Beauty & Wellness

[Merged] laser eye surgery

  • Last Updated:
  • Oct 21st, 2017 7:40 pm

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

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Yes
 
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No
 
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peanutz wrote:
Jul 29th, 2017 2:41 pm
@Aznsilvrboy I'm sorry about that...I'm not sure what to say. I hope it improves and you are able to get back to work soon.
@peanutz One thing I'm not too clear on is whether MMC drops were prescribed to prevent haze or are they only applied during the surgery? I don't believe the FML drops and MMC are the same thing right?
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Aznsilvrboy wrote:
Jul 29th, 2017 2:48 pm
@peanutz One thing I'm not too clear on is whether MMC drops were prescribed to prevent haze. I don't believe the FML drops and MMC are the same thing right?
They are not the same thing.

PLEC uses MMC drops on all their laser eye surgery patients. MMC indeed is used to prevent haze during the surgery (around 8-30 second application time). Treatment of haze also utilizes MMC application, but in a duration that is typically longer (e.g. 2 minutes long.) I specially asked to skip the MMC step and Dr. Lin would not allow me to (I gauged my risk as relatively small, and noted studies that showed that haze, if it occurs, tends to naturally resolve over the course of a year. Of course most patients do not want this so I trusted Dr. Lin to go by the protocol he chose.) MMC is classed as an "antimetabolite" drug.

FML drops are anti-inflammatory steroid drops that modulate healing. Healing is slower, but more controlled, lessening the damaging effects of our body's natural inflammation system.

Steroid drops such as FML or prednisolone are also sometimes used to try to treat temporary haze. It is not effective in all types of haze, only some.

One thing I am confused about is that most modern PRK patients who experience post-op haze, are said to experience it ~1 month after the procedure. PLEC's notes to the optometrist included a blurb, if I recall correctly, about looking for haze that may occur in the 1-2 month interval in any of the patients. Delayed-onset haze may occur about a year after the surgery.

I am really not sure what happened that you are experiencing it so soon, I'm sorry to hear that.
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peanutz wrote:
Jul 29th, 2017 2:55 pm
They are not the same thing.

PLEC uses MMC drops on all their laser eye surgery patients. MMC indeed is used to prevent haze during the surgery (around 8-30 second application time). Treatment of haze also utilizes MMC application, but in a duration that is typically longer (e.g. 2 minutes long.) I specially asked to skip the MMC step and Dr. Lin would not allow me to (I gauged my risk as relatively small, and noted studies that showed that haze, if it occurs, tends to naturally resolve over the course of a year. Of course most patients do not want this so I trusted Dr. Lin to go by the protocol he chose.) MMC is classed as an "antimetabolite" drug.

FML drops as anti-inflammatory steroid drops that modulate healing. Healing is slower, but more controlled, without the damaging effects of our body's natural inflammation system.

Steroid drops such as FML or prednisolone are also sometimes used to try to treat temporary haze. It is not effective in all types of haze, only some.

One thing I am confused about is that most modern PRK patients who experience post-op haze, are said to experience it ~1 month after the procedure. PLEC's notes to the optometrist included a blurb, if I recall correctly, about looking for haze that may occur in the 1-2 month interval in any of the patients. Delayed-onset haze may occur about a year after the surgery.

