and then the laser reshapes the cornea for the desired correction.   After the surgery, a soft contact lens is placed on the eye to act as a bandage for several days until the epithelium regrows.

Usually if you have a thin cornea PRK is performed, however the stronger the correction the more applicable the PRK is as well. My prescription was -6.75 and -7.00.

My optometrist gave me a few referrals to the best surgeons in town. When it comes to zapping my eyes with lasers I was not interested in the lowest bidder.

I decide to go to the Pacific Laser Eye Centre in Vancouver. I booked a free consultation.  I arrived at the clinic and was shown a video about the procedures, my eyes were then examined by a clinic optometrist. I was then given a  a personal consultation with Dr. Lin. This gentlemen is a pro. He asked me which procedure I was interested in. I told him my concerns with both. The concern with Lasik was the flap flapping around. My biggest concern with PRK was the potential for pain. I have friends who had PRK and were in agonizing pain for days after the surgery. I told the doctor – hey you are the expert what do you recommend?

Even though my corneas were nice and fat the doctor recommend that I was a good candidate for the PRK and borderline for Lasik.  With the amount of correction that I required meant that PRK was the way to go. If I went with the Lasik procedure and ever needed a second surgery it might not be possible where as PRK left more doors open.

Dr. Lin made sure I well understood the potential risks of the procedure which include:

  • Potential of Infection and delayed healing
  • Potential for under or over correction
  • Excessive corneal haze
  • Regression
  • Halo effect
  • Raised eye pressure (steroid induced gylcoma)
  • Equipment malfunction

Even if the procedure was 100% successful, because I was over 40 I might still need reading glasses because of age-related change in the lens, unrelated to laser eye surgery.

OK Fine – Make it so

I scheduled my appointment for three weeks later. Holy Crap am I doing the right thing? The voice in my head was really active What if? …. What if?……..What if?

Pre Operation

One of the things that really impressed me was that a  full pre-op examination was  conducted with my eye doctor. Checks and balances are important when zapping ones eyes with lasers!

I was also instructed not to wear contacts for one week prior to the procedure. Contact lenses tend to warp the cornea slightly. Time is needed for the cornea to resume its natural profile. I was also advised to start taking Omega -3 fish oil a week prior to surgery to assist with the healing process.

The Surgery Appointment –  Wednesday January 25th 2012

On the day of surgery, after I signed  my life away, and making a payment on the Doctor’s Porsche, another eye examination was done – just to make sure! This time the data was programmed into the computer controlling the laser.

I was led into a waiting room where the first of many gallons of eye drops were administered – they freeze your eyes before they “burn” them. I was  given an instructional video to watch and was instructed on how to self administer eye drops – this was very important in the weeks and months to come. I was also given a Gravol and an Ativan to help me chillax.

Once my eyeballs were sufficiently anesthetized, I was lead to the operating room and  positioned on the operating table. I has given a tension ball for each hand – visions of the western movies where the patient has to bite the bullet came to mind. The laser was moved into position. There is a green blinking fixation light which I was instructed to look at. The doctor did not say it but I as thinking If I screw up and don’t fix my gaze I would end up  looking like Hiedi the cross eyed possum. 

Dr. Lin put a few more gallons of eye drops in my eyes before installing an eyelid holder. Then Dr. continued scrap off  the epithelium (outer skin of my eye) with a spatula. My vision stared going blurry.

The doctor then started rubbing my eye – to polish it I understand. Then the fireworks began. The doctor was right behind me assuring me that the smell of burning hair was normal and nothing to worry about. Don’t worry we are only burning layers of your eye with a fricken laser nothing to be alarmed about!

The whole laser procedure took only a matter of seconds.

After the laser light show the doctor polished my eyeball, placed a bandage contact lens and it was one to the next eye.

After both eyes were finished smoking, I was escorted to the holding room were I sat in a comfy chair waiting for the councillor to debrief me. I was given a goodie bag of eye drops:

  1. Tobradex
  2. Ciprofloxacin
  3. Voltaren
  4. BBS saline solution
  5. Celluvisc

I was also given a prescription for Doxycycline , Tylenol 3 and Ativan – Hey I thought you said this was not going to hurt!

I was also given a styling pair of Roy Orbison wrap around sunglasses and was sent packing with explicit instruction to keep everything out of eyes especially my fingers. I was also to avoid getting any water in them. When taking a shower, keep your eyes tightly shut. Swimming pools and hot tubs – not gonna do it- for two weeks.

Yvonne was there to drive me home this was a good thing because I could see squat!

Before I was scheduled for surgery I was recommended that I take at least 4 or 5 days off work to recover – This turned out to be good advice.

Post Operation

Day 1 Post Operation Wednesday Jan 25 2012

Once I got home the first afternoon and evening was spent laying in bed applying a variable plethora  of drops into my newly shaped eyes.

My vision was very blurry it was looking through thick wavily glass – like the bottom of a bottle of Coke.

