Health & Wellness

[Merged] laser eye surgery

  • Last Updated:
  • Jan 15th, 2019 10:54 pm

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

  • Total votes: 280. You have voted on this poll.
Yes
 
147
53%
No
 
40
14%
Pizza is yummy
 
93
33%
Newbie
Dec 18, 2018
5 posts
2 upvotes
dorayaki wrote:
Dec 20th, 2018 11:22 pm
My prescription is about -6.00 to -7.00 for both eyes, with -0.50 astigmatism for one eye.
I went to 3 places for consultation and received 3 different suggestions.

Nvision suggested smart surface PRK, as my cornea is about 520 microns (avg is 540-550) thick. For lower prescription, cornea thickness at 520 microns is still good for LASIK, however for my prescription which is relatively high, they would be more conservative hence suggested PRK. Operation will be performed by Dr. Machat.

Bochner suggested LASIK, however due to my small eye opening, the suction cup used in LASIK might not fit. If that's the case, they will switch to PRK. The type of the procedure will be decided on the surgery day. (Cost for both LASIK and PRK are the same). Operation will be performed by Dr. Stein. Bocher's Cost = Nvision + $300

Herzig suggested SMILE, since SMILE is less invasive and my astigmatism is low enough for SMILE to treat. They didn't suggest LASIK or PRK due to invasive procedure and long recovery period. If I'm a good candidate for SMILE, why not SMILE? Operation will be performed by Dr. Herzig. Herzig's cost = Nvision + $1200

Anyone falls into a similar situation as me? What did you choose? I'm in this big dilemma right now. All 3 places mentioned that PRK is possible if I need further enhancement after the first surgery.

The cost of the procedure and the time needed off from work are not main issues for me. I'm willing to invest both time and money in my eyes.

Any suggestions are welcome. Thanks in advance!
My prescription is not as high as yours, however, I received similar feedback from each of the clinics.
1) At NVISION they recommended SmartSurfACE PRK.
2) At Bochner they recommended PRK.
2) At Herzig I was recommended SMILE and therefore did not ask about PRK.

If you read through this thread and do a little research, many people say that SMILE is "not there yet" and wouldn't necessarily recommend it. However, my coworker's wife had it done and is completely happy with it.

I had a hard time choosing between Bochner and NVISION for PRK, but ultimately booked my appointment with NVISION because of their technology.
Newbie
User avatar
Apr 6, 2010
13 posts
dorayaki wrote:
Dec 20th, 2018 11:22 pm
My prescription is about -6.00 to -7.00 for both eyes, with -0.50 astigmatism for one eye.
I went to 3 places for consultation and received 3 different suggestions.

Nvision suggested smart surface PRK, as my cornea is about 520 microns (avg is 540-550) thick. For lower prescription, cornea thickness at 520 microns is still good for LASIK, however for my prescription which is relatively high, they would be more conservative hence suggested PRK. Operation will be performed by Dr. Machat.

Bochner suggested LASIK, however due to my small eye opening, the suction cup used in LASIK might not fit. If that's the case, they will switch to PRK. The type of the procedure will be decided on the surgery day. (Cost for both LASIK and PRK are the same). Operation will be performed by Dr. Stein. Bocher's Cost = Nvision + $300

Herzig suggested SMILE, since SMILE is less invasive and my astigmatism is low enough for SMILE to treat. They didn't suggest LASIK or PRK due to invasive procedure and long recovery period. If I'm a good candidate for SMILE, why not SMILE? Operation will be performed by Dr. Herzig. Herzig's cost = Nvision + $1200

Anyone falls into a similar situation as me? What did you choose? I'm in this big dilemma right now. All 3 places mentioned that PRK is possible if I need further enhancement after the first surgery.

The cost of the procedure and the time needed off from work are not main issues for me. I'm willing to invest both time and money in my eyes.

Any suggestions are welcome. Thanks in advance!
I have decided to only consider two places, Nvision(transPRK) and Bochner(hopefully LASIK over PRK, but with thin cornea and suction cup issue, it might go to PRK on the day of procedure too).

https://www.maidalaser.com/2016/05/30/l ... thickness/
Based on this website, the calculation if I use the -7.00 value:
520 - 160 - (7 x 14) = 262, just 12 microns over the minimum(250) as noted.

My biggest dilemma right now is whether LASIK is worth the risk over PRK mainly for the faster recovery time and less pain.
It seems to me right now that PRK is the conservative approach with more time/pain endurance needed for result vs LASIK as the aggressive approach.

Any other opinion/feedback on this? Thanks
Newbie
Feb 22, 2007
35 posts
Toronto
So just starting to do some research on laser eye surgery clinics in the GTA.

