Beauty & Wellness

[Merged] laser eye surgery

  • Last Updated:
  • Dec 9th, 2017 9:30 pm

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

  • Total votes: 198. You have voted on this poll.
Yes
 
101
51%
No
 
29
15%
Pizza is yummy
 
68
34%
Sr. Member
Oct 6, 2015
884 posts
433 upvotes
learsid wrote:
Oct 10th, 2017 3:56 am
Hi RFd need your recommendation.

As an airline pilot what procedure and clinic would you recommend!? Im in the GTA but can travel if need be!
I can personally testify to the fact that as a large-pupilled, blue-eyed person, that PLEC in Vancouver with their transPRK SmartSurfACE, has left me with night vision superior to that of wearing glasses and contact lenses, and at a 20/12 visual acuity at my last check-up, and quite likely 20/10 right now. Even at very low light conditions (ie: getting out of the city at night and looking at the stars!).

The problem with laser eye correction for a pilot is that undergoing a procedure, whether it is LASIK or PRK (I prefer PRK for many reasons, especially since airplane air is very dry), is that such will take you out of the cockpit for a while. And that complications could ruin your career. Ask your medical examiner or Transport Canada for actual details, but your license will be suspended/revoked for a month or two at least until you meet the standards.
Sr. Member
Aug 21, 2005
899 posts
386 upvotes
Toronto
Quick update, about a month since surgery and generally vision has been pretty good. Punctual plugs are still there and After the first couple days, I don't really notice that they're there at all (maybe a few instances since insertion... I guess I really did have dry eyes?)

At my 1 month, one eye was coming up as 20/20, the other 20/25... Optometrist mentioned my recovery has been pretty good overall (remarks that another recent unnamed PRK patient was 20/40 one-week post surgery, compared to my 20/25)
rabbitz wrote:
Sep 4th, 2017 7:45 am
edit: Also, how blurry is blurry? The whole trip is going to be one of those walking around in malls / eating trips so perfect for healing but I might need to drive a bit, would it be ok to drive down to seattle for example? If not, I might want to go to seattle earlier in the trip and do PLEC right after.
Aside from some blurriness, I think what bothered me most during that first week after was I was definitely light sensitive, even with sunglasses, and especially with the bright lights shining everywhere at night. Vision was sketchy and sometimes I felt things were too bright and rather keep eyes closed/resting... Definitely don't plan around driving during that week if you can help it... Especially not knowing how your eyes/body will respond to the surgery.
Newbie
Oct 11, 2017
10 posts
13 upvotes
Hi all,
Great thread, so far, wanted to add my 2 cents. I’ve got about -4.50 in both eyes, otherwise quite healthy.

I’m not particularly sure why PLEC is so highly recommended here over other options though. While I do not doubt the expertise of the surgeons, or their technology, I was quite underwhelmed when I went in for my consultation last week.
Apart from the shabbiness of the office itself, I had a very quick eye-exam (nothing comparable to the thorough pre-op screening from LasikMD, or King Lasik/FVCL) and saw some crappy video of the doctors promoting Lasik eye surgery, only to be then told that they do not preform Lasik at all.
I think what bothered me most was that the girls hosting the seminars were not exactly a fountain of knowledge and mostly talked about horror stories regarding flap complications and how outdated and problematic Lasik is, which I do not believe to be true. They made it sound like Lasik was obsolete and the flap can be dislodged by practically anything.

The fear mongering really put me off, and when I confronted Dr. Holland about this, he admitted that he has had microkeratome Lasik 20 years ago without a single complication, and that the risks are low.

I also get that the doctors there patented this new TransPRK technique, but that doesn’t automatically make it the ‘best’ option, surely their decision to make it their sole treatment also contributes to their research projects. There is nothing inherently wrong with this, but it doesn’t necessarily make it the ‘best’ option for eye surgery either. I think I was quoted about $3100 + $600 btw.

