Beauty & Wellness

[Merged] laser eye surgery

  • Last Updated:
  • Jan 19th, 2018 5:24 pm

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

  • Total votes: 205. You have voted on this poll.
Yes
 
107
52%
No
 
29
14%
Pizza is yummy
 
69
34%
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Oct 6, 2015
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ttmkactus wrote:
Dec 22nd, 2017 1:21 am
Oh! So, just to clarify: you are now 20/12 (or better) and can read your credit card numbers now?
Yes, 20/12, maybe a bit better, and unfortunately, can read credit card numbers. :lol:
Is there ever a situation where a patient does not regress the over-correction?
Sure, if there was too much overcorrection performed. If you're a younger patient, they will program in more overcorrection, than if you're an older patient. Also, the healing process can promote more regression or less regression, due to physical factors. The Schwind Amaris has algorithms that compensate for age in the ablation process, but a heavy smoker, in-the-sunlight all the time 40-year-old dehydrated alcoholic, for example, might have a different physiological response to the laser radiation than, for instance, an albino fair skinned light eyed person in perfect health. Surgeon experience *might* be able to tweak this (ie: one surgeon on YouTube claims that intelligent Asians experience more regression than others) though.

Curiously Dr. Tan in Singapore, who only treats one eye at a time, cites this as a reason for such. He treats one at a time to observe the response of the eye, and then treats the other. But a little bit of overcorrection isn't the end of the world -- it just means slightly earlier reading glasses.
Also, I really do apologize for potentially asking the same question again, but what is the difference between over-correction and 20/12 (or 20/10) vision?
Does that mean if we are "over-corrected" and have 20/12 vision, it would potentially "regress" to 20/15 or 20/20? Did I use the terms properly? Haha
Overcorrection typically implies loss of close-up vision, but doesn't have much impact on far vision. You have to regress to worse than -0.5 to be any worse than 20/15 or 20/20. As a person gets older, other factors, rather than corneal optical power, come into play in terms of visual acuity. Such as cataracts and increasing spherical aberration. And changes to the retina and vitreous. So you won't have young eyes forever!
Last edited by burnt69 on Dec 22nd, 2017 2:43 am, edited 1 time in total.
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ttmkactus wrote:
Dec 22nd, 2017 1:21 am
Is there ever a situation where a patient does not regress the over-correction?
Probably. People naturally heal slightly differently. Face With Stuck-out Tongue And Tightly-closed Eyes These are questions better directed to the surgeons or optometrists...I can't honestly answer your overcorrection type of questions with much confidence, hehe.
ttmkactus wrote:
Dec 22nd, 2017 1:21 am
@peanutz Do you have a specific optometrist you go to for co-management? Or do you just like that location in general?
Dr. Toomsalu is my longtime optometrist and she did the majority of my co-management. But since there are a few days she does not work, the other optometrists will cover for each other as needed. So it was Dr. Jill Paterson who checked and ensured my epithelium was "closed", and gently flicked off my bandage contact lenses on Day 5; and a newer Italian lady happened to be working on the day of one of my follow-ups (I forget her name, I only met her once.)

This is not an endorsement or recommendation of any sort lol...just who I happen to be with since they are close to where I've lived in Toronto. So I am not saying they are necessarily better than anyone else. :)
Banned
Sep 22, 2009
691 posts
290 upvotes
Toronto
2 days post surgery and itch in left eye is definitely subsiding.. Visit with optometrist yesterday revealed I now have 20/16 vision! She said she has never seen vision so good right after surgery before and it will only get better.

Dr. Herzig ROCKS!!!
Newbie
Dec 1, 2017
19 posts
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Happy New Year!

I'm getting my SmartSurface PRK in 3 days - any tips on what to get beforehand to make the recovery better, supplements or drops? Anyone know of a cheap pair of sunglasses that actually have UV protection, or should I just stick with goggles since they cover the entire eye?

@peanutz You mentioned that PLEC also asked you to get swimming goggles - is it just for showering, or for everything else?
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tgreen2017 wrote:
Jan 1st, 2018 6:00 pm
I'm getting my SmartSurface PRK in 3 days - any tips on what to get beforehand to make the recovery better, supplements or drops? Anyone know of a cheap pair of sunglasses that actually have UV protection, or should I just stick with goggles since they cover the entire eye?
Drops -- what your Dr. prescribes you. Allergan Refresh Optive Fusion Preservative-Free was what Dr. told me to use. If you go onto Allergan's facebook page, there's a $5 coupon for such drops that you can print out and redeem bringing the cost down to something more reasonable.

The Refresh drops in individual unit dose vials can be re-used. Just don't touch the tips, and try to refrigerate them if you can. Opening them upside down somewhat stops the contents from being wasted, although sometimes you will have to shake them to get the drop back to where it needs to be. Don't obsess too much if you waste a drop or two, especially in the early days -- the cost of another box of drops is trivial compared to the cost of the surgery!