Some people on this forum have recommended Clearview Institute...I checked out the website and some other online posts and it seems that they also offer cosmetic procedures there...kinda weird combination no? Wouldn't you want to go to a place that truly specializes in eyes? Is this a yellow or red flag at all?

Is Bochner alot more expensive than TLC or Clearview? My eyes are -7 and -8 with high astigmatism also.
Deal Addict
Oct 6, 2015
1428 posts
758 upvotes
drtse wrote:
Jan 3rd, 2019 2:18 pm
So just starting to do some research on laser eye surgery clinics in the GTA.

Some people on this forum have recommended Clearview Institute...I checked out the website and some other online posts and it seems that they also offer cosmetic procedures there...kinda weird combination no? Wouldn't you want to go to a place that truly specializes in eyes? Is this a yellow or red flag at all?

Is Bochner alot more expensive than TLC or Clearview? My eyes are -7 and -8 with high astigmatism also.
https://www.clearviewinstitute.com/

Are you even looking at the same website? I don't see any mention whatsoever of 'cosmetic' procedures. Just refractive procedures and cataract surgeries.

-8 with (high) astigmatism, make sure you research PRK, not just LASIK. Your prospective surgeons with whom you attend consultations will explain what you qualify for, but a PRK recommendation wouldn't surprise me.
Newbie
Feb 22, 2007
35 posts
Toronto
burnt69 wrote:
Jan 4th, 2019 12:23 am
https://www.clearviewinstitute.com/

Are you even looking at the same website? I don't see any mention whatsoever of 'cosmetic' procedures. Just refractive procedures and cataract surgeries.

-8 with (high) astigmatism, make sure you research PRK, not just LASIK. Your prospective surgeons with whom you attend consultations will explain what you qualify for, but a PRK recommendation wouldn't surprise me.
Yes, I was looking at the page about their staff. They have two staff members named Angie and Marisela whose focus is on cosmetic procedures...says nothing about an ocular role.

TransPRK with NVision seems like a good bet for me...I will be making a consultation appt with them also. Thx.
Newbie
Feb 22, 2007
35 posts
Toronto
So my optometrist contacted Bochner and TLC on my behalf and gave them my prescription details. She said Bochner recommended implantable contact lenses while TLC recommended LASIK.

Anyone personally go the ICL route or know someone else who did it?
Newbie
Jan 6, 2019
1 posts
1 upvote
You have no idea how happy I am to have found this thread!

I started researching corrective vision surgery about 10 years ago. My prescription is high currently in the -10 range in each eye, the right slightly higher than the left.

When I started skimming this thread I was relieved to find that there are others who have received varying procedural recommendations.

10 years ago:

Yonge/Eglinton considered me a good LASIK candidate, I was pleased but wanted a second opinion so I went to Herzig.

Herzig would not consider me for a laser procedure, instead indicated that they would only do an ICL. I was disturbed that with the same eyes, these top tier clinics had differing opinions, so Dr. Herzig came to speak to me and ultimately said it all comes down to a surgeons comfort level with his technology. He would do a laser procedure if I wanted that, but felt I would have the best results with an ICL. So I figured Bochner would certainly re-affirm one of these recommendations ....

Nope. Bochner would only recommend PRK.

So, I was discouraged. After much contemplation I put this on the back burner, and thought I'd wait for my eyes to change in my mid-40's. Fast forward to the current day ...

The ICL is appealing to me, as it is entirely reversible and does not change the anatomy of my eye, So I went back to Herzig to see if his recommendation is still the same, and fortunately it is. My brother who is in the -6/-7 range had a corrective vison procedure (laser) done on Friday at NVision. He messaged me that the woman that he was waiting with was a -13 and that I should call them for a consult. So ... I've booked for the end of January.

Thanks to everyone who has shared their story here ... I have a lot to read and welcome any insight as I attempt to make an informed decision.
Deal Addict
Oct 6, 2015
1428 posts
758 upvotes
allynjanicki3447 wrote:
Jan 7th, 2019 8:25 pm
My brother who is in the -6/-7 range had a corrective vison procedure (laser) done on Friday at NVision. He messaged me that the woman that he was waiting with was a -13 and that I should call them for a consult. So ... I've booked for the end of January.
Thanks to everyone who has shared their story here ... I have a lot to read and welcome any insight as I attempt to make an informed decision.
Yeah lots of people can be treated with PRK as -10's. The issues can be corneal thickness, over-flattening, and, if you have large pupils, more tissue is needed compared to people with smaller pupils.

