Beauty & Wellness

[Merged] laser eye surgery

  • Last Updated:
  • Dec 16th, 2017 9:22 pm

Poll: Mid twenties a good age to get it done?

  • Total votes: 200. You have voted on this poll.
Yes
 
103
52%
No
 
29
15%
Pizza is yummy
 
68
34%
Deal Addict
User avatar
Oct 1, 2011
4950 posts
781 upvotes
burnt69 wrote:
Feb 3rd, 2017 10:08 pm
After reviewing my documentation (the informed consent form, page 7, item 5.), the 2 week check-up wasn't optional after all for PRK. However, I'm not clear on whether I need a 2 month check-up now.
Naw, I noticed the discrepancy and clarified during the next-day checkup. They said they USED to order the 2-week checkup, but removed it since the majority of patients were doing well by the 2-week mark.

You'll have to ask PLEC about the 2-month checkup, which the notes they provided said is an important time to note any rebound haze from stopping the FML steroid drops.

Here is their wording:
"AT 2 MONTH POST-OP VISIT *KEY VISIT*
The patient should be done all steroid drops at this time. This is the most important check-up for any rebound haze directly after steroids are completed...Send post-op assessment report to our office."
Sr. Member
Oct 6, 2015
902 posts
436 upvotes
peanutz wrote:
Feb 3rd, 2017 10:16 pm
Here is their wording:
"AT 2 MONTH POST-OP VISIT *KEY VISIT*"
The patient should be done all steroid drops at this time. This is the most important check-up for any rebound haze directly after steroids are completed...Send post-op assessment report to our office."
Ah yes. In that envelope of instructions to the optometrist which I reviewed and then handed over. Thanks!

But at my 2 week checkup, Betoptic S was discontinued. If you don't get a 2 week checkup, how would they know? Did they check your pressures (air puffer machine) at 1 week? My optometrist didn't check mine till week 2, claiming it wasn't allowed.
Deal Addict
User avatar
Oct 1, 2011
4950 posts
781 upvotes
burnt69 wrote:
Feb 3rd, 2017 10:21 pm
Ah yes. In that envelope of instructions to the optometrist which I reviewed and then handed over. Thanks!

But at my 2 week checkup, Betoptic S was discontinued. If you don't get a 2 week checkup, how would they know? Did they check your pressures (air puffer machine) at 1 week? My optometrist didn't check mine till week 2, claiming it wasn't allowed.
No, they did not check my intraocular pressure at 5 days. :razz: I guess there is no real hurry to make patients stop the Betoptic-S, they just happened to tell you it's OK to stop because your pressure was checked and you were fine.

My optometrist's office has a scanner so that's why they handed me back the envelope. I didn't peek at it before they gave it to me. :)
Newbie
Apr 3, 2012
6 posts
1 upvote
Toronto
@burnt69 @peanutz I really appreciate the thorough responses from both of you. This has been very helpful. I scheduled a third consult at TLC Yonge Eglinton for that exact reason of getting a second, second opinion. I'm still leaning heavily towards PRK as the most suitable option as cost and pain is not an issue (but quality of night vision, ability to have a revision if necessary and because PRK seems to be chosen a bit more frequently for the type of work I'm hoping to transition into.)

Thanks again for taking the time to respond, this entire thread has been an excellent resource.
Sr. Member
Oct 6, 2015
902 posts
436 upvotes
Just for those reading here, another SmartSurfACE PRK study (this being one of the first that is independent of Schwind company paid consultants) just hit the journals:

http://www.contactlensjournal.com/artic ... 0169-2/pdf

Just a few points from my read:

1) Pain scores are cut from 2.98 to 2.1 straight off the table for SmartSurfACE, 1.78 to 1.02 the next day, and fall to practically zero on the 3rd day.

2) The difference in visual recovery times particularly in the first month is amazing. Patients literally have better vision straight off the table, than patients would have had with the older technology 1 month post-procedure.

