Beauty & Wellness

[Merged] laser eye surgery

  • Last Updated:
  • May 21st, 2018 1:10 am

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

  • Total votes: 224. You have voted on this poll.
Yes
 
117
52%
No
 
32
14%
Pizza is yummy
 
75
33%
Newbie
Dec 31, 2016
30 posts
4 upvotes
Anyone have experience with EVO Visian ICL?

I have a high prescription (over -10 in each eye) and was recommended ICL. I heard stories about halos and glare and wanted to see if anyone else here had experiences with ICL?

Thanks!
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Oct 6, 2015
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ohfive wrote:
Jan 28th, 2018 9:48 pm
Anyone have experience with EVO Visian ICL?

I have a high prescription (over -10 in each eye) and was recommended ICL. I heard stories about halos and glare and wanted to see if anyone else here had experiences with ICL?

Thanks!
From my reading, its basically the same problem that arises when PRK/LASIK are done with optical zones that are not sized to the pupil properly.

Not that I'm giving an opinion on your personal suitability, but PLEC has done up to -15 with PRK, so -10 isn't out of the realm of possibility with PRK. I have a relative who was a -11 or a -12 who was PRK'ed. You might want to seek out additional opinions and get a copy of your measurements (pupil size, corneal thickness, and prescription in particular) to work through the math and understand the risks.
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Jul 30, 2010
1405 posts
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I had Lasik done at Imageplus in Winnipeg back in 2011. At that time it was already full laser; the cutting and resurfacing was all done by lasers (no microkeratone blade).

Total cost was about $5000, and I was up and going in 2 days with perfect vision and regimen of drops.

My vision was -2.5 myopic when I went in, came out with 20/8 vision. Haven't had any issues since then once the dry eyes disappeared (about a year or so). The owner was apparently one of the pioneers for Lasik in Western Canada, and was super professional. Met twice before the surgery and twice after for checkups and measurements to make sure everything was good.

No regrets and anytime is a great time to get laser eye surgery (granted the fact that your eyes are no longer "getting worse"). I was 28. The friend of mine that referred me there was 49 and he had zero regrets as well. Any amount of time you can spend without the need for glasses is a great time.
Deal Addict
Oct 6, 2015
1300 posts
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thadsan wrote:
Jan 30th, 2018 12:21 pm
I had Smart Surf PRK about 2 weeks ago, and my vision is 20/20 when I did the last checkup. However, when I go to the office, or anywhere in the building, it's dropping to like 20/40 or worse and it's hard to make out the text on the computer/phone. I can use the phone/computer perfectly fine outside/at home and pretty much anywhere else.

Anyone had any related issues like this? I am constantly using the eye drops - but doesn't improve the situation.
Yeah I had a lot of fluctuation for those first few weeks. Just have to be patient. You are probably overcorrected at this point quite significantly. Over time, the overcorrection should regress to your planned target or pretty near it. A few weeks out there can be haze as well.

How old are you?
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Oct 6, 2015
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thadsan wrote:
Jan 31st, 2018 9:47 am
Good to know! Will see how it goes. I am 32.
Okay probably no presbyopia there. But still sounds normal. I'm a bit older, and while I lost much of my near vision for the first few months after the surgery, it has mostly (but not completely) recovered.
Newbie
Dec 1, 2017
26 posts
13 upvotes
Just wanted to update (in case anyone's interested :P), had my first month check up today:
My vision is a little bit worse than the 2 week mark, and the optometrist couldn't refract me to 20/20 - which he says it's a good thing, because that means it's not my prescription that's imperfect but that my eyes that are still healing. Reading glasses help a tiny bit and my optometrist advised against it because the changes are so minimal and fluctuates daily. He also mentioned my recovery is a bit slower than typical patients, but that's expected of some patients. However, in terms of timescale, he's talking about it 6 months rather than 2 months now, which is kind of worrying to me.
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Oct 6, 2015
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tgreen2017 wrote:
Feb 1st, 2018 9:55 pm
Just wanted to update (in case anyone's interested :P), had my first month check up today:
My vision is a little bit worse than the 2 week mark, and the optometrist couldn't refract me to 20/20 - which he says it's a good thing, because that means it's not my prescription that's imperfect but that my eyes that are still healing. Reading glasses help a tiny bit and my optometrist advised against it because the changes are so minimal and fluctuates daily. He also mentioned my recovery is a bit slower than typical patients, but that's expected of some patients. However, in terms of timescale, he's talking about it 6 months rather than 2 months now, which is kind of worrying to me.
Easier to underpromise and over-deliver, than to over-promise and under-deliver. Unless its truly disabling, its easier just to do stuff to take your mind off of it, and in time, it'll probably be better than you ever imagined.

