Beauty & Wellness

[Merged] laser eye surgery

  • Last Updated:
  • Nov 20th, 2017 9:13 pm

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

  • Total votes: 196. You have voted on this poll.
Yes
 
100
51%
No
 
29
15%
Pizza is yummy
 
67
34%
Newbie
Jul 26, 2014
13 posts
New Westminster, BC
I have been thinking about laser eye surgery for a while.
Have done some research and I have narrow down to London Eye Center and Pacific Eye Center.
I am interested with the "SmartSurfACE PRK" procedure offered at Pacific, just wondering if the 'NO Touch' PRK at London the same thing? (just different naming?).
‘No Touch’ PRK/Intralase SBK/SmartSurfACE PRK; between the 3 procedures, which would be the safest and have less complications in the future?
Why would one pick a particular procedure and not the other two? (if price is not a decision factor)
Sr. Member
Oct 6, 2015
807 posts
411 upvotes
bb12345 wrote:
Feb 24th, 2017 6:30 pm
I have been thinking about laser eye surgery for a while.
Have done some research and I have narrow down to London Eye Center and Pacific Eye Center.
I am interested with the "SmartSurfACE PRK" procedure offered at Pacific, just wondering if the 'NO Touch' PRK at London the same thing? (just different naming?).
They are definitely not the same thing. London Eye Centre uses a VISX Star S4 laser (and its related equipment). Pacific uses the Schwind Amaris 1050rs (and related Schwind equipment).

From my research (which may or may not be correct -- verify the facts for yourself), "No Touch" was merely a way to describe the method of alcohol-assisted PRK. As opposed to a cutting procedure (LASIK), or a surface abrasion procedure (brush PRK). It is not, in my research, a transepithileal PRK procedure. (transepithelial = the laser removes the epithelium).

‘No Touch’ PRK/Intralase SBK/SmartSurfACE PRK; between the 3 procedures, which would be the safest and have less complications in the future?
Why would one pick a particular procedure and not the other two? (if price is not a decision factor)
I can only speak directly for SmartSurfACE as that's the procedure I took. Recovery was dramatically faster than anything I've seen online in terms of PRK recovery. Pain was so minor that I did not require narcotic pain medication, barely even took the non-narcotic "suggestions" of Tylenol and Ibuprofen, and was actually less painful than "bad contact lens days".

I believe PRK-family procedures (PRK, SmartSurfACE, LASEK, epi-LASIK, etc.) are safer procedurally and longer-term side-effect wise.

I literally only lost 3 days of being able to use a computer with ease, days 3, 4, and 7 (right after the bandage contact lens was removed!). When referenced against various blogs describing PRK initial recovery dragging on for weeks, such result is quite amazing. I was 20/25 "straight off the table.

Both clinics you mention have amazing reputations and large numbers of procedures performed with satisfied customers. All I can do is offer you my experience with one of them, PLEC, which was glowingly positive as an out-of-province patient.
Newbie
Jul 26, 2014
13 posts
New Westminster, BC
Thanks! Your input was really helpful!
I am leaning towards PLEC and the SmartSurfACE. Just 2 drawbacks with PLEC that's keeping me thinking about going to London instead.
1. Long wait time...even to just book a consultation to see if I am suitable for the procedure. (My consultation is booked at end of March)
2. The need to go to own eye doctor to remove bandage and after surgery follow-ups (London includes all these in the package)
I guess I will just visit both for the consultation before deciding.
Deal Addict
User avatar
Oct 1, 2011
4859 posts
734 upvotes
My PLEC trans-PRK followup: I am at 4.5 weeks post, currently. Still "perfecting" on the healing as well. On my visit last week for the 4-week checkup, my optometrist didn't tell me on the x/20 scale but I still had some blurring on the small letter lines, could only read like 2/4 fuzzy letters...and there may be some residual astigmatism left in my eyes like 0.3-0.5 (as opposed to 1.00 in both eyes before.)

Only time will tell if they will go away while healing up.