I ultimately decided to go with Lasik, simply because I can’t get the time off needed for any PRK procedure, and my lifestyle doesn’t make PRK necessary. My biggest decision hereafter was to decide between the microkeratome and femtosecond method. One tech I spoke with said there is really no practical difference for my eyes (I have enough corneal tissue, pupils are above average but not very large, no real dryness issues etc.) and I may as well save the money and get the bladed method. Another tech elsewhere told me that the main advantage has to do with fewer 'accidents' during the procedure itself, as the flap is created by the laser vs. manually - so the machine can pick up where it left off etc. if there are any issues. The research I’ve read mostly draws the same conclusions, but does point to two noticeable advantages: strength of the flap is higher with the femtosecond procedure, and in one study it resulted in significantly less short-term dryness post-op.

So I’ve decided to get the femtosecond Wavefront procedure done at LasikMD (Alcon laser) instead of FVCL, only because the former offers a lifetime warranty (albeit, only if your vision degrades -1.00) and were more flexible with price matching. Apparently they have also bought out Coal Harbor and London Eye Center. Oh and I also liked their technician more, who did my pre-op, he seemed very un-biased and honest as it wasn’t his job on selling me a procedure. I really hope the procedure goes well!!
Deal Addict
User avatar
Oct 1, 2011
4925 posts
771 upvotes
publicmanservant wrote:
Oct 12th, 2017 12:57 pm
Hi all,
Great thread, so far, wanted to add my 2 cents. I’ve got about -4.50 in both eyes, otherwise quite healthy.

I’m not particularly sure why PLEC is so highly recommended here over other options though. While I do not doubt the expertise of the surgeons, or their technology, I was quite underwhelmed when I went in for my consultation last week.
Apart from the shabbiness of the office itself, I had a very quick eye-exam (nothing comparable to the thorough pre-op screening from LasikMD, or King Lasik/FVCL) and saw some crappy video of the doctors promoting Lasik eye surgery, only to be then told that they do not preform Lasik at all.
I think what bothered me most was that the girls hosting the seminars were not exactly a fountain of knowledge and mostly talked about horror stories regarding flap complications and how outdated and problematic Lasik is, which I do not believe to be true. They made it sound like Lasik was obsolete and the flap can be dislodged by practically anything.

The fear mongering really put me off, and when I confronted Dr. Holland about this, he admitted that he has had microkeratome Lasik 20 years ago without a single complication, and that the risks are low.

I also get that the doctors there patented this new TransPRK technique, but that doesn’t automatically make it the ‘best’ option, surely their decision to make it their sole treatment also contributes to their research projects. There is nothing inherently wrong with this, but it doesn’t necessarily make it the ‘best’ option for eye surgery either. I think I was quoted about $3100 + $600 btw.
I hope your surgery goes well and you get the outcome you want.

Just for discussion:

I can't speak for anyone else and their reasons for making their choices; I explained mine over a number of posts and it pretty much came down to *my* consultation being rushed with LASIK MD back in 2011; any potential concerns or risks of LASIK being completely glossed over; my strong interest in PRK (even if I opted for it at LASIK MD) being dismissed; and the fact that at the time, my pupils measured ~6.5mm in diameter and they told me that the optimal zone was 6mm (i.e. their laser's limitations of the time increased my chances of having night vision aberrations.) Yet they still recommended I go for it, so instead I waited for technology to improve, which it did.

Also, I wasn't pushing PLEC specifically so much as I am supportive of the Schwind Amaris transPRK with the SmartSurface technology. A number of us posters discussed other surgeon/clinic options outside of Canada such as Dr. Jerry Tan in Singapore, and Dr. Kang in Korea (who, BTW, himself opted for femtosecond LASIK with SmartPulse.)