If anyone's on the fence about getting PRK, and fears the long recovery time traditionally associated with the procedure, please check SmartSurfACE PRK out. A great "Made in Canada" innovation/technology. As a recent patient of the procedure, I can tell you, my "computer down-time" was literally three days (and my computer has a 14" 1080p screen!).
Deal Addict
User avatar
Oct 1, 2011
4950 posts
781 upvotes
@burnt69 I've noticed an increasing trend towards calling the modern, improved PRK techniques as "advanced surface ablation"--one reference I read created the acronym of ASA to differentiate it from the earlier versions that are associated with more discomfort. A rose by any other name...

@bumblebeeeee You're sweet! Good luck. If cost, time, and proximity to Toronto weren't an issue I would strongly recommend Vancouver's PLEC for the trans-PRK with SmartSurface but people have had regular PRK as well and not regretted that choice.

Undergoing this choice has been very recent and close to my heart, and I have a younger brother who has expressed interest in it as well, so the nerding-out exercise is a hobby for me (and I think burnt69 as well.)

The final review for possible excluding health conditions are listed here:
http://www.medscape.com/viewarticle/827454_4

Here's an excerpt:
Another relative contraindication is uncontrolled systemic immune-mediated diseases such as Sjogren's syndrome, rheumatoid arthritis, systemic lupus erythematous, ankylosing spondylitis, psoriatic arthritis, inflammatory bowel disease (IBD) with arthritis and Behçet's disease. Patients with these conditions may be candidates for LASIK if the disease is controlled with or without medication for over 6 months without any active symptoms or signs confirmed by the treating physician, there is no active ocular complications secondary to the disease and the patient exhibits a normal tear film.
Because I have atopic dermatitis (commonly referred to as eczema) that can flare and go away, I thought about testing for any possibility of, and ruling out lupus. But since I've never had mysterious joint pains or debilitating fatigue, I played my odds and went ahead with the PRK. I don't want to be a scaremonger, but it's just something that I was wary of, since there are some inflammatory conditions that aren't uncommon, and sometimes people are undiagnosed if they have them mildly.
Newbie
Feb 4, 2017
1 posts
1 upvote
Prk is better and safer than Lasik. Less dry eye and lower risk of keratoconus and ectasia. But visual recovery time is longer than Lasik
Sr. Member
Oct 6, 2015
902 posts
436 upvotes
peanutz wrote:
Feb 5th, 2017 4:16 pm
Because I have atopic dermatitis (commonly referred to as eczema) that can flare and go away, I thought about testing for any possibility of, and ruling out lupus. But since I've never had mysterious joint pains or debilitating fatigue, I played my odds and went ahead with the PRK. I don't want to be a scaremonger, but it's just something that I was wary of, since there are some inflammatory conditions that aren't uncommon, and sometimes people are undiagnosed if they have them mildly.
I think a lot of those 'contraindications' are basically throwing the kitchen sink at things, or are along the lines of things to watch out for in the post-treatment medication regime in terms of medication interactions. For instance, eczema is treated with corticosteroids, which is also the treatment post-LASIK/PRK. So a medication adjustment may be in order if one is taking oral steroids for that condition, and also taking intraocular steroids to treat the corneal wound induced by LASIK/PRK.

Similar with diabetes. Its not an absolute bar to a refractive surgery procedure, but the patient should be evaluated when they are at a normal blood sugar, confirmed by glucometer testing, rather than in a myopia-inducing hyperglycemic state.

Any good refractive/PRK/LASIK surgeon will do a complete medical history, or acquire such information from a co-management arrangement with an optometrist. This may be one of the benefits of using co-management, rather than showing up at an all-inclusive clinic and perhaps, in the rush of it all, not disclosing conditions or medications that may require relevant modifications to the treatment algorithm. I know there's a lot of controversy over whether co-management fully serves the interest of the patient (or is just a marketing tool for high-volume clinics!), but I've been very happy with my optometrist and the feedback provided to her (and myself) from the surgery center.
Sr. Member
May 11, 2008
700 posts
24 upvotes
Toronto
Update after exactly 2 weeks with PRK at clearview...