Supplements -- Omega 3 supplements were really helpful, fish oil, 2000mg daily for a month or two, and then tapering down. A year later, still on them a little bit.

Once the BCL's come out, I used overnight ointments. Lacri Lube was officially prescribed, but I found Systane Nighttime to be a superior product (although a bit more expensive) due to being thicker, slightly less irritating, and easier to apply.

Most cheap sunglasses have UV protection. My Dr. gave me a set of obviously imitation Ray-Ban Wayfarer-style plastic sunglasses with the clinic logo screened onto them.

PLEC advised the use of swimming goggles for showering and bathing for the first week to keep any tapwater (and contaminants associated with such) out of them.

Make sure you take all your drops, lubes, etc., with you to the follow-up appointments, especially your 1-week follow-up.

No need to buy any of this "before-hand" except for the Omega-3 supplements and the goggles if you don't have a set. Found that Jamieson Omega-3 "Select" brand was good, although any high quality brand that's reasonably fresh shouldn't be a problem.

Doctor said that "Muro 128" drops could be used to reduce blur "for reading", but I never bothered.

Also in terms of pain medication, I took Tylenol and Aleve (naproxen) the first night, as well as Gravol (dimenhydrinate) as a sleep aid, although ibuprofen (Advil, Motrin, etc.) or pretty much any other oral NSAID would do the trick (Voltaren, Toradol, etc.). The Dr. *may* give you a prescription for stronger stuff and/or a sleeping pill, but in most (but not all) cases, its not necessary.
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tgreen2017 wrote:
Jan 1st, 2018 6:00 pm
Happy New Year!

I'm getting my SmartSurface PRK in 3 days - any tips on what to get beforehand to make the recovery better, supplements or drops? Anyone know of a cheap pair of sunglasses that actually have UV protection, or should I just stick with goggles since they cover the entire eye?

@peanutz You mentioned that PLEC also asked you to get swimming goggles - is it just for showering, or for everything else?
Happy New Year, good luck!

Call your clinic to ask them if they will be supplying sunglasses. PLEC provided these for us.

The goggles are for showering, or even for washing your face. No splashes of tap water allowed in post-surgery eyes. PLEC's PRK patients require them until the bandage contacts are taken out, which is 5-7 days.

You should already be taking the supplements...but if not, then Omega-3 and vitamin C. Have the lubricant drops ready (Refresh Optive Fusion preservative-free is highly recommended.) I also made sure I got my prescription* post-surgery eye drops filled in advance, and Advil ready as well (as recommended by Dr. Lin) because I didn't want to be shopping and reading labels post-surgery. Again, ask your clinic if they will be providing all drops that will be needed, or if you will have to pick some up after surgery.

Don't forget to prepare your clothing for day-of-surgery. Dress in layers, and if taking a sweater, make sure it's not too linty as the surgical room is to be kept clean--this is what PLEC patients are told.

*Not a bad idea to double-check the prescription label instructions either...another reason I did this before the surgery. Mistakes do occasionally happen, and I didn't want one to potentially happen when my vision is blurred.

Lastly, prepare some non-vision-dependent entertainment. Maybe download some podcasts or audiobooks. :)
Sr. Member
Jun 7, 2007
562 posts
167 upvotes
Richmond Hill
Happy New year!

Just want to do an update after my surgery in early December at NVision. I did the SmartSurface procedure, and for the first 3-4 days it was irritating at certain times. on the 3rd day i was not able to see properly at all, as the epithelium was healing towards the center of my eye. Next day was better and did not hurt as much, and my optometrist was able to remove the contact lenses no problem. Vision was a bit blurry once it was removed, but within the week they have gotten much better. However my right eye is still currently not as clear as my left eye. I always compare my eyes by closing 1 and then the other to see how far I can see. My Left eye is amazing at seeing street signs or words/numbers pretty far, but my right can't do as much, even after almost 1 month. Both eyes are still pretty bad during night time as I get pretty bad star bursts and halos when driving. They were definitely worse compared to pre-op. Also, I haven't seen much improvement since the surgery either. These are my only issues currently, going 1 month in.

My experience with the halos is mostly during low light, ie when driving at night. The halos start coming out mostly to dim lights like the red tail lights behind cars. They go away for a while when I look at on coming head lights, and start to reappear when I look away.

In terms of star bursts and halos, did you guys have these issues? If so, for how long? And did it get better overtime?
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@25jai I only had halos in the immediate 7-day period after surgery, so in my case it seems they were caused by post-surgical inflammation as my surgeon explained.

I still have minor starbursts at night that don't get in the way of driving. I am almost 1 year post-surgery and don't expect these to go away.

As for the differences in left vs. right, my right eye was a bit behind the left but by around the 2-3 month mark it had caught up. No noticeable difference in vision between the two now.
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25jai wrote:
Jan 4th, 2018 11:55 am
In terms of star bursts and halos, did you guys have these issues? If so, for how long? And did it get better overtime?
Yeah I'd say a good 2 months or so. There was quite a noticeable period of healing once I came off the steroids. Night driving for the first 2-3 months is very sketchy. It does get better.