May I ask what kind of LASIK quotes you got, and where LASIK MD pricematched with? You seem to be local to Vancouver, so I'm wondering which clinic you went to, and if they are all owned by LASIK MD, did they quote the same for all three? Were you given any discounts due to your profession/work, or other incentives in general?
Sr. Member
Oct 6, 2015
884 posts
433 upvotes
@peanutz covered a lot of what I would've said. I don't know the specific type of procedure that's being proposed, but on the Alcon laser, you would need to have a T-CAT treatment (sometimes called "Contoura") to equal the results of PLEC's Schwind in "Corneal Wavefront" treatment. Getting the treatment perfectly centered is a critical factor in determining whether you end up as say, a 20/16, or a 20/12 (or even the typically rare 20/10) for your post-surgical visual acuity once you're healed up.

PLEC, whether its a matter of professional ethics, disinterest in marketing and becoming a LASIK mill, etc., doesn't expend a lot of effort to educate people as to the quality of their treatments. They do a little bit of it in their "continuing education" programs with optometrists (you can Google for a presentation), but the focus there is on the harder-to-treat cases. My impression from their presentations is that as long as you get PRK somewhere else, PLEC can usually fix a botched outcome if need be. And for good reason -- they charge nearly twice as much for a repair as a primary procedure I'm told.

Some clinics will use the Alcon, or even the Schwind, in what is sometimes described as a "Wavefront Optimized" or "Abberation-Free" mode. While such produces decent results, the topography-guided treatments (ie: Schwind Corneal Wavefront, Alcon Contoura/T-CAT) have a statistical advantage. All treatments done by PLEC are truly custom treatments, topography-guided. Don't know about Lasik MD. Wasn't going to take any chances, especially with my 8.5mm pupil'ed blue eyes.

I was driving this afternoon in downtown Chicago, and it was absolutely utterly amazing how far ahead into the distance I was able to see the traffic. Couldn't believe my eyes. I know that surgeons won't promise you a final visual acuity number, but having what is likely 20/10 vision at this point is something that I can't even put a pricetag on.
peanutz wrote:
Oct 12th, 2017 10:37 pm
Also, I wasn't pushing PLEC specifically so much as I am supportive of the Schwind Amaris transPRK with the SmartSurface technology.
Good point. That's the neat thing about SmartSurfACE, its pretty idiot-proof. With LASIK, there can be variation in flap thickness, issues with the patient interface units, fluence levels on 2 different lasers, etc., as well as how smoothly the flap is replaced after the ablation process (ie: striae are always a possibility with LASIK). With PRK, there can be subtle variations in corneal dehydration as parts of the cornea are scrubbed first with the alcohol before the laser is fired. With transPRK SmartSurfACE, its all automatic, its done by the laser as one treatment, the doctor has incredibly little work to perform in the procedure. With flap creation, and how slow the 'other' lasers are, what was 5 minutes in the OR for me at PLEC, could have been 10 minutes at another place. Plus the femtosecond laser supplies are $50-$100 per use, and the huge cost of the laser itself.

I suppose if one waits long enough, maybe 5 years, everyone will have the technology, and there will be a price war. But right now, yes, at PLEC, you are paying an early adopter premium. Much like you pay extra to buy the latest cell phone. Once you start getting down to the 20/12 and 20/10 (and maybe even 20/8) visual acuities, some of these very small factors can start to present themselves as being limiting. So SmartSurfACE transPRK with Corneal Wavefront basically is topography-guided ablation (best centration strategy, best treatment of astigmatism) + transPRK (no touch, no variations due to unpredictability in alcohol, PRK safety) + SmartPulse (smooth surface for fastest recovery).
Deal Guru
User avatar
Oct 3, 2006
10284 posts
651 upvotes
Toronto
burnt69 wrote:
Oct 13th, 2017 1:36 am
@peanutz covered a lot of what I would've said. I don't know the specific type of procedure that's being proposed, but on the Alcon laser, you would need to have a T-CAT treatment (sometimes called "Contoura") to equal the results of PLEC's Schwind in "Corneal Wavefront" treatment. Getting the treatment perfectly centered is a critical factor in determining whether you end up as say, a 20/16, or a 20/12 (or even the typically rare 20/10) for your post-surgical visual acuity once you're healed up.

