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I've thought about getting laser surgery for many years. Price was mostly the reason why I hadn't done it before now, but I was also a little concerned about the risks. In May, 2000 I decided I wanted to check out the options for refractive correction. I called and made an appointment to go to the Wilmer Eye Clinic at Johns Hopkins Hospital in Baltimore.
My appointment lasted about 45 minutes. They gave me a complete retinal and eye exam, as well as check my current glasses and vision. The doctor told me that I was a candidate. She confirmed what I already knew - that I would lose the ability to see things to "point blank range" that I enjoyed as a nearsighted person. I would also lose some clarity and magnification of things at close range. In short, after the surgery I would see like a "normal" person. The doctor also said that it was possible that if I had the surgery I would need glasses to read after the age of 40.
She informed me that my pupils dilated to 7mm, which is on the high side of average. The eximer laser they use only corrects 6.5mm of the cornea, so in very dim light I would be seeing through the ridge between the corrected and uncorrected part of my cornea. This would cause a "haloing" effect around light sources. She was unsure exactly how pronounced it would be for me, but said it would be very similar to when I wore my contacts at night. She suggested wearing my contacts for a week straight. This was to see if I could live with the loss of my better than average near vision I enjoy as a nearsighted person, and to see if the haloing would bother me too much. That would approximate what it would be like with corrected vision. At work, I do close work with very small objects and was concerned about how much near vision I would lose. The consultation cost $95 - which is deducted from your surgery bill should you decide to go through with it.
I wore my contacts for a week at work and decided that I could deal with the loss of my very clear "point blank" vision. I was concerned with the haloing effect the doctor talked about and the list of possible side effects. I did a great deal of considering before deciding to go through with the surgery.
On the day of my surgery, they gave me another short exam and tested my vision again. I had to sign all the scary consent forms and then the most scary one of all - the bill. The remaining balance of the $5000. There are many cheaper places to go, but I wanted the best in the country - That's Johns Hopkins. http://www.wilmer.jhu.edu/departments/REFRACT.HTM
They sent me back to the waiting room until they were ready for the surgery to begin. When they called me in to the surgery room, the made me put a silly blue paper shower cap on. The nurse gave me two squeezy-stress-things to hold, and sat me down in a dentist-like chair that reclined all the way. They lowered me down and slid my head under an apparatus that was several meters long and about a half meter wide. It was attached to a much larger device on the floor by a movable arm and large cables. They taped my left eye closed with a small piece of masking tape. The doctor explained everything she was going to do before she did it. She had her nurse perform many of the steps involved. The doctor had me look at the "blinking red light" which was just an LED inside the laser housing for you to focus on. She told me to stare at the red blinking light for the entire procedure.
First, the nurse put numbing drops in my eyes, then the doctor placed the speculum on my eye. (see : A Clockwork Orange) A speculum is a device that keeps your eye from blinking. It didn't hurt at all, but it was a little strange. I didn't actually have the urge to blink, but I may have been subconsciously suppressing that myself - I'm not sure. The nurse then lowered a little device down onto my eye. It looked like a transparent ring from my perspective. It made contact with my eye. I could not "feel" it because of the numbing drops, but I was aware of it. It was a little bit like when I had a tooth pulled at the dentist. I had Novocain and could not "feel" the tooth - but I could feel the forces acting on the surrounding tissue and bones. Ok, well maybe not quite like that, but you get the idea. I couldn't feel it directly, but indirectly through non-numbed areas I was aware of things. The nurse turned on the suction. This device suctions your eyeball to it so it can't move around too much while the incision is made and the laser is operating. When the suction was turned on, everything got very blurry and dim. Eventually going almost black after about a second or two. The doctor had prepared me for this. She told me to keep staring at where the light was, and that some vision would return after a moment. The doctor then took a pointer and marked my cornea. She touched it in about four or five different places. I could not see any markings she was making from my perspective - just her touching my eyeball with a thin, pencil like object. This is done so they know exactly where to reposition the flap when they fold it back down. She then used the computer to control the microkeratome, which cuts a flap in your cornea. Don't ask me what a microkeratome is. It sounded like a little buzz saw and lasted maybe a second or two. The doctor then took what looked like a pair of tweezers and lifted the flap she had made in my cornea. When she did this everything got WAY blurry. She told me to keep staring at the red blinking light in case I had forgotten or gotten overwhelmed and was wigging out. I wasn't - it was actually cool. The red light was a red blur now. The technician/ assistant had programmed my parameters into the laser while all this was going on. The tech told me the computer had determined a 20 second sequence was needed for this eye. She warned me before the laser stared. When it did, there was no visible effect at all. There was a "tick-tick-tick-tick" sound from the large device on the floor - that's it. It was a little difficult to keep staring at the red-blur-dot. I'm not sure if this was because the laser was reshaping my cornea, my slight apprehension manifesting itself, or just jitters. I wondered how critical it was to keep completely still and did my best. When it was done, the doctor folded the flap in my cornea back into place. She used a spatula-like device to smooth it down and line it up with the marks she had made. They removed the suction and the scapula. They had me close my right eye and untaped my left. The whole procedure for that eye took about 2-3 minutes.
The left eye went pretty much exactly like the right except I had a 25 second round with the laser because my vision was worse in that eye. I did actually squeeze the stress-squeezy-thing in my left hand for this eye. I think the doctor may have noticed, or it might have been something else, because she rubbed my left arm a little during the laser procedure for this eye. I was grateful for the touch. It's amazing what a small touch can do. People always underestimate the power of touch. When they were done, they had me slowly stand up. The nurse told me that some people get dizzy because the reclining chair puts your head slightly below your heart. The doctor told me everything went perfectly.
I was led out by another doctor to the waiting room. He taped both eyes shut and had me sit for 20 minutes. When he came back he untaped my eyes and brought me to an examining room to check the position of the flaps. He told me they were perfect and gave me instructions on the administering of drops to my eyes for the next week. One was a steroid to lesson swelling, and another was an antibiotic, I forget what the third was for. I was only half listening to him because I was WATCHING HIM. CLEARLY and WITHOUT GLASSES. I guess he must get that quite a bit, because he had it all written down on a piece of paper for me. When I went outside, the sunlight was a little bright. They had dilated my pupils some, so everything was blurry because of that. The guy who was driving me home asked how my vision was. "Everything is clear except for the fact that it's all blurry." was my reply. He thought I was joking, but I wasn't. I could tell that everything was clear now - it was just the dilated pupils that was making things fuzzy in the bright light.
The better vision was a little like getting used to a new pair of glasses. My eyes aren't used to seeing through a correctly shaped cornea, so the muscles have to focus differently. They had me wear plastic covers over my eyes the first night of sleeping so I wouldn't rub my eyes by accident. My left eye was very scratchy for the first 24 hours. I returned the next day for them to check the flaps again and my vision. The flaps were fine and my vision was 20/20 in my right eye and 20/25 in my left. The doctor said that my left eye would likely improve some as it healed.
Some random observations the first week
The months after
One year after