Corneal cross-linking (CXL, or sometimes even called "XTra") is a new treatment "on the table" these days that probably wouldn't have even been considered 10 years ago. So if you are a marginal PRK case, a surgeon can potentially give you a treatment of cross-linking (basically UV light + riboflavin solution), and then be more confident in leaving your corneas a little bit thinner than what previously might have been the max they were comfortable with after doing a PRK treatment. 10 years ago, there was less confidence in doing high corrections with PRK due to the haze issue, but MMC and smoother lasers have largely minimized such.

PLEC has a case study where they treated someone as a -15 with SmartSurfACE/transPRK. Obviously not for everyone, but if your measurements work out, PRK seems to be far less invasive and prone to fewer long-term side effects than the ICLs. Or at least that's been my research.
Newbie
Feb 22, 2007
35 posts
Toronto
So my consultations have been set at TLC, Bochner and NVision over the next few weeks. The duration of each consultation is different across the board: TLC 1.5 hrs, Bochner 1 hr, Nvision ~2 hrs. Is the length of these consultations any sign the quality of service and outcome?

Also regarding post-surgical symptoms of haze, blurriness, pain and overall vision...if I had my surgery on a Thursday, could I be back to work on Monday without too much problem. I am not in front of the computer for my work and just need to have workable mid-range vision as I am meeting with people mostly. I know everyone's results may vary but I can't afford to be off work too much. With respect to activity, when could I go back to swimming?

Thx!
Deal Addict
Oct 6, 2015
1428 posts
758 upvotes
drtse wrote:
Jan 9th, 2019 12:59 pm
So my consultations have been set at TLC, Bochner and NVision over the next few weeks. The duration of each consultation is different across the board: TLC 1.5 hrs, Bochner 1 hr, Nvision ~2 hrs. Is the length of these consultations any sign the quality of service and outcome?
Not that I can personally imagine. The longest part of the pre-op process for me was the cycloplegic refraction, in which the optometrist had to wait half an hour between instillation of the drops, and actually taking the refraction. The drops taking time to fully take effect. The rest was basically just going from various machine to machine for measurements or imaging which took only 5 minutes at best per machine. There may also be a counselling and/or "meet the surgeon" component at some clinics which has to be worked into their overall workflow. Some clinics, like PLEC, only do refractive-surgery specific tests (ie: topography, refraction), and have the rest of the thorough pre-op done by a (proposed) co-managing optometrist, so the clinic consult visit can actually be very short with only minimal testing.
Also regarding post-surgical symptoms of haze, blurriness, pain and overall vision...if I had my surgery on a Thursday, could I be back to work on Monday without too much problem.
With LASIK, "probably" if you were working a daytime indoor office job and don't need to drive at night. With PRK, even SmartSurfACE PRK, depending on your healing rate, Monday could be quite profoundly blurry due to how the epithelium heals and you probably could not work at all. With SmartSurfACE, my worst day was the 3rd day, ie: Wednesday/Thursday after a Monday procedure. Traditional PRK, maybe add a day or two to the initial healing timelines and lower visual acuity of course for the first month comparably.
I am not in front of the computer for my work and just need to have workable mid-range vision as I am meeting with people mostly. I know everyone's results may vary but I can't afford to be off work too much. With respect to activity, when could I go back to swimming?
I think they usually want a month away from swimming for either PRK or LASIK. Just because water is so bacteria-laden.
Newbie
Feb 22, 2018
3 posts
Endeav wrote:
Dec 21st, 2018 12:19 am
I did LASIK at NVISION today, with the SmartPulse upgrade. Procedure was done at 230, everything went as I had expected - I was considering not taking the offered Ativan but did anyways even though I had no jitters or concerns in the morning. Didn't move at all on the table, didn't feel uncomfortable as the speculum went in and suction was achieved, etc. Procedure was probably 10 mins inside the operating room. They checked my flaps with the slit lamp after about 20 minutes and sent me home.

Car ride I kept my eyes closed but I opened here and there to direct my dad how to get home (Asian driver meme!) and could, to my own surprise, see my phone, though it was definitely blurry. Looking outside (with sunglasses on of course) was uncomfortable only because my eyes themselves were sore, not because of light sensitivity. I went home and knocked out for 5 hours.

As I write this now, I see my phone as clearly as I did pre-surgery, and walking around my house I'd say most things are in-focus and clear. To my more pressing concerns, I definitely see Starbursting and halos around small light sources that were not there before - but I'm looking for these halos since they've been my concern since it all started. I would say my night vision right now is functional, and I'm of rather high hope since I'm about 9 hours removed from surgery and the halos are, I'd rate, 'not bad'.

I don't know if it's cause it was the Schwind platform + Smartsurface or all LASIK ends up like this, but it's 12 am, my eyes were lasered around 240 pm, and currently I feel no discomfort in my eyes, not even dryness. I have never felt dry eye before my procedure, so maybe I do have dry eye now and simply don't feel it. In any case, the soreness is completely gone and my eyes feel like they have any other day of my life.