PLEC, whether its a matter of professional ethics, disinterest in marketing and becoming a LASIK mill, etc., doesn't expend a lot of effort to educate people as to the quality of their treatments. They do a little bit of it in their "continuing education" programs with optometrists (you can Google for a presentation), but the focus there is on the harder-to-treat cases. My impression from their presentations is that as long as you get PRK somewhere else, PLEC can usually fix a botched outcome if need be. And for good reason -- they charge nearly twice as much for a repair as a primary procedure I'm told.

Some clinics will use the Alcon, or even the Schwind, in what is sometimes described as a "Wavefront Optimized" or "Abberation-Free" mode. While such produces decent results, the topography-guided treatments (ie: Schwind Corneal Wavefront, Alcon Contoura/T-CAT) have a statistical advantage. All treatments done by PLEC are truly custom treatments, topography-guided. Don't know about Lasik MD. Wasn't going to take any chances, especially with my 8.5mm pupil'ed blue eyes.

I was driving this afternoon in downtown Chicago, and it was absolutely utterly amazing how far ahead into the distance I was able to see the traffic. Couldn't believe my eyes. I know that surgeons won't promise you a final visual acuity number, but having what is likely 20/10 vision at this point is something that I can't even put a pricetag on.



Good point. That's the neat thing about SmartSurfACE, its pretty idiot-proof. With LASIK, there can be variation in flap thickness, issues with the patient interface units, fluence levels on 2 different lasers, etc., as well as how smoothly the flap is replaced after the ablation process (ie: striae are always a possibility with LASIK). With PRK, there can be subtle variations in corneal dehydration as parts of the cornea are scrubbed first with the alcohol before the laser is fired. With transPRK SmartSurfACE, its all automatic, its done by the laser as one treatment, the doctor has incredibly little work to perform in the procedure. With flap creation, and how slow the 'other' lasers are, what was 5 minutes in the OR for me at PLEC, could have been 10 minutes at another place. Plus the femtosecond laser supplies are $50-$100 per use, and the huge cost of the laser itself.

I suppose if one waits long enough, maybe 5 years, everyone will have the technology, and there will be a price war. But right now, yes, at PLEC, you are paying an early adopter premium. Much like you pay extra to buy the latest cell phone. Once you start getting down to the 20/12 and 20/10 (and maybe even 20/8) visual acuities, some of these very small factors can start to present themselves as being limiting. So SmartSurfACE transPRK with Corneal Wavefront basically is topography-guided ablation (best centration strategy, best treatment of astigmatism) + transPRK (no touch, no variations due to unpredictability in alcohol, PRK safety) + SmartPulse (smooth surface for fastest recovery).
Mostly good points, but the cost per use of the laser is of no concern to the patient. I do not consider it a point in favor of TransPRK with SmartSurfACE from a patient's perspective.
Sr. Member
Oct 6, 2015
884 posts
433 upvotes
Aznsilvrboy wrote:
Oct 13th, 2017 9:56 pm
Mostly good points, but the cost per use of the laser is of no concern to the patient. I do not consider it a point in favor of TransPRK with SmartSurfACE from a patient's perspective.

Well if you believe a 'lifetime guaranty' or even lower-cost re-treatments (if needed) is something that's valuable in undergoing treatment -- then you definitely want to go with a doctor who is the most productive, has the most accurate results, etc. Eventually the economically sound practices will survive, the ones who are using older lasers and can't collect enough fees to be viable will go out of business. Especially if a technology like SmartSurfACE which, as I suggested, saves the surgeon a bunch of $$ on lasers and supplies, forces the other surgeons into a self-destructive price war to compete as newer technology (ie: SmartSurfACE) captures greater market share.

So in a roundabout way, if you need a re-treatment down the road, a highly productive and efficient practice is more likely to exist, and will be able to drive prices down enough to run the laggards out of business, resulting in the preservation of the warranty provided on the initial treatment. I'm sorry if I didn't make the economic argument clear.
Newbie
Oct 13, 2017
0 posts
1 upvote
Hi all,

Been following this thread for a while. Like Burnt, I'm one of those people with blue eyes and large pupils. My prescription is actually pretty weak though, at about -3 each eye with no astigmatism.