I am really not sure what happened that you are experiencing it so soon, I'm sorry to hear that.
Thanks for clearing that up. At this point I can only hope that it will dissipate quickly and then never return again. But honestly, I am underwhelmed that I'm even getting it given I received MMC when I went through transPRK with SmartSurfACE using the fastest laser platform available today, and my low prescription.
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Aznsilvrboy wrote:
Jul 29th, 2017 3:03 pm
Thanks for clearing that up. At this point I can only hope that it will dissipate quickly and then never return again. But honestly, I am underwhelmed that I'm even getting it given I received MMC when I went through transPRK with SmartSurfACE using the fastest laser platform available today, and my low prescription.
That's understandable. I would have thought you would be at low risk for haze, too. I hope your optometrist and his/her correspondence with PLEC will be able to clear up what's going on and what they could suggest for you.
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Aznsilvrboy wrote:
Jul 29th, 2017 2:20 pm
I must say I'm somewhat disappointed by the results of the transPRK with SmartSurfACE. Dr. Lin spoke very confidently when he assured me I could go back to work on Monday which now seems unlikely. I guess the back to work after 1 week thing is only in the best scenario, which makes me wonder if that is common at all and I'm just an outlier or most people take longer to recover like me? The only good things I can say about it so far is the painless surgery, and recovery process (so far), and that I was able to see pretty well off the table and next day as well, but none of that is important if I can't see well in the end.
My vision went downhill quite a bit the day of the BCL removal. I booked an 8am appointment for the removal, and performed very poorly on the eye charts (as did you). I was told to come back in the later afternoon for a repeat of the same checks.

There's definitely going to be some ups and downs over the next few weeks, but mostly ups. As far as working, do what you're comfortable with.
I am underwhelmed that I'm even getting it given I received MMC when I went through transPRK with SmartSurfACE using the fastest laser platform available today, and my low prescription."
I went through quite a bit of doubting in the first week or two, and then again after a month or two when I was struggling with dry eye. It should get better.

edit: PLEC claims nobody has suffered haze from SmartSurfACE PRK that required anything but trivial treatment to resolve:

https://members.optometrists.bc.ca/BCAO ... lation.pdf

(page 26)

"Haze: 2% have 1+ haze at 3 months, no 4+ haze  All haze cases resolved with standard FML protocol over 4 weeks, Restasis and lubricants"
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In the meantime, I guess the only thing for me to suggest is to continue to take 4 caps Omega-3 per day, and plenty of vitamin C to support good healing processes.

When I was in my 3-month healing phase, I also wore sunglasses indoors if I was facing a nearby window. If your office is by a window, or you are in a car, you should be wearing UV eye protection. Many modern buildings should have 99%+ UV blocking treatment, but generally speaking there is no way to really know unless you can get some building managers to tell you. And many side windows in cars are not adequately treated at the factory.

@Aznsilvrboy If you might need an extra few days to rest and recover, might your employer be able to give you a few "sick days"? Since you were assured by PLEC that you should be expected to return to work, if your case falls a bit outside of doctor expectations, would that be OK to ask?

One of my friends got LASIK done around 2012 or 2013 and had to get her flap readjusted, and I think our employer gave her a few days under "Sick" rather than forcing her to use her Vacation days.
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peanutz wrote:
Jul 29th, 2017 9:20 pm
In the meantime, I guess the only thing for me to suggest is to continue to take 4 caps Omega-3 per day, and plenty of vitamin C to support good healing processes.

When I was in my 3-month healing phase, I also wore sunglasses indoors if I was facing a nearby window. If your office is by a window, or you are in a car, you should be wearing UV eye protection. Many modern buildings should have 99%+ UV blocking treatment, but generally speaking there is no way to really know unless you can get some building managers to tell you. And many side windows in cars are not adequately treated at the factory.

@Aznsilvrboy If you might need an extra few days to rest and recover, might your employer be able to give you a few "sick days"? Since you were assured by PLEC that you should be expected to return to work, if your case falls a bit outside of doctor expectations, would that be OK to ask?

One of my friends got LASIK done around 2012 or 2013 and had to get her flap readjusted, and I think our employer gave her a few days under "Sick" rather than forcing her to use her Vacation days.
@peanutz I actually used up my personal/sick days allotment already this year, so I'm on vacation days at the moment. I'm not worried about taking more time off, as I could just go on leave without pay if it comes down to that and would not be financially stressed for a long while. My major concern is that I'm supposed to be starting a new job in about 3 weeks and my future employer does not know I underwent laser eye surgery. I also did not notify them of such plans during the recruiting process. I am hoping that my vision will be good enough to go back to work by then so I don't have to inconvenience my new employer right off the bat or worse, jeopardize my new employment. Also, I guess my other point of frustration comes from not being do my usual activities for a longer period of time than originally anticipated. I've pretty much been surviving on Harry Potter audiobooks for the past few days since my vision got blurry.
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Aznsilvrboy wrote:
Jul 29th, 2017 9:55 pm
Also, I guess my other point of frustration comes from not being do my usual activities for a longer period of time than originally anticipated. I've pretty much been surviving on Harry Potter audiobooks for the past few days since my vision got blurry.
Well you can take comfort in the fact that you got off the table at 20/20 (which is pretty extraordinary, most traditional PRK's are lucky to be even 20/80, and until your report of 20/20, I wasn't aware of anyone achieving >20/25.). So the actual process with the laser was done correctly. And haze as a complication is extremely rare. But epithelial healing doesn't take place overnight, and sometimes expectations need to be tempered.