Vision:
It is getting better and clearer everyday. I don't see any haze at all at this point. I could start driving maybe on day 10. Vision got really blurry again after removing the contact lens on day 5.
I can tell my vision is way better than before in the morning (I had around -1 on both eyes and -1 astigmatism). However it does fluctuates a lot throughout the day. I can literally force myself to yawn to get my eyes wet and I can see super well for about a minute, and get back to blurriness. Interestingly, artificial tears does not provide the same effects.

Feel:
I have had 0 pain and I have taken 0 pain killers after the surgery. Maybe it is due to my low prescriptions?
My eyes were dry occasionally during sleep, I had to use drops to the eyes before opening them when I wake up. Maybe once or twice a week so far.
I was really sensitive to light for the first week or so, by now I don't even need sunglasses outdoor with bright sun light, but I do wear sunglasses as much as I could.
I had originally planned to do LASIK, but final testing shows the "back?" of my cornea had a kind of large gap at the thinnest point. Dr. Kranemann was honest and said he does not want to risk it and offered PRK. The long recovery and blurriness was making me grumpy. I used to have good up close vision with great sharpness but now it's fuzzy still.

Drops: Anti-bacterial, Anti-inflammatory, and steroid drops for first 5 days, after removal of bandage contacts, only steroid drops were needed, 4 times a day for the first month. 3 times a day for next 2 months.

After care: I did not get to see Dr. Kranemann after the surgery so far with 2 post op visits. However Dr. Yu is also a very thorough and nice. She did all the checks and answered all my questions.

Over all: Mixed feeling, most likely due to my expectations were changed last minute. That said I wasn't pressured in any way to change my decision, I just took a week off already and went for it. Given the reviews here so far, I would have done trans-PRK with PLEC if I were to choose again knowing PRK was my only option.
Sr. Member
Oct 6, 2015
902 posts
436 upvotes
lkt01071 wrote:
Feb 9th, 2017 11:04 am
Interestingly, artificial tears does not provide the same effects.
Are you doing Omega-3 supplements as well? Speaking from experience taking 2000mg twice daily (Jamieson Omega-3 "Select", 4x1000mg capsules daily!) pre-op, this *definitely* helped my eye hydration. Not all Drs recommend it, but I don't see how it could hurt if you're struggling with minor amount of dry eye.
I had originally planned to do LASIK, but final testing shows the "back?" of my cornea had a kind of large gap at the thinnest point. Dr. Kranemann was honest and said he does not want to risk it and offered PRK.
Its good that you had PRK then. Saved you a lot of grief if you were at a high risk of developing a 'buttonhole' due to the topography. You were looking to have an Intralase (femtosecond) flap, right, before you got switched?
The long recovery and blurriness was making me grumpy. I used to have good up close vision with great sharpness but now it's fuzzy still.
Close-up seems to be worse for me than medium-vision. So not entirely unexpected (3.5 weeks out for me!). Strangely after being really clear for most of the past week, I've been getting a bit of a blur :(. PRK recovery is hit and miss, that's for sure!
Over all: Mixed feeling, most likely due to my expectations were changed last minute. That said I wasn't pressured in any way to change my decision, I just took a week off already and went for it. Given the reviews here so far, I would have done trans-PRK with PLEC if I were to choose again knowing PRK was my only option.
Yeah sounds like you've had a rough time of it, and for such a small correction too. Well it does get better!

What brand of artificial tears are you using? Although expensive (but you can find a $5 off coupon at the Allergan website, and they come in packs of 30 as opposed to 24 for "Bion Tears" or similar), PLEC told us to use the Refresh Optive Fusion Sensitive Preservative-Free. Don't know how much difference the brand or type of preservative-free Artificial Tears can make, but some may be better than others.