After doing quite a bit of my own research, I also decided to go with PLEC. And like others, I noticed that PLEC's sales team doesn't seem quite as funded/flashy, nor their office as aesthically pleasing, as LasikMD. Fortunately, I don't care about those things - I care about the technology they are using, which seems to be top of the line and capable of creating the large optical zone that is ideal for someone with large pupils. I also enjoyed my talk with Dr. Holland.

Anyway, I did my consult with PLEC and booked my surgery. There IS one thing that is kind of nagging at me the closer and closer to the surgery date that I get:

When I went in for my consult, the young tech who did some brief testing on my eyes (LASIKMD's consult seemed more thorough) mentioned my pupil size as being around 7 mm when I asked. At first I thought I heard incorrectly because I've always had massive pupils, to the point that people have even commented on it. A few years back they were measured at 8.5mm ish (don't remember exact decimal) in scotopic, or dark adapted conditions. When I spoke with Doctor Holland during the consult, I briefly mentioned to him how I thought my pupil measurements may be off. He didn't seem too concerned and said that they would double check everything again before the surgery. That put me at ease.

After my PLEC consult I phoned LASIKMD to ask for the pupil measurements from my LasikMD consult: 8.8 mm and 8.6 mm for my left and right eyes, under scotopic conditions. And at my recent optometrist appointment a week back, in a barely dim room, she measured my pupils at ~8mm. As you can imagine, this has made me a bit anxious again. All the researching I have done has indicated that if the effective optical zone created by the laser is significantly smaller than your peak/max scotopic pupil diameter, there is a likelihood you'll see halos around lights in the dark.

For those who have had their treatment at PLEC:
1. Did they re-do any measurements more thoroughly during your pre-op the day before surgery or during the day of surgery?

2. Did you discuss with Dr. Lin or Dr. Holland the potential size of the optical or treatment zone that was to be used for your surgery? What about blend or transition zones? I'm sure for myself, due to my weak prescription and lack of astigmatism, they could do the max optical zone size without sacrificing too much corneal tissue.

3. Do you know what device they were using for measuring your pupil diameter? Procyon pupillometer, colvard pupillometer, or the pupillometer that is integrated into the schwind corneal and ocular wavefront analyzers? (provided that they have one of these analyzers... which is a separate device from the actual laser treatment system)

4. This one is more for Burnt, since I've seen him mention this number before. For the 9.8 mm max treatment zone you've mentioned the schwind system can provide, do you know if that includes the transition/blend zone (which is non corrective)?

Most of this is probably me getting over anxious and nervous... whenever I feel this way my solution is to read and learn as much as possible.

Anyway, I'll be sure to update this thread with how things go.
Deal Addict
User avatar
Oct 1, 2011
4925 posts
771 upvotes
FaithBuster wrote:
Oct 16th, 2017 12:14 am
For those who have had their treatment at PLEC:
1. Did they re-do any measurements more thoroughly during your pre-op the day before surgery or during the day of surgery?
Yes. Depending on schedule/availability, they will redo measurements day before, or day of surgery. In my case, it was day of surgery.
FaithBuster wrote:
Oct 16th, 2017 12:14 am
2. Did you discuss with Dr. Lin or Dr. Holland the potential size of the optical or treatment zone that was to be used for your surgery? What about blend or transition zones? I'm sure for myself, due to my weak prescription and lack of astigmatism, they could do the max optical zone size without sacrificing too much corneal tissue.
Yes. I had the opportunity to have a chat with Dr. Lin right before surgery (when the assistants put in eye drops, and offer some meds (Advil, Tylenol, lorazepam, Gravol) and I asked what my optometrist had sent in for my pupil diameter. To my surprise, it was smaller than what my LASIK MD consult from a few years ago told me (5.8mm vs. 6.5mm), and he replied that pupil size can get smaller with age. However, he said he would give me 6.7mm zone of treatment, which I was satisfied with. I do not get halos, but I get mild starbursting at night in my right eye. My optometrist confirmed that I have some residual astigmatism remaining, which is a likely factor.