I'd say with transPRK with SmartSurface, expectations can be like this:
- Need to take at least 5 days off from work, if not 7 "just in case". Not only for the healing/blurring time, but also because your eyedrops schedule will be the most annoying here. I got my bandage contacts taken out at Day 5 and my field of work is public/interruptive (busy retail settings) so it would have sucked to schedule my drops in the middle of work.
- Expect to be able to be fairly functional (i.e., able to read, move around) comfortably say, after about 1 week... but distance vision compared to glasses/contact lens will be at like 70-90% for at least 3-4 weeks. (I believe I'm probably at 85% right now.)
- You should wear sunglasses always when outside for at least 3 months after surgery. If you're looking forward to traveling to sunny destinations, swimming/scuba, etc. within those 3 months...heh...just be aware. I plan on wearing my sunglasses religiously for the 6 months post-surgery because I want to minimize any chance of UV-induced haze or interruption in ongoing healing processes. I also tend to sunburn easily even though I'm not super-pale, so I probably have weaker innate sun defense system--so I am being more cautious for this reason. Be aware that I have read of haze forming even 1-year post-surgery. Don't expose your eyes to constant sun damage, especially crucial at this time when there are healing processes going on, and because your cornea will be thinner, period.

Everyone should probably be wearing some form of sunglasses when outside for the majority of time, anyway...for those who normally wore glasses and had some UV protection, this may be easy to forget.
Deal Addict
Nov 10, 2005
1520 posts
141 upvotes
Vancouver
Just called PLEC and was told not a good candidate for procedure.
Scheduled a consultation anyway with Dr. Lin.

Question for knowledgeable people here:
If I work with computers all day and my prescription is not stable, is there something intrinsically wrong with my eyes? Others work with computers all day before and after procedures and this doesn't seem to bother them. I know ways of protecting eyes in general but they don't seem to help me much from how things are going. Can't deal with not using computers as well coz that pays the bills.
Newbie
Jan 30, 2017
17 posts
5 upvotes
bb12345 wrote:
Feb 27th, 2017 5:38 pm
Thanks! Your input was really helpful!
I am leaning towards PLEC and the SmartSurfACE. Just 2 drawbacks with PLEC that's keeping me thinking about going to London instead.
1. Long wait time...even to just book a consultation to see if I am suitable for the procedure. (My consultation is booked at end of March)
2. The need to go to own eye doctor to remove bandage and after surgery follow-ups (London includes all these in the package)
I guess I will just visit both for the consultation before deciding.
Yeah...PLEC does have a long wait time for consultation and surgery.
I have to book both of them a month ahead of time.
Newbie
Jan 30, 2017
17 posts
5 upvotes
burnt69 wrote:
Feb 23rd, 2017 1:22 pm
No. PLEC uses a Schwind Amaris 1050rs. Coal Harbor uses a B&L Technolas laser, or the Alcon/Allegreto Wavelight EX500.

The 'difference' is the Schwind Amaris supports "transPRK", which is a single step process where the excimer laser removes the epithelium while applying the treatment. When combined with "SmartPulse", this procedure has been called "SmartSurfACE" by Schwind and PLEC.

Whereas with the Coal Harbor lasers, to perform a PRK, the surgeon will use a "well" of alcohol to dissolve the epithelium, removes it manually, and then applies the laser treatment. Basically a traditional PRK.

The Schwind is also slightly faster than the Wavelight EX500 (1050Hz versus 500Hz) at delivering the treatment, but requires more pulses due to its smaller spot size. The difference in treatment time is negligible.

So you probably will recover more quickly visually and have less pain from a PLEC (trans)PRK/SmartSurfACE than you would a Coal Harbor PRK. But it will cost you extra $$$$, give or take, to use PLEC. I don't know what Coal Harbor's fee is (I hear its quite low!), but minimum all-in at PLEC including follow-up care and prescription/non-prescription drops is ~$4000, and that can go higher with a higher prescription.

