It has already been two months since my laser vision correction, and so much information was found and read before it that I decided to systematize it a little and supplement it with my own experience. Especially since this experience is double in our family because two years ago my wife had laser vision correction. Although I knew about the entire procedure firsthand, the idea of laser eye surgery still evokes fear and distrust, which can only be overcome by learning the smallest details. I hope that my experience and collected information will help those who are thinking about laser vision correction to decide. But I will note, and this is important, that I am not a doctor, and my own experience is described here, which in no way replaces your medical advice.
What is laser vision correction and to whom is it recommended?
The name of the procedure, of course, reveals the basis of its essence, but in more detail, laser vision correction is derived from changing the shape of the cornea of the eye. It is the cornea that can be treated with a laser and not its outer protective layer, but the middle one (stroma). How the doctor “gets” to it depends on the method of surgery, which I will talk about later.
Doctors may recommend laser vision correction in the case of short-sightedness (myopia) when you see well up close, but not far away; or congenital farsightedness (hypermetropia), when, on the contrary, you can see far, but not up close; and also with astigmatism.
In general, laser correction can be recommended between the ages of 18 and 45. “Recommend” is a very important word here, because if there is no direct medical need, then laser vision correction is not a mandatory procedure. After the examination, the doctor should not impose it, because it is also possible to improve vision in the case of shortsightedness or farsightedness with the help of glasses or lenses. Therefore, a patient chooses what is more comfortable for them.
For myself, I realized that after more than 10 years of wearing glasses, I got tired of them, the frames break, the lenses get scratched, it’s uncomfortable to do sports, and much more. The wife’s positive experience showed that glasses can be abandoned. At least until the time when age-related farsightedness begins to develop. There is a misconception that if you have short-sightedness, then at an older age your vision will level off due to the natural development of farsightedness. But in fact, you will need to have two pairs of glasses – one for seeing far, and the other for reading. This became an additional argument for me.
What methods of laser vision correction exist?
I mentioned above that laser correction is a change in the shape of the cornea of the eye, which is currently done by three main methods.
The oldest of these are PRK, LASEK, or TransPRK. It involves the removal of the upper protective layer of the cornea with special solutions or a laser and subsequent laser correction of the shape of the cornea. Due to the need to restore the protective layer of the cornea, special contact lenses are put on the patient’s eyes immediately after the surgery, which will have to be worn for several days. This method is considered more difficult, because it has the longest recovery period, and vision improves within a month. You can visually see how laser correction and post-operative recovery using this method takes place, thanks to the excellent video of journalist Michelle Yang from Insider Tech, who shared her experience.
The most popular method is LASIK. It can also take other forms such as Femto LASIK and many marketing names. However, its essence boils down to the fact that the surgeon uses a laser or a special tool (microkeratome) to make an incision in the upper layer of the cornea, forming a so-called “flap”, then bends it back, and then the laser corrects the shape of the cornea.
After this procedure, the “flap” is put in place and begins to heal, however, the nerve endings are not completely restored. With a severe eye injury, the “flap” may shift, so this method is not recommended for professional athletes who play contact sports. Otherwise, it is quite effective, because it has a relatively short recovery period. A few hours after the operation, a person begins to see well, and unpleasant sensations in the eyes disappear in one or several days. After 7 days you can return to work, and after a month lead the same lifestyle as before the surgery.
The newest method is SMILE. It is the least invasive and involves changing the shape of the cornea with a laser without creating a “flap”. Basically, the laser burns out the desired layer of the cornea, and the remaining refractive lenticule is extracted from it with a special tool through a microscopic incision.
Given less intervention in the eye, the recovery period is even shorter. However, since the method is new, it is rarely practiced and is the most expensive. In addition, SMILE, unlike LASIK, is not yet repeated in case of any unforeseen problems.
Which method of laser correction is better?
In my opinion, the answer to this question is very simple, because you do not have to choose a method. You should choose a clinic to which you are ready to trust your eyes, and a professional doctor will choose the method that best suits your case, describing all the advantages and disadvantages. For example, LASEK is still used because it can work for people with thin corneas. That is, you should not focus only on the fact that some method is newer or more popular.
What do you need to know before the surgery?
If you have already decided to do laser correction, have chosen a clinic and maybe even had time to read reviews on the Internet, you most likely have even more questions than before. At least, recalling my “research” on this topic, I can say that this is exactly what happened to me. In fact, all the main answers about laser correction can be obtained from a doctor at a consultation, but for this, you need to understand what to ask. Therefore, in this section, I have collected the answers that I was looking for before the surgery.
I will immediately note that before the laser correction itself, you need to undergo a medical examination. The clinic where the operation takes place conducts a detailed eye examination that lasts approximately 2 hours. It is always done before the operation, so even if you decide to go through it on one day and have the operation done on another day, you will most likely go through the examination twice. For myself, I decided not to lose time, so I immediately made an appointment for an examination and laser vision correction in one day.
It is important to know that only the eyes will be examined in the clinic, so if you haven’t had a general medical examination in a long time and you can’t say for sure if you have or don’t have chronic diseases, then it’s worth doing. After all, the success of laser correction may depend on this.
Before the surgery itself, you will be asked not to wear contact lenses for a week if you use them, and a day before the procedure and on the day of its performance, not to drink alcohol and not to apply cosmetics, creams, and, in general, any chemicals that can get into the eyes.