Day 2 Post Operation Thursday Jan 26 2012

The next day we went back to the clinic for a follow up,  more ophthalmologists peering into  my eyes. I was given even more drops.

Tobradex  1 drop 6 times a day for 2 days, then 2 drops a day for 1 day

Ciprofloxacin 1 drop 2 times a day for 3 days, then once a day until the bandage contacts come out.

Voltaren  1 drop 2 times a day for 1 day, then 1 drop the second day.

My vision was spotty it was constantly changing but definitely improving.

Day 3 Post Operation Friday Jan 27 2012

Vision was getting much better things were looking up!

Day 4 Post Operation Saturday Jan 28 2012

Up to today I had experienced very little pain or discomfort. That changed today – I guess because I had stopped taking the Trobradex and the Votren. My eyes felt like they had sand poured in them.

My vision also went for a dump as well – This is great my eyes are getting sore & I can’t see! I think something is wrong here!

Day 5 Post Operation Sunday Jan 29 2012

Pain has gone away my vision is still blurry.

Day 6 Post Operation  Monday Jan 30 2012

Today I went back to the Pacific Laser Eye Centre to have the contact lens bandages removed by Dr. Lin. The doctor was very pleased with the progress and said my healing was complete. My vision I was told will improve steadily over the next few days. Today was a drug free day for my eyes – tomorrow I start steroid drops.

My Eyes on Steroids

The steroid drops FML (fluorometholone)  are used to reduce the  possibility of haze or regression. These drops however may cause an increase in eye pressure drug-induced glaucoma

Another eye drop is prescribed to counteract the tendency to increase the intraocular pressure. This drug is Betopic S (betaxolol hydrochloride).

I am also continuing to take 2000 mg of omega -3 fish oil twice a day of for a month after surgery to asset with the healing process – To help me see like a fish?

The steroid regime I will be on is a 9 week program and looks like this:

Starting Tuesday January 31 2012

Ending Tuesday April 9 2012

Steroid (FML)

1 drop 4 times a day for 2 weeks

1 drop 3 times a day for 2 weeks

1 drop 2 times a day for 2 weeks

1 drop once a day for 2 weeks

1 drop every 2nd day for 1 week

Betopic

1 drop 2 times a day for 6 weeks

1 drop once a day for 1 week

Day 8 Post Operation February 1 2012 

Still off work and my vision is definitely improving today. As the day wore on the fuzziness started to creep back into my vision.

Still not able to drive. Will not be able to drive until I get clearance from my eye doctor.

Day 10 Post Operation February 3 rd 2012

First day back to work my vision is improving every day. Working at the computer is very difficult. My vision is good in the morning but I suffer from eye strain as the day goes on.

Day 11 Post Operation February 4 th 2012

Did a 1 1/2 hour stretch on the computer today and I am paying for it. I am feeling the effects of eye strain. Things are still blurry but I can see the light at the end of the tunnel

Post Operation Visits with my Optometrist

Pacific Laser Eye Centre set up a co management arrangement with my Optometrist in Coquitlam Dr Alan Nicholson at the Austin Heights Optometry Clinic for the on going monitoring of my eyes.These visits are important especially during the steroid regime after PRK  to see whether the steroid drops are causing an increase in eye pressure

First optometrist visit Post Operation Day   Monday February 6th  2012

Dr Nicholson indicates that my corneas are slightly pitted and it will take some time for them to heal completely. When the epithelium becomes smooth (optical grade) I will have 20/20 vision!

I was given clearance to drive today!

Day 14 Post Operation  February 8th 2012

My eyes are coming around and my vision is AWESOME! It is an amazing feeling after almost 40 years of wearing glasses to be able to see the alarm clock in the morning with out fumbling around for your glasses. You can get up in the morning and just get on with it.

March 3 2012  – 1 month Post Operation 

My vision is AWESOME!

Six Month Post Operation visit with Dr Nicholson

My eyes are fine, I have a slight regression in one eye of -0.5. This does not mean I require glasses and usually any regression occurs with in the first six months. The bottom line is that my vision is perfectly fine to function normally with out glasses or contact lenses.

I still go to bed sometimes thinking “Oh crap I forgot to take out my contacts!” Then I think “nope I don’t have to do that any more!”

Conclusion:

I have absolutely no regrets with the results of my PRK procedure. I am glad I waited to have Dr. Lin do my procedure rather than going for the Russian procedure of 30 years ago.

Life without glasses or contacts is absolutely fabulous!

About the author: Apparently born under a wandering star, Michael spent hours as a kid poring over maps, atlases and plotting where he wanted to travel when he grew up. Sadly Engineering school got in the way….. “it takes 5 years to complete and a lot longer to get over”. He still considers himself a “recovering” Professional Engineer. He escaped the rat race at 44 and now pursues his passions for travel, photography, Tai chi, scuba diving, cooking and sampling the world’s wines. Michael is also… Fiercely independent, a bit of a rebel, is on a self-imposed media diet & married to an incredible lady.

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