Dr. Kirzner has done 80k+ procedures. Dr. Lin has done 60k+ procedures, but takes on some incredibly challenging cases with respect to keratoconus patients/botched surgery elsewhere/etc. and has R&D interests with an academic publishing record to match.
Yes! Coal Harbour's price is half of PLEC. Since they use different technology, I guess is not comparable.
Still I booked my appointment with PLEC with SmartAce technology and lots of good reviews here :)
Sr. Member
Oct 6, 2015
807 posts
411 upvotes
bogummy wrote:
Mar 2nd, 2017 7:26 am
Yes! Coal Harbour's price is half of PLEC. Since they use different technology, I guess is not comparable.
Still I booked my appointment with PLEC with SmartAce technology and lots of good reviews here :)
Let us all know how it goes, and most importantly, whether your experience is consistent with that reported by peanutz and I.
Sr. Member
Oct 6, 2015
807 posts
411 upvotes
vipjn wrote:
Mar 1st, 2017 6:46 pm
Just called PLEC and was told not a good candidate for procedure.
Scheduled a consultation anyway with Dr. Lin.

Question for knowledgeable people here:
If I work with computers all day and my prescription is not stable, is there something intrinsically wrong with my eyes?
Some people's eyes just don't stop changing until they're older. In my personal case, this didn't really occur until I was in my 30s. A refractive surgery procedure done in my early 20s, for instance, would have, assuming a progression to my 'stable' correction, would have left me in a position to need a follow-up procedure for a -1.25D correction or so in my 30s. The whole idea is to avoid needing a follow-up procedure, especially for LASIK, but even PRK isn't something that should be repeated without very careful consideration.

Of course, you should be seeing your optometrist regularly to rule out any significant eye diseases that will affect your refractive stability. The Dr. is probably agreeing to meet with you because there is a small chance that you have a rare corneal condition beyond refractive error that he can help you with. LASIK/PRK clinics have certain diagnostic equipment available that most optometrists do not.
Others work with computers all day before and after procedures and this doesn't seem to bother them. I know ways of protecting eyes in general but they don't seem to help me much from how things are going. Can't deal with not using computers as well coz that pays the bills.
Well stick with glasses and contact lenses until you meet the treatment criteria would be my (non-professional, non-medical) advice. Wear good UV protection when in the sun, and see your optometrist to monitor and address overall eye health issues annually or bi-annually, whatever is recommended.
Sr. Member
Oct 6, 2015
807 posts
411 upvotes
So 7 week follow-up here after "SmartSurfACE" PRK. Finally almost done my steroid treatment as well, one drop every 2nd day for the next 2 weeks, a slight alteration from the prescribed schedule as counselled by PLEC, changed in consultation with PLEC and my optometrist.

Close-up vision seems to be better, so some of my over-correction has probably regressed, a normal part of the process (they deliberately over-correct slightly in anticipation of regression).

Night halos continue to improve. I can drive at night with complete confidence. Still have a bit of dryness, but that might be more due to my active lifestyle and spending lots of time in the wind (windsurfing, cycling, etc.). So still using the artificial tears 3-5X a day.

Overall, still a positive experience. Stopped doing the Lacri Lube as I found I was waking up with too much irritation in the eyes from it.

Steroid wise, I will use a little more than 2 bottles of the FML. Unfortunately the pharmacy filled for 4 bottles, so I have a complete unopened wasted bottle. $10 wasted I guess, but trivial in the whole scheme of things.
Deal Addict
User avatar
Oct 1, 2011
4859 posts
734 upvotes
^ I kinda stopped the Lacrilube too, a little past the month. Made my eyes feel a bit sticky in the morning.
Newbie
Jan 30, 2017
17 posts
5 upvotes
Is starburst or halo common side effect after laser eye surgery?? Seems like most of the people experienced that after the laser
Sr. Member
Oct 6, 2015
807 posts
411 upvotes
bogummy wrote:
Mar 8th, 2017 2:44 am
Is starburst or halo common side effect after laser eye surgery?? Seems like most of the people experienced that after the laser
Right after, no starbursts, but halos even during the daytime from light sources. The cause is corneal swelling due to the procedure (PRK in my case).

But pretty much completely gone at this point. And starbursting is only for distant light sources distance, not closer-up.

Modern wavefront-guided treatments with appropriately sized optical/treatment zones have eliminated most of the classical starbursting/haloing side effects disproportionately experienced by individuals with large pupils (most often, lighter eyed patients!) treated with the older lasers
Deal Guru
User avatar
Oct 3, 2006
10279 posts
650 upvotes
Toronto
Which laser eye surgery clinics and surgeons are reputable in Toronto these days? With so many different types of procedures (PRK, LASIK, SMILE, ???) these days, which one is most recommended?

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