I do not know the more technical details about what devices were used to measure the pupil size, or whether my quoted 6.7mm zone includes the transition area or not.

You could send an e-mail with your concerns before your surgery date.
Sr. Member
Oct 6, 2015
884 posts
433 upvotes
FaithBuster wrote:
Oct 16th, 2017 12:14 am
1. Did they re-do any measurements more thoroughly during your pre-op the day before surgery or during the day of surgery?
I travelled from a'far, and the only pre-surgical information PLEC had about my pupil size is that my optometrist wrote on the referral report, "large pupils".
2. Did you discuss with Dr. Lin or Dr. Holland the potential size of the optical or treatment zone that was to be used for your surgery? What about blend or transition zones? I'm sure for myself, due to my weak prescription and lack of astigmatism, they could do the max optical zone size without sacrificing too much corneal tissue.
I had the concerns (as did you), but I did not make additional inquiries about the matter to Dr. Lin. Corneal Wavefront topographical-guided ablation, which is what PLEC uses on nearly all cases, does not rely upon taking the measurements at a certain pupil size, as the cornea's shape, not the cornea's optical wavefront, is what is treated by the laser. The Schwind Amaris naturally has a very large treatment zone (up to 9.5mm), and thus, is able to produce a very natural shape across the entire cornea. Compare and contrast such with, for instance, some other laser platforms which are limited to 6.5mm custom treatments. There's a paper out there that claims that, at a conference, a presenter put up a bunch of topographies of virgin emmetropic corneas and Schwind Amaris-treated corneas, and the audience was unable to distinguish the two!

So literally the only inquiry I made of Dr. Lin was that of the treatment algorithm to be used that day, to which he responded simply, "Corneal Wavefront". For some reason I was terrified that he'd accidentally perform LASIK on me, so that was the rest of my conversation, lol. (must've been the Ativan!)
3. Do you know what device they were using for measuring your pupil diameter? Procyon pupillometer, colvard pupillometer, or the pupillometer that is integrated into the schwind corneal and ocular wavefront analyzers? (provided that they have one of these analyzers... which is a separate device from the actual laser treatment system)
The female optometrist (Ashley, with a European accent??) used a Colvard Pupillometer on me. Its been a few months (~10 in fact), but I think I was tested on an Oculus Pentacam, and the Schwind combined corneal/ocular wavefront analyzer. So pupil size data would have been available from 3 sources.
4. This one is more for Burnt, since I've seen him mention this number before. For the 9.8 mm max treatment zone you've mentioned the schwind system can provide, do you know if that includes the transition/blend zone (which is non corrective)?
9.5mm can be true fully corrected optical zone. The laser can ablate out to 10mm, but the ORK-CAM software limits the fully corrected optical zone to 9.5mm to provide for a 0.5mm transition zone if needed. Such an ablation would be exceedingly rare though, but the Wavelight EX500 is limited to 8mm or so (I forget which). (source: http://www.eye-tech-solutions.com/en/ho ... m/ork-cam/) So the Schwind does have a theoretical edge in treating huge pupils if/when pachymetry allows.

I can happily report that despite being a -5.75 with thin-ish corneas (~520um) and large pupils, my night vision is better than it was prior to surgery, and I have absolutely no haloing or ghosting at extremely low light conditions (ie: going out of the City and looking at the stars). My research indicated that Dr. Lin "fixes" that complaint in his practice amongst patients who underwent prior treatment on other lasers (ie: the VISX), so he'd avoid inducing it in the first place. The "best" surgeon is one that you hopefully never have to see again (either because he turns you away, or because you're fully and properly treated!!)!!!