That's maybe one of the downsides of SmartSurfACE -- the initial recovery is so darn quick that the patient almost gets spoiled. So when healing inevitably slows down, its kind of disappointing. I saw quite noticeable changes to clarity of distance vision even between the 3 and 6 month point.
Newbie
Dec 1, 2017
26 posts
13 upvotes
burnt69 wrote:
Feb 1st, 2018 10:23 pm
Easier to underpromise and over-deliver, than to over-promise and under-deliver. Unless its truly disabling, its easier just to do stuff to take your mind off of it, and in time, it'll probably be better than you ever imagined.

That's maybe one of the downsides of SmartSurfACE -- the initial recovery is so darn quick that the patient almost gets spoiled. So when healing inevitably slows down, its kind of disappointing. I saw quite noticeable changes to clarity of distance vision even between the 3 and 6 month point.
Speaking as a person who's on the slower end of the healing spectrum, I'm less confident about SmartSurface than I was at the beginning of the surgery. While it's faster than traditional PRK, the healing is still ridiculously long, whereas a vast majority of Lasik patients heal and have 20/20 vision within a couple of days. For perspective: my friend who had traditional PRK got his BCL off in a week, whereas for me it was 3 days. My vision fluctuates from 20/30 to 20/40, a month after surgery. An entire month and reading is still hard! And I'm not even sure if it's a 1-time-and-never-worry-about-it-again thing! If I get regression (which is likely with my prescription), I really hope I can pick Lasik, but I wouldn't be surprised if I had to go through Smartsurface again, to which I truly hope the recovery would be shorter.

What gives me comfort is that my optometrist recommended Smartsurface because of my dry eyes when Nvision typically recommends Lasik. In fact, my friend who has -7 eyes, was recommended Lasik there because her eyes weren't dry.
Member
Nov 25, 2007
220 posts
57 upvotes
Toronto
I understand your disappointment/frustration, tgreen2017. My wife also did her SmartSurface PRK 1 month ago, and she's still no where near 20/20 yet.

There's no doubt that Lasik's recovery time is faster than PRK's (traditional or SmartSurface). However, I think most people who pick SmartSurface PRk is mainly for its safety rather than fast recovery. Although most Lasik patients got 20/20 vision (or even better) shortly after the surgery, there're also a lot if unsuccessful stories. My friend had a Lasik done 4 months ago, and one of his eyes was "unsuccessful" and it had to be re-treated with PRK 2 months ago. Even after the PRK re-treatment, his vision is still not very good (the other eye is OK though). Honestly, I would be freaking out if I were him!

I guess there's no guarantee on any surgery, whether it's Lasik or PRK. There are too many factors that could affect the final results (your prescription, age, health, corneal shape/thickness etc.) But one thing for sure is that SmartSurface PRK is safer, and if a future re-treatment is needed, your choices will be greater. I hope your vision will keep improving. Please let us know how it goes later. Good luck!
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Oct 1, 2011
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@raptorsfans, you said it so elegantly.

I wasn't sure how to say it, because I don't want to minimize anyone's discomfort (some pain as in a few reports here), or inconvenience. I guess this is what surgeons refer to when speaking of "managing expectations." I think it's important not to overstate the early recovery phase, as I personally did not feel comfortable driving until after the 10-14 day mark (I mean, I could have if there were a natural disaster and I had to slowly drive my way out of town? lol)

My timeline was:
- 5 days until regular device use (they took my bandage lenses out on Day 5)
- 10-14 days for functionality (to go back to work, or drive reasonably comfortably)
- 2.5 months for good vision which continues to improve slightly until 6 months

It is also why I am hesitant to recommend it to people with mild myopia, like -1.50 or less; their improvements in vision compared to the same, drawn-out recovery period may be smaller.

My personal choice had to do with the fact that I've worn glasses for 20 years, so 6 months of slight blurriness with improving vision was absolutely worth it to me. The greater mechanical safety, and the larger margin of error (more tissue left for touch ups + no chance of a flap getting damaged during/after surgery and resorting to PRK post-LASIK, which is a double-whammy of lost tissue and discomfort) were why I far preferred the slow healing versus the LASIK convenience.

Furthermore, we may not know it yet, but there may be hidden benefits in the far future come cataracts surgery time. I just like having the extra tissue in case of many unknowns.

Lastly, the internal healing for post-PRK eyes can continue through 2 years as the corneal nerves regrow. At 1 year post-surgery, the dryness of my eyes has subsided very significantly; my optometrist said they didn't look dry at all. I do not need eye drops anymore (but I still try to lubricate on some days in case some dryness is beyond my sensation.) This is major for me, considering I started out with slightly dry eyes to begin with. For LASIK, this could take 3-5 years as the cut is deeper.
Newbie
Dec 1, 2017
26 posts
13 upvotes
Thanks, and agreed! It's hard for me to say because I'm not in the alternate universe where I had Lasik instead, so I have no idea how dry my eyes would be/complications otherwise. I was under the impression that healing would be a lot faster using Smartsurface, not a bit faster. Other than that, I'm really happy about the results and lack of complications, like no halos/starbursts. I'm just a bit disappointed since I was hoping for a much speedier recovery and it looks like I won't get it soon, and it would really suck if I had to go through this again. My optometrist mentioned that patients usually get farsighted in the 2nd month and stabilizes in the 3rd, but my eyes haven't progressed to the level where it's becoming more farsighted yet. Almost all of my friends have had Lasik (with amazing results), but that's a small sample size.