Are you on any sort of night-time dry eye treatment? PLEC has its patients on "Lacri Lube" which is basically a sort of sterile opthamalic Vaseline for one's eyes overnight.
Sr. Member
May 11, 2008
700 posts
24 upvotes
Toronto
burnt69 wrote:
Feb 9th, 2017 9:47 pm
Are you doing Omega-3 supplements as well? Speaking from experience taking 2000mg twice daily (Jamieson Omega-3 "Select", 4x1000mg capsules daily!) pre-op, this *definitely* helped my eye hydration. Not all Drs recommend it, but I don't see how it could hurt if you're struggling with minor amount of dry eye.
Yeah, I am taking 2 deepsea fish oil capsules per day (1000mgx2) 2 days after the surgery. I think it definitely helped. After hearing from your experience, maybe I should be taking 4x everyday! Clearview said it's great to take omega 3 supplements, but it wasn't mandatory. They recommended to take multivitamins on their post op schedule.
burnt69 wrote:
Feb 9th, 2017 9:47 pm
Its good that you had PRK then. Saved you a lot of grief if you were at a high risk of developing a 'buttonhole' due to the topography. You were looking to have an Intralase (femtosecond) flap, right, before you got switched?
Yeah, I appreciated their honesty. Yes they were offering me intralase flap lasik with MEL90 from Zeiss before. Even the PRK I did this time was bladeless, no microkeratome involved, just not with smart pulses like the transPRK.
burnt69 wrote:
Feb 9th, 2017 9:47 pm
Close-up seems to be worse for me than medium-vision. So not entirely unexpected (3.5 weeks out for me!). Strangely after being really clear for most of the past week, I've been getting a bit of a blur :(. PRK recovery is hit and miss, that's for sure!
Ah! That's too bad but also a relieve that there aren't something wrong with my eye. Everyone seems to talk about distance vision on youtube etc for PRK recovery, no one really talks about close-up for reading etc. I was worried at one point my close-up vision problem was caused by something else. I work with computer 95% of my work time with a lot of text so close-up vision is a must for me. :(
burnt69 wrote:
Feb 9th, 2017 9:47 pm
Yeah sounds like you've had a rough time of it, and for such a small correction too. Well it does get better!

What brand of artificial tears are you using? Although expensive (but you can find a $5 off coupon at the Allergan website, and they come in packs of 30 as opposed to 24 for "Bion Tears" or similar), PLEC told us to use the Refresh Optive Fusion Sensitive Preservative-Free. Don't know how much difference the brand or type of preservative-free Artificial Tears can make, but some may be better than others.
Yeah, just more rough than what I expected. I have been a lot more worse stories on youtube for PRK recovery. :)

I was recommended BION Tears, and they gave me preserved tears (BLINK, SYSTANE ULTRA, Optive Fusion) and preservative free tears (celluvisc) in the post OP package. I didn't really like the celluvisc since it was VERY thick, it is long lasting lubrication but it literally blocks my vision for first 3 minutes lol.

I didn't end up getting BION tears, I got systane ultra high performance preservative free drops for like $14 with 24 packs. Each pack can last me about 6 drops for both eyes. They are fine. Interestingly, I also felt the Refresh Optive Fusion Sensitive drop ( mine has preservatives so I don't use it very often) was the most long lasting and provide best vision.
burnt69 wrote:
Feb 9th, 2017 9:47 pm
Are you on any sort of night-time dry eye treatment? PLEC has its patients on "Lacri Lube" which is basically a sort of sterile opthamalic Vaseline for one's eyes overnight.
Not really, I usually am ok during the night, only some times I feel my eyes can't open after the night and I had to put drops in to open it. Scared to force it open lol. My vision is usually the best when I wake up.

Thanks for the tips and sharing your experience! I am sure I will be satisfied and become a happy man again after the recovery (which according to the steroid drop schedule it's about 3 months). Wished it was shorter or I could skip thorough it though. :P Keep us posted with your recovery road trip too!
Sr. Member
Oct 6, 2015
902 posts
436 upvotes
lkt01071 wrote:
Feb 9th, 2017 10:53 pm
Ah! That's too bad but also a relieve that there aren't something wrong with my eye. Everyone seems to talk about distance vision on youtube etc for PRK recovery, no one really talks about close-up for reading etc. I was worried at one point my close-up vision problem was caused by something else. I work with computer 95% of my work time with a lot of text so close-up vision is a must for me. :(
Yeah there's two distinct issues with blurred close-up vision:

a) The portion of the eye that actually deals with close-up vision is the inner portion. So if you're trying to focus, corneal imperfections during the PRK recovery tend to be exaggerated.