@peanutz , I suffer motion sickness, particularly on trains/boats, was popping Gravol pills like tic-tacs, and had a horrible sore throat on my arrival in Vancouver which I took numbing lozenges for. Totally forgot to tell them about such in the pre-op interview (out of fear that they'd reject me, or not understanding the seriousness of the question!). Think any of those meds would have interfered with pupil size measurements? I turned out okay, but looking back....
Newbie
Oct 2, 2017
11 posts
6 upvotes
I'm scheduled for surgery at PLEC on December 4. Had to switch optometrists to one in the neighborhood who co-manages laser surgery, and they will have to do their own pre-op. Earliest I could get in was mid-November. The plan is to go up Friday with my wife, do a pre-op at PLEC on Friday afternoon, walk around in the rain for the weekend, wife drives back on Sunday, surgery Monday, post-op and bus or train back to Seattle on Tuesday. Bandage contact lens removal in Seattle the following Monday.
Sr. Member
Oct 6, 2015
884 posts
433 upvotes
VinceInSeattle wrote:
Oct 17th, 2017 4:20 pm
I'm scheduled for surgery at PLEC on December 4. Had to switch optometrists to one in the neighborhood who co-manages laser surgery, and they will have to do their own pre-op. Earliest I could get in was mid-November. The plan is to go up Friday with my wife, do a pre-op at PLEC on Friday afternoon, walk around in the rain for the weekend, wife drives back on Sunday, surgery Monday, post-op and bus or train back to Seattle on Tuesday. Bandage contact lens removal in Seattle the following Monday.
Wasn't even aware that pre-ops were an option at PLEC, other than the free consultation for local people. But sounds like it'll work. Lots of stuff to do in Vancouver for a few days. Granville Island. Stanley Park. Could even drive up to Whistler and spend a day there skiing as the skiing starts 3rd week of November I think.
Newbie
Oct 11, 2017
10 posts
13 upvotes
Hi again,

Few more details for those interested. My procedure with Dr. Boudreault from LasikMD went quite well. He used the femntosecond laser to cut the flap, then the EX500 for the actual surgery and as I understand it, it had the Contura software/setting enabled. I'm not really sure what difference this makes exactly, but from my understanding it is one of the latest machines available for this procedure. As far as I know, their Vancouver location is equipped with this machine, and their Surrey location uses the Ex400.

The first day was kind of rough, but not bad enough for me to use the numbing drops, by the next morning it was significantly better. I'm a few days post-op now and I'm quite happy with the results thus far, but my vision is certainly still improving. My close-up vision isn't perfect, and overall while I can see 20/20, it isn't as `crisp`as I would like it to be. I`m told that this is normal and to expect it to improve over time. My night vision is fine for the most part, but I do see starbursts coming off of light sources, I`m hoping this gets better too. If anyone has any feedback on this, I'd love to hear it.

For reference, my pupils are around 7.3mm and my corneal thickness was ~520m. I was told that this laser adapts to larger pupils to prevent bad night vision, and it is the way to go for those with thin'ish corneas. At the same time, I`m pretty sure I overheard the Dr. talking about how they still don't like to make the flap too large as it can increase risks of it folding over and what not, so I'm not really sure what that is about.

Although I am still recovering, I am quite amazed at how quickly the eyes heal. I really only suffered on day 1, where I could barely keep my eyes open. On day 2 I could feel my eyes getting better literally by the hour, and woke up with no pain. Quite fantastic really!