Eye imbalance is perfectly normal. Took 2 months or so before I totally had no signs of it. At 1-year followup, supposedely there's a slight bit of astigmatism in one eye (the other being basically plano cylinder), but I can't tell any difference, even at night. Which means either I'm completely neuro-processing the astigmatism away, or it was just a measuring error.
Sr. Member
Jun 7, 2007
562 posts
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Richmond Hill
NVision has me on lotemax (steroid) drops for 4 times a day for first month, and then 3 for second, 2 for third, and 1 for 4th month. My eye doctor was kind of suspicious on this prescription/dosage because she's had PRK patients doing it for 4 times first week, and 3 next week and so on. However, she's never had transPRK patients before so I'm her first and last time for my check up she said she will talk to Dr. Machat about it. Speaking of steroid drops, my eye doctor said my eye pressures have gone really high, and she suspects I'm reacting from the steroid drops. Prior to surgery she said I was at 16-17mmHg, and typically patients who did laser eye surgery would drop to 12-13mmHg, respective to what my initial eye pressure was. After the first week I was at 20mmHg, so she prescribed me another drop to put on every morning to lower the pressure.

I'm hoping my starbursts and halos go away eventually, and also that my right eye would be catching up.
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25jai wrote:
Jan 4th, 2018 2:13 pm
NVision has me on lotemax (steroid) drops for 4 times a day for first month, and then 3 for second, 2 for third, and 1 for 4th month. My eye doctor was kind of suspicious on this prescription/dosage because she's had PRK patients doing it for 4 times first week, and 3 next week and so on. However, she's never had transPRK patients before so I'm her first and last time for my check up she said she will talk to Dr. Machat about it. Speaking of steroid drops, my eye doctor said my eye pressures have gone really high, and she suspects I'm reacting from the steroid drops. Prior to surgery she said I was at 16-17mmHg, and typically patients who did laser eye surgery would drop to 12-13mmHg, respective to what my initial eye pressure was. After the first week I was at 20mmHg, so she prescribed me another drop to put on every morning to lower the pressure.

I'm hoping my starbursts and halos go away eventually, and also that my right eye would be catching up.
I would definitely be interested in your optometrist's correspondence with Dr. Machat.

I just did a quick Google search:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5340049/

Hmm, looks like the Lotemax regimen is evidence-based. For PLEC patients, we had FML and the tapering was finished after 6 weeks; some people may require a slower tapering but would definitely be done by 8 weeks.
Last edited by peanutz on Jan 4th, 2018 2:23 pm, edited 1 time in total.
Sr. Member
Jun 7, 2007
562 posts
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Richmond Hill
peanutz wrote:
Jan 4th, 2018 2:23 pm
I would definitely be interested in your optometrist's correspondence with Dr. Machat. I hope this is not a prescription error.

PLEC's steroid taper (FML drops) finished after 6 weeks, some people may need a slower tapering but definitely off by 8th week.
It was on a printed piece of paper on what the first days i'm suppose to drop with, so I don't think they would make that big of an error. I will follow up with her this saturday for my 1 month.
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Aug 21, 2005
904 posts
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Toronto
Might be a misprint, but Guardian and IDA is advertising Refresh Optive Fusion 30x 0.4mL for $9.00 until February 1st.

The Refresh website has a coupon for $3-5 off, but YMMV depending on how much trouble each pharmacy gives you... or if you can price match (my local walmart/RCSS are specific with who you can match with now) and use the coupon... even better. My Guardian took a week to specially order it in for me (most locations don't seem time readily carry it), so I didn't want to argue!

Good luck!
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Last edited by lynn24 on Jan 4th, 2018 2:27 pm, edited 2 times in total.
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25jai wrote:
Jan 4th, 2018 2:27 pm
It was on a printed piece of paper on what the first days i'm suppose to drop with, so I don't think they would make that big of an error. I will follow up with her this saturday for my 1 month.
I edited my above post after Google!
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lynn24 wrote:
Jan 4th, 2018 2:27 pm
Might be a misprint, but Guardian and IDA is advertising Refresh Optive Fusion 30x 0.4mL for $9.00 until February 1st.

The Refresh website has a coupon for $3-5 off, but YMMV depending on how much trouble each pharmacy gives you... or if you can price match (my local walmart/RCSS are specific with who you can match with now) and use the coupon... even better. My Guardian took a week to specially order it in for me (most locations don't seem time readily carry it), so I didn't want to argue!

Good luck!
Thank you for sharing. I'm reading the coupons as $9 for either the Refresh Optive 10mL bottles, or the Refresh Plus preservative-free vials.

The Refresh Optive preservative-frees cost a bit more and may be excluded from this promotion.

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