b) If you're near the age of 40 or older, you could be developing presbyopia. I actually think I have a little bit of this going on, as my very close up vision really isn't that good anymore. Its just something you have to accept as a trade-off.
I didn't really like the celluvisc since it was VERY thick, it is long lasting lubrication but it literally blocks my vision for first 3 minutes lol.
Interesting. I'm actually finding the Refresh Optive Fusion to be a bit on the thin side. But its what 'they' started me on at the Dr's, so I'm reluctant to spend money trying other products. At this point I'm just putting the lubricant drops in, not because I think I need them, but rather, because they are supposed to help with recovery.
I didn't end up getting BION tears, I got systane ultra high performance preservative free drops for like $14 with 24 packs. Each pack can last me about 6 drops for both eyes. They are fine. Interestingly, I also felt the Refresh Optive Fusion Sensitive drop ( mine has preservatives so I don't use it very often) was the most long lasting and provide best vision.
Interesting. There's no good online review source for the various drops. But definitely agree that I can put the Refresh Optive Fusion Sensitive drops in at any time, and immediately get back to whatever I need to do. Driving, computer work, etc.

Not really, I usually am ok during the night, only some times I feel my eyes can't open after the night and I had to put drops in to open it. Scared to force it open lol. My vision is usually the best when I wake up.
A night-time ointment might help you if that's the case. But I'm not a Dr. Part of the theory of lubrication and the overnight products is to keep the cornea well hydrated so it can heal.
Thanks for the tips and sharing your experience! I am sure I will be satisfied and become a happy man again after the recovery (which according to the steroid drop schedule it's about 3 months). Wished it was shorter or I could skip thorough it though. :P Keep us posted with your recovery road trip too!
Ouch, PLEC has us off steroids at the 7 week point. The first week has a heavy regimen, week 2/3, 3X daily, 3/4, 2X daily, 5/6 1X daily, and then every other day thereafter for another week as the final taper. The taste of the drops gets into my sinuses and into my throat, so I'm glad to be into the taper at this point. Its kind of crazy, really, how I went from barely being able to put in drops last year (when I got some free sample drops from my optometrist to try just to get the hang of things) to being a total pro at it now, lol.
Newbie
Jan 30, 2017
20 posts
1 upvote
I'm thinking about getting laser eye surgery but I'm still on the fence. I have about -5.00 in both eyes and work with computers for hours every day (and honestly I've been stupid about taking better care of my eyes). I've been in once for a consultation in Vaughn where they did a preliminary examination to determine if laser eye surgery was suitable for me. I was there for maybe 10 minutes and the person working there said, yes, I was eligible for it. I waited a few more minutes, she took me to the office at the back where I met with a (very very young) lady who gave me a small info package and a quote. After my visit, I still wasn't feeling comfortable with it all - first I felt like the clinic I went to had focused primarily on the costs and told me almost nothing about anything else. In retrospect I should have asked more questions but at the time I was feeling a little overwhelmed with the entire process.

My question is I feel like my eye sight gets slightly worse every year. Is this a normal thing or just a result of me spending way too much time working with computers? And if my vision is gradually becoming worse, is eye surgery for me? And if I do end up getting it, (and assume I take better care of them), would it be worth it in terms that I would still have to be working with computers as my job requires?