I don't know what your occupation is, but if I were a betting man, I would suggest that you'll probably be back here on Monday or Tuesday reporting a dramatic improvement, even over the next day or two.
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Just wanted to follow up, I'm booked in at PLEC the last week of August... Flying there Sunday, surgery Monday, follow up and then flying back Tuesday.

Did everyone fly out the day after surgery, shortly after the 1-day follow-up? I had a lot of colleagues expressing concern over travelling and air pressure post-surgery.

Hopefully I'll be able to report back with positive post-surgery news... I've booked a week off from work, but that is really as much as I can spare! (Aznsilvrboy, hope things for you have improved since!)

One thing that did somewhat surprise me, it seems like a lot of optometrist charge a lot more than regular visits for laser surgery follow-up? I was quoted pricing by a few optometrists... Seems like the going co-management fee is $1000/year.

There was a lot of information to take in thus far... I guess as I go back to review everything, any advice over the next month as I prep to go for the surgery? Starting to feel a bit nervous now!
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lynn24 wrote:
Jul 30th, 2017 9:18 pm
Just wanted to follow up, I'm booked in at PLEC the last week of August... Flying there Sunday, surgery Monday, follow up and then flying back Tuesday.

Did everyone fly out the day after surgery, shortly after the 1-day follow-up? I had a lot of colleagues expressing concern over travelling and air pressure post-surgery.

Hopefully I'll be able to report back with positive post-surgery news... I've booked a week off from work, but that is really as much as I can spare! (Aznsilvrboy, hope things for you have improved since!)

One thing that did somewhat surprise me, it seems like a lot of optometrist charge a lot more than regular visits for laser surgery follow-up? I was quoted pricing by a few optometrists... Seems like the going co-management fee is $1000/year.

There was a lot of information to take in thus far... I guess as I go back to review everything, any advice over the next month as I prep to go for the surgery? Starting to feel a bit nervous now!
I had my 1 day follow up first thing in the morning and flew out later that afternoon. Dr. Lin said it's no problem as long as you keep your eyes lubricated. He also suggested taking Ibruprofen and Tylenol Extra Strength before boarding so ease the pain/discomfort. I put in the lubricant drops every 1-2 hours but it was still pretty dry. Overall, it was a uncomfortable flight. I feel like I'm seeing very slight improvement daily, but still a ways to go before I can return to work. My optometrist charges me $99 per visit for the co-management fee which is her regular pricing for a regular visit, so it's not really a rip off in my case.
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lynn24 wrote:
Jul 30th, 2017 9:18 pm
Just wanted to follow up, I'm booked in at PLEC the last week of August... Flying there Sunday, surgery Monday, follow up and then flying back Tuesday.
If you haven't already booked, I'd suggest adding an extra day on the front-end? The eyes can get really dry after flying, and it takes some time to recover. Vancouver is a beautiful city to do a little bit of exploring in as well :). Its important to get good rest before the procedure, keep yourself well hydrated, etc.
Did everyone fly out the day after surgery, shortly after the 1-day follow-up? I had a lot of colleagues expressing concern over travelling and air pressure post-surgery.
I travelled there by rail and arrived 2 days before my procedure. Just an overnight trip from Kamloops (central BC) where I spent some time with family the week previous.