Hope everyone else's recovery is going smoothly!
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Oct 1, 2011
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@tgreen2017 I understand. :) I would say that the vision in early recovery phase (first ~2 weeks or so) are the main advantage as far as I can tell, but there is no way for SmartSurface to accelerate ordinary healing processes.

I'd say I was hovering around 80% acuity until the 2.5 month mark, where I then got 95%. The remaining 5% of healing took place for me from 3-12 months.

I read many, many horror cases that might not possibly apply to the majority of modern LASIK patients but there were case studies of ectasia like 5-6 years afterwards. I am sure these patients were raving about their vision before then...one was a doctor (see Dr. Jerry Tan's YouTube presentation on treating post laser ectasia cases using PRK+corneal crosslinking.)

It's not a race, your eyes are different from your friends' and all of us won't know the long term impacts until years or even decades pass. I only have one friend I know who did (LASIK) and she said that 1 week after, one morning, she had a lot of pain and had to return to the doc. There was a wrinkle in her flap that had to be smoothed down again; I am not envious of her experience or the fact that she had it done ~5 years before me. And glasses are still cute lol...I am not dreading the day I will need reading glasses, there are many stylish ones out there.

One aspect I am OK with is that if we need a touchup PRK, we can maybe do one eye at a time next time and therefore skip the "debilitating" phase? It can be annoying, but keep in mind that some patients not long ago have suffered permanently compromised vision due to rushing or choosing the less appropriate procedure for their eyes. I hope the reading glasses will help with any strain for you at work for the time-being. I am thinking of getting some anyway because a) I wonder if they might slow any regression, and b) blue light radiation or whatever.
Newbie
Oct 25, 2017
5 posts
4 upvotes
Tomorrow will be 6 weeks since getting SmartSurface PRK at Nvision by Dr. Machat. Being the cautious type, I'm only doing one eye at a time. I was about -1.5 in each eye.

Everything at the clinic went great, everyone was super nice, and the procedure was super smooth. I'd say the early healing was better than expected, though I took 2 weeks off work and had a patient girlfriend administering all my eye drops...

Vision in my left eye (the one I had done) got noticeably better at around the 2 week mark. That said, improvement since then has been slow. Currently, the eye is at about 20/25 on its own. What is concerning is that it can be refracted to be better, so I may be undercorrected? Perhaps someone with more experience/knowledge can clarify, but does undercorrection improve as time goes on? My understanding is that the procedure intentionally overcorrects, and then you slide down to where you "should" be. I'm worried I've already "slid" too far.

Getting one eye done has been interesting... haha I'm constantly testing the two against each other. I've noticed I actually get less halos in my left eye now. I'm still getting pretty significant ghosting in that eye though- particularly with lights on a dark background (traffic lights at night are the best example).

Overall, the experience hasn't been too bad, though I am worried about the undercorrection.
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Oct 6, 2015
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tornadotrick wrote:
Feb 7th, 2018 12:33 pm
Vision in my left eye (the one I had done) got noticeably better at around the 2 week mark. That said, improvement since then has been slow. Currently, the eye is at about 20/25 on its own. What is concerning is that it can be refracted to be better, so I may be undercorrected?
You should be overcorrected at this time. The epithelium contributes to optical power, and takes a while to fully heal back to its normal thickness of 56um or so.

Perhaps someone with more experience/knowledge can clarify, but does undercorrection improve as time goes on? My understanding is that the procedure intentionally overcorrects, and then you slide down to where you "should" be. I'm worried I've already "slid" too far.
No, you probably haven't slid enough. You'll have worse vision as a +1, for example, than you will have as a +0.5, or plano.

Getting one eye done has been interesting... haha I'm constantly testing the two against each other. I've noticed I actually get less halos in my left eye now. I'm still getting pretty significant ghosting in that eye though- particularly with lights on a dark background (traffic lights at night are the best example).
Perfectly normal.
Newbie
Oct 25, 2017
5 posts
4 upvotes
burnt69 wrote:
Feb 7th, 2018 12:47 pm
You should be overcorrected at this time. The epithelium contributes to optical power, and takes a while to fully heal back to its normal thickness of 56um or so.

No, you probably haven't slid enough. You'll have worse vision as a +1, for example, than you will have as a +0.5
Hm, I'm a little confused though. At my one month follow-up, my optometrist measured my left eye as being -0.25. Wouldn't this mean I'm undercorrected as opposed to overcorrected? That said, I guess I'm also overcorrected in that my near vision in that eye is still a little fuzzy.

On a related note, for those who's entire job is on a computer (like me), doing one eye at a time has made getting back to work much easier. I took 2 weeks off and coming back felt totally fine doing my work. I always have to remind myself to put my drops in- they never feel irritated and my vision never feels fuzzy.

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