I'm entirely unsure what to do and feel like I'm searching in the dark. Hopefully someone here can share some of their experiences?
I would love to go glasses and contacts-free but at the same time I'm worried. Any advice or suggestions greatly appreciated!
Sr. Member
Oct 6, 2015
902 posts
436 upvotes
Huntress03 wrote:
Feb 10th, 2017 6:16 pm
I'm thinking about getting laser eye surgery but I'm still on the fence. I have about -5.00 in both eyes and work with computers for hours every day (and honestly I've been stupid about taking better care of my eyes). I've been in once for a consultation in Vaughn where they did a preliminary examination to determine if laser eye surgery was suitable for me. I was there for maybe 10 minutes and the person working there said, yes, I was eligible for it.
Do you know what sort of tests were run? With a -5, most patients can have either PRK, LASIK, or even SMILE, but any reputable laser clinic will screen you more extensively for eye corneal conditions such as keratoconus, ectasia, etc., as well as a few other eye health screenings before making a final treatment decision.
I waited a few more minutes, she took me to the office at the back where I met with a (very very young) lady who gave me a small info package and a quote. After my visit, I still wasn't feeling comfortable with it all - first I felt like the clinic I went to had focused primarily on the costs and told me almost nothing about anything else. In retrospect I should have asked more questions but at the time I was feeling a little overwhelmed with the entire process.
If you have any doubts whatsoever, then you shouldn't go through with it. There are many clinics out there, some spend a lot of effort on marketing. Some don't spend any on marketing, and view themselves purely as medical practitioners.
My question is I feel like my eye sight gets slightly worse every year.
Do you see an optometrist for regular eye exams? Has your prescription actually been getting worse? I am thinking that you perhaps should be having the conversation about your suitability for refractive surgery with your optometrist with access to your long-term records. Rather than with a refractive surgeon (or their office staff) who have a vested interest in selling you a procedure. Most optometrists these days have a preferred referral surgeon they deal with and are very interested in being a part of your overall treatment plan through co-management.
Is this a normal thing or just a result of me spending way too much time working with computers?
How old are you? Losing some near sight, due to an inability to 'accommodate' (ie: change your lens' optical power), is a natural eye condition that occurs in the early 40s known as "presbyopia". Other possibilities include developing dry eye disease. This is something you should discuss with your optometrist.
And if my vision is gradually becoming worse, is eye surgery for me?
Laser eye surgery requires refractive stability. If you prescription is changing, you should not have refractive surgery.
And if I do end up getting it, (and assume I take better care of them), would it be worth it in terms that I would still have to be working with computers as my job requires?
I think the important thing is to get to the root cause of your vision problems before rushing into a procedure. Working on a computer alone will not damage your eyes. However, it is my understanding that extensive computer users tend to experience "dry-eye" at a high rate. You might end up being more of a PRK (or SMILE) candidate than a LASIK candidate for that reason. But you really should see your optometrist, get to the bottom of why you are having vision problems, and then, if a refractive procedure is of interest, pursue such accordingly.
I'm entirely unsure what to do and feel like I'm searching in the dark. Hopefully someone here can share some of their experiences?
Read my (and peanutz's) posts in the past few pages. But you really need to get advice specific to your eyes, particularly *why* your vision has been worsening. An optometrist is where you should be starting. Not a surgeon with a vested interest in selling you a procedure.
I would love to go glasses and contacts-free but at the same time I'm worried. Any advice or suggestions greatly appreciated!
It took me 15 years from when I started being interested, to actually going under a laser. Much of the 'delay' was technology-related as I wasn't happy with the technology available at the time. Do as much research as you feel necessary, and don't let any question you have go unanswered.
Newbie
Jan 30, 2017
20 posts
1 upvote
Thank you for replying with so many useful suggestions and information. I'll definitely read a few pages back to the past posts.
I was feeling like the clinic I went to was more invested in making money than actually helping me. I'm definitely going to go to my optometrist and find out more information. The exam they gave me at the clinic was very basic as well, just a simple eye examination to test what my prescription was at and nothing else. I didn't even know they could have run so many other tests. I'm in my early 30s and over the years, my prescription has been getting worse and I'm not sure if this has been normal. (I'll definitely talk to my optometrist about it). I started off about -2.00 in my early teens and now it's more than doubled over the years. I've always attributed the change in prescription to my career but now realize there may be other reasons.
burnt69 wrote:
Feb 10th, 2017 6:52 pm
Read my (and peanutz's) posts in the past few pages. But you really need to get advice specific to your eyes, particularly *why* your vision has been worsening. An optometrist is where you should be starting. Not a surgeon with a vested interest in selling you a procedure.
This is excellent advice. I hadn't even thought of it that way because I thought of the surgeon as only a healthcare professional but now I realize they really do have a vested interest in selling me the procedure. I'm definitely going to speak to an optometrist and see.

Top

Thread Information

There is currently 1 user viewing this thread. (0 members and 1 guest)