Air pressure is not a problem. If you're able to pick the type of airplane you fly on, the Boeing 787 apparently has a higher cabin pressure and higher cabin humidity which may help slightly. But I really wouldn't worry about it. When I flew home, I picked a window seat and I kept my eyes closed the entire time anyways. Having 10-12 drinks over the period of 6 hours in the MLL might've helped too :) (but don't mix with pain meds if you're gonna drink!!!).
One thing that did somewhat surprise me, it seems like a lot of optometrist charge a lot more than regular visits for laser surgery follow-up?
Yeah mine quoted me $100/visit for the 1-week, 2-week, 1 month, 2 month, 3 month, 6 month, 12 month follow-ups ($700). But actually ended up charging me $115/visit "because of the extra forms". She did the pre-op for free though (part of my normal yearly check-up), so I'm not overly bitter. Not a show-stopper. The clinic she routinely works with locally pays her $600 for bilateral LASIK surgery, but there are fewer follow-ups involved. And they went out of their way to help me with contact lenses for the 20 years I wore them, including a half dozen free visits trying to unsuccessfully fit me with toric lenses, even though I didn't buy them from the clinic most of the time.

The fly away the afternoon/evening the next day after surgery works out well because its actually on the 3rd and 4th day that vision goes downhill significantly. Then it progressively gets better. Vision is actually really good on the day of surgery and the day after.

@Aznsilvrboy , improved since your last update???
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@burnt69 It's been 2 days since my last update and 9th day post-op overall. This morning I woke up and saw the biggest 1 day improvement since the surgery. I usually test my vision by standing about 9-10 feet away from my living room clock to see if I can read the numbers with clarity and this morning I was able to read them with good clarity with only a slight blur. I would rate it slightly below the 20/20 vision I had on day 1 and 2. There still seems to be some haze lingering around, but only little. I hope it only gets better from here.

One thing I've noticed is that my vision tends to be blurry until focused on something for about 1 second. For example, if my eyes are initially closed and then I open them to look at the clock, it takes about 1 second for it to become clear. I'm not sure if this is normal during the healing process or to be expected even after the eyes have completely healed. @peanutz @burnt69 did you guys notice the same thing and did it improve for you over time?
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Aznsilvrboy wrote:
Aug 1st, 2017 11:27 am
..
Sounds pretty consistent with my experience. 9 days out, I had one eye that was still ghosting a bit compared to the other. Nothing to worry about. Your recovery is sounding pretty consistent with mine overall. I was just quite worried when you stated that you were unable to return to your job; did that resolve for you?
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burnt69 wrote:
Aug 1st, 2017 1:31 pm
Sounds pretty consistent with my experience. 9 days out, I had one eye that was still ghosting a bit compared to the other. Nothing to worry about. Your recovery is sounding pretty consistent with mine overall. I was just quite worried when you stated that you were unable to return to your job; did that resolve for you?
I took a few more days off work this week. My work involves sitting in front of a computer all day, so I want to be certain my eyes are good enough for it before I return to work. It's been a few hours since I woke up and my vision has deteriorated slightly and will probably continue to deteriorate as the day goes on as I've experienced over the last few days. I think I'll return to work when I can maintain consistent good vision throughout the work day.
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Aznsilvrboy wrote:
Aug 1st, 2017 2:13 pm
I took a few more days off work this week. My work involves sitting in front of a computer all day, so I want to be certain my eyes are good enough for it before I return to work. It's been a few hours since I woke up and my vision has deteriorated slightly and will probably continue to deteriorate as the day goes on as I've experienced over the last few days. I think I'll return to work when I can maintain consistent good vision throughout the work day.
Sounds like a bit of dry eye to me (the generic 'answer' to most problems in the first few weeks, lol!), but yeah, you definitely will fluctuate quite a bit. They wanted me to do day-time Lacri Lube I think at my 2 week appointment because of that, and I was like, "heck no, I can't function on that stuff". Lol. So I skipped it, and at my follow-up (after being in the nice moist heat of Florida/Virgin Islands for 3 weeks), things progressed favourably.

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