Day 1 followup at 1 pm today, genuinely curious what my CDVA is right now, but I'd ballpark 20/30
Hi I am wondering if you can provide a further update about your eyes? i booked a surgery with Nvision next week. Still feel very scary about the surgery..
How do you feel now?
Newbie
Feb 22, 2007
35 posts
Toronto
pptao1127 wrote:
Jan 9th, 2019 8:07 pm
Hi I am wondering if you can provide a further update about your eyes? i booked a surgery with Nvision next week. Still feel very scary about the surgery..
How do you feel now?
pptao1127...just curious what your prescription is like? Did Nvision present you with various treatment options at all? What was the consultation like? I am going for mine on Jan 29th.
Newbie
Jan 5, 2012
16 posts
4 upvotes
Brampton
pptao1127 wrote:
Jan 9th, 2019 8:07 pm
Hi I am wondering if you can provide a further update about your eyes? i booked a surgery with Nvision next week. Still feel very scary about the surgery..
How do you feel now?
So I had my LASIK done on Dec 20th. I haven't experienced any pain, and the discomfort has been... Barely noticible? If that. With regards to vision, my halos started off pretty bad, since I decided to return to work after a week and my work environment is rather bright (Toronto Pearson security screening, new checkpoint is really bright). After my first day back, halos while getting driven home were such that stoplights were engulfed by the halos and I did not feel safe driving at night. It's gotten slightly better, I went out at night this week and drove, though by the end of the night the halos had gotten bad again, whether due to fatigue or dry eyes I couldn't tell you.

My overall vision is still a bit blurry at long distance, though my myopia was rather high and everything is as I expected it would be so far. I was at -9.0 on both eyes and figured blurriness would remain for a while, we'll see how it goes after my one month checkup.

Again about the procedure itself, if you're still at unease I'd request to talk to Dr. Machat beforehand, and go into this whole thing with realistic expectations.

Oh, forgot I didn't post it on rfd, but my day 1 showed 20/20 on the left eye with 20/30 on the right eye, the day 7 checkup showed 20/20 on my right eye and 20/30 on my left eye, probably because my eyes were in different degrees of dryness. I doubt any enhancement will be necessary, the continual blurriness I have now I'm gonna chalk up to it not yet being even a month since my procedure.
Newbie
Dec 31, 2016
41 posts
6 upvotes
drtse wrote:
Jan 7th, 2019 7:08 pm
So my optometrist contacted Bochner and TLC on my behalf and gave them my prescription details. She said Bochner recommended implantable contact lenses while TLC recommended LASIK.

Anyone personally go the ICL route or know someone else who did it?
I had ICL done at Bochner last year and absolutely no regrets. Still see great 20/20 but as you may have read, halos at night may be an issue but it doesn’t bother me really. I think you get used to it as time goes on. No dry eyes either which is a plus. I could basically see immediately right after the procedure was done but took about a week for the light sensitivity and tiredness to go away.
Last edited by ohfive on Jan 14th, 2019 11:22 am, edited 1 time in total.
Newbie
Feb 22, 2007
35 posts
Toronto
Endeav wrote:
Jan 11th, 2019 4:54 pm
So I had my LASIK done on Dec 20th. I haven't experienced any pain, and the discomfort has been... Barely noticible? If that. With regards to vision, my halos started off pretty bad, since I decided to return to work after a week and my work environment is rather bright (Toronto Pearson security screening, new checkpoint is really bright). After my first day back, halos while getting driven home were such that stoplights were engulfed by the halos and I did not feel safe driving at night. It's gotten slightly better, I went out at night this week and drove, though by the end of the night the halos had gotten bad again, whether due to fatigue or dry eyes I couldn't tell you.

My overall vision is still a bit blurry at long distance, though my myopia was rather high and everything is as I expected it would be so far. I was at -9.0 on both eyes and figured blurriness would remain for a while, we'll see how it goes after my one month checkup.

Again about the procedure itself, if you're still at unease I'd request to talk to Dr. Machat beforehand, and go into this whole thing with realistic expectations.

Oh, forgot I didn't post it on rfd, but my day 1 showed 20/20 on the left eye with 20/30 on the right eye, the day 7 checkup showed 20/20 on my right eye and 20/30 on my left eye, probably because my eyes were in different degrees of dryness. I doubt any enhancement will be necessary, the continual blurriness I have now I'm gonna chalk up to it not yet being even a month since my procedure.
Endeav, do you think you could have gone back to work earlier and worked pretty normally? I'd like to go back to work after 4 days...fortunately I don't have to work with computers.

Also, did you have any significant astigmatism?

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