Saturday, October 03, 2009

Laser Eye Surgery

So, over the last couple years I have gone back and forth with deciding whether or not to have laser vision correction. Contacts were fine, and I wore glasses only when I really needed to do so. However, in the last two years wearing contacts has become nearly impossible. Whether a function of the Colorado climate, allergies or staring at a computer 10 hours a day, my eyes reject the contacts after only a few hours. They become so dry that I cannot see. So I pushed back my fear of having my eyeballs operated upon and ignored all the horror stories that I hear and sought out some LASIK consultations. In my research about vision correction, I have heard many things about the surgery itself and the recovery. Reading other people's blogs has helped me to get a better picture, so I decided to share my experience.

It is a few days before my surgery, but I will back up and describe how I got to this point. The squeamish may want to stop reading.


I sought out three different eye surgeons and learned way more about eye surgery than I ever thought possible. Or wanted. Perhaps most importantly, I learned that I am not a candidate for LASIK surgery. LASIK is a procedure through which a flap is created on the cornea, opened, and the surface of the eye is altered. Just a few minutes later, the flap is replaced and the cells begin to heal almost immediately. It is this minimal cutting to the eye that makes LASIK relatively uncomplicated with a quick recovery time.

I cannot have LASIK for three reasons:
1. My corneas are too thin
2. The degree of my astigmatism is too high to make traditional LASIK successful
3. Evidently I have abnormally large pupils. Most people have normal pupils of about 5-6mm. Mine are 8.5 and 9 mm respectively. For some reason this makes correcting vision more difficult.

So, my option is PRK, otherwise known as Photoreactive Keratectomy. This does not involve the creation of a corneal flap (I do not have enough cornea to do so), but rather, the actual surface of the eye is modified.

The top layer of epithelial cells in the eye is removed by the surgeon (I believe the terminology is "delicately scraped". We will see about that...), then the laser reshapes the surface of the cornea. To protect the eye, a large "bandage" contact lens is placed into each eye and must stay in for 3-5 days. PRK has a lower risk of complications, but the recovery is significantly more painful because more nerves are impacted.

I am having a hard time imagining what this will be like. A few years ago I scratched my cornea with a bit of sand, and that was pain like I have never felt before. I cannot fathom what deliberately abrading a significant area of BOTH eyes will feel like. This is where people like to tell their horror stories.


In preparation, the surgeon is having me take three medications in advance of the surgery. An anesthetic eye drop (Acular), an antibiotic eye drop (Zymar), and most significantly, a nerve-blocking agent called Neurontin. Taking these in preparation apparently cuts down on the pain in recovery. I have a prescription for Vicodin, but I absolutely do not want to fill it. I think I will take pain over the side effects of narcotics. But I also know where the nearest 24 hour Walgreen's is.

I have also lined up an army of people to help me because I live alone. Including my friend Nicole who actually gets to witness the surgery and its immediate aftermath, a couple friends who are on 24 hour call and some coworkers that live only minutes away. I have been told that my vision immediately following the surgery will be improved, but within the next few hours, as the cells began to heal, it is nearly impossible to see. It is necessary to keep the eyes completely covered in the beginning because bright light can hinder healing. Which means I will need help with some things. I hate cooking on a good day and it will not be fun blindfolded. I will not be able to drive for at least three or four days and am not allowed to stare at a computer for extended periods of time, so I will be out of work for a few days. I stocked up on audio books because there is not much else I will be able to do.

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