Beyond the surgery itself, I do think that the industry has quite a few problems. While I've mentioned before my reasons for going with LasikMD, I'm kind of convinced all these outfits are essentially the same, and the customer/patient is just forced to pick one over the other based on mostly trivial things ... apart from the actual differences in technology I suppose, but even the difference between the most commonly used machines is probably marginal in terms of real world results.
Sr. Member
Oct 6, 2015
884 posts
433 upvotes
publicmanservant wrote:
Oct 17th, 2017 4:37 pm
The first day was kind of rough, but not bad enough for me to use the numbing drops, by the next morning it was significantly better. I'm a few days post-op now and I'm quite happy with the results thus far, but my vision is certainly still improving. My close-up vision isn't perfect, and overall while I can see 20/20, it isn't as `crisp`as I would like it to be. I`m told that this is normal and to expect it to improve over time. My night vision is fine for the most part, but I do see starbursts coming off of light sources, I`m hoping this gets better too. If anyone has any feedback on this, I'd love to hear it.
Sounds like what I went through for the first week or two after PRK, the starbursts. Seems to be caused by cornea edema which is associated with the trauma of the procedure. Its awesome that you were treated with T-CAT / Contoura topography guided ablation. The 20/10 outcomes in the FDA study were very high after 1 year. With LASIK, there isn't much initial overcorrection (there's no epithelium to grow back!), but there is still a period in which your entire optical system needs to adapt to its new focusing power and neuro-adapt to the higher order abberations (or lack thereof) in your corneas. Additionally, if you're in your late 30s or older, presbyopia could be setting in.
Beyond the surgery itself, I do think that the industry has quite a few problems. While I've mentioned before my reasons for going with LasikMD, I'm kind of convinced all these outfits are essentially the same, and the customer/patient is just forced to pick one over the other based on mostly trivial things ... apart from the actual differences in technology I suppose, but even the difference between the most commonly used machines is probably marginal in terms of real world results.
I think those of us posting in this thread who decided to go to PLEC, versus, say, LasikMD, had done so because we were committed to PRK, not LASIK, whether for technical (ie: corneal thickness) reasons, or for personal (ie: sports, paranoia over LASIK flaps or ectasia, etc.). There are definitely some advantages of the laser PLEC uses for PRK, but if you're okay with LASIK, then the Wavelight in T-CAT/Contoura is an excellent choice in the hands of a competent surgeon. Keep us posted, and hopefully you're part of the 15.7% or so that hit the holy grail of 20/10 UCVA!
Newbie
Oct 11, 2017
10 posts
13 upvotes
Thanks, I forgot to mention that your rationale (and that of others) for going with PLEC made a lot of sense to me, and my primary reason for opting for Lasik over PRK was the recovery time and my lifestyle choices - not so much the outfit or the doctor, even though I was underwhelmed after my visit to PLEC.

I appreciate your input, I did notice that during my 24hr check up, I had 20/20 with both eyes, but my left eye seemed blurrier than my right. Now this isn't any different than my results pre-op, in which it was determined that my left eye (also higher prescription) is just not as strong as my right, and a change in prescription doesn't fix that. So I am expecting this to remain the case going forward ...

I was also told that having 'perfect' vision (20/20 or better) is not always ideal, because having a mild prescription usually delays the need for reading glasses. This was news to me, but also helped put to rest the fears of regression in the future (of which I have an apparently 20-25% chance due to being -4.50 / -4.75), since I think I would rather be -.25 than need to wear reading glasses every time I pick up a book. I guess you can't have it all, lol.

I'm in my early 30s, and to be clear, my close-up vision has improved even since yesterday, I do feel that my eyes get more tired overall than usual, but I attribute that to the healing & adjustment process. I'm just really glad I'm not experiencing chronic dry eye, as that was one of my fears. Oh yeah and I do have some bruising - red patches - outline of the suction device they used on my eye - but it isn't visible unless I open my eyes really wide thankfully. I'm told this can take up to a month to fade away. I will say that that was easily the most uncomfortable and jarring part of the surgery, I felt a LOT of pressure on my eye when they put that apparatus on, uncomfortable for sure, but not intolerable.

Sounds like I should expect my vision to gradually improve further over the next few months, up until a year. That is quite awesome .. I won't be too bothered if it doesn't improve past 20/20 ... but I did ask the doc to hook me up with that 'eagle eye vision', lol, so one can hope!

Edit: Hey burnt69 - you seem to be quite knowledgeable on this topic, it is great reading your posts. I'm curious about the Contura technology you mentioned, is it possible that some EX500 devices don't have it enabled? Or do they all come with it? I was told they used Contura, and they did an 'orb scan' right before the surgery because of the newer EX500 machine, but now I'm wondering if there is any way to make sure.

Top

Thread Information

There is currently 1 user viewing this thread. (1 member and 0 guests)

tgreen2017