After laser correction, you will definitely need to wear sunglasses, so you should take them with you immediately. They are needed both because your eyes will be very sensitive to light in the first hours after surgery, and to protect against large particles of dust and sand. In the future, sunglasses will need to be worn for 7 days every time you go outside.
Probably the most common question, which is primarily of interest to people who plan to undergo laser correction, is Is it possible to lose vision during the surgery?
Data from US Food and Drug Administration (FDA), which at one time approved laser vision correction surgeries, as well as data from the British National Health Service (NHS) indicate that there has not been a single case of a patient losing sight during such an operation.
However, here it is worth returning to the issue of medical examination because people can also lose their vision due to concomitant diseases. For example, a person goes to do laser correction and does not know that they have the initial stage of diabetes or an oncological disease. In this case, the results of laser correction will be unpredictable.
After the examination and before the laser correction, the doctor in the clinic must provide the patient with comprehensive information about possible side reactions, in my case, it was an A4 sheet on which the probability of various postoperative problems was written. Most of them were solved either by repeated surgery or by additional treatment. There is also no risk of going blind during the surgery in the description of side effects.
Another popular question about laser correction is about the halo from artificial light sources at night, how strong will it be and will it interfere? But to begin with, it is worth understanding what this effect is and why it appears. To put it simply, the laser ablation of the corneal stroma leaves micro scars that affect how a person sees the radiation of light sources at night after laser correction. For example, when a person looks at street lights. The light around them can have a small halo, or it can diverge in different directions. The effect’s intensity can vary for different people.
A rough illustration of how the same light source can be seen at night after laser correction:
This is generally very individual and can be either not noticeable at all, or cause discomfort, especially when driving at night when cars with headlights on are coming in your direction. In the case of a strong halo after laser correction, it can be corrected by repeated surgery, of course, at the expense of the clinic.
In my case, I did not see street lights at night or car headlights much differently than it was in glasses. However, you should be prepared that such a feature may manifest itself.
Dry eye syndrome is also a fairly common side effect of laser vision correction. When the eyes are not hydrated enough, they can burn, have irritation and even feel like there’s a foreign body in them. Basically, with sufficient water consumption per day, healthy sleep and the use of moisturizing drops, dry eye syndrome passes after some time after surgery. However, it may be that you will have to use the drops almost constantly.
I was diagnosed with dry eye syndrome even before the operation, so I did not even consider this possible “side effect”. But in general, it allowed me to look at eye health differently. I really used to spend a lot of time in front of a computer screen, and I always had dry and red eyes. So now I try to take breaks, get more sleep, and use eye drops.
All in all, these are the questions I was most interested in before laser correction, and I hope you find the answers to them useful.
The surgery process
Preparation for laser vision correction takes much longer than the surgery itself. After an almost two-hour examination, you will be asked to go to the operating room, where you will have to wait for some time until everything is ready. Before this, the doctor will offer sedation, it is not mandatory and is done for an additional fee. It can be useful for those who are very worried and understand that they will not be able to calmly go through the entire procedure.
I decided to do without sedation, I was most worried before the examination, but when I signed the consent for the surgery, I understood that there was no point in worrying anymore and that I just needed to relax and trust the surgeon. Everyone who was with me in the operating room also did not use this option, so it is possible to do without it.
After you are invited to the operating room, you put your smartphone, watch, glasses, and generally those things that can interfere in the locker, and then the waiting begins. It is worth noting that the operating room in large and popular vision clinics is a conveyor belt, people go one after the other. Therefore, you will have to wait for some time, and you may also be asked to look at a bright light during this time to narrow the pupils because they are dilated with special drops during the pre-operative examination.
When it’s your turn, the staff invites you into the pre-op room, where the nurse does another quick look at your eyes and injects a topical anesthetic into them, after which you go into the operating room itself and lie down on the couch next to the laser machine. Before starting the procedure, the surgeon fixes the eyes first. You can’t see yourself, but I think from the outside it looks something like a scene from Stanley Kubrick’s A Clockwork Orange.
Fixation of the eyes is the most painful part of the whole surgery, especially for people whose eyes are deeply “planted”. However, this is not very difficult to endure.
After successful fixation, the surgery itself begins, let me remind you that it was performed with the LASIK method, so the surgeon used a microkeratome – a mechanical tool that is placed on the eye and makes an incision, you feel its weight and coldness, but there are no painful sensations. This is not done on both eyes at the same time, first, the surgeon deals with the left eye, then moves to the right.
The entire surgery, depending on the time it takes for the laser to change the shape of your cornea, takes literally 5-10 minutes. I spent probably 4-5 minutes on the operating table. Everything is really fast.
First, an incision is made on the left eye, and the “flap” is bent, at this time you begin to see very blurry. This is one of the unpleasant moments. Then you are asked to look at the light and not take your eyes off it. Interestingly, you do not see the laser itself but look at the LEDs. Next, the surgeon washes the eye and closes the flap, and the procedure is repeated on the right eye.
Immediately after that, you walk out of the operating room on your own, your vision is still very blurry, but you can make out objects. You will also be immediately asked to wear sunglasses to protect your eyes from dust and light.
The first postoperative examination takes place immediately after leaving the operating room, another surgeon checks whether the laser correction was successful and gives recommendations. To begin with, getting home by taxi or having someone drive you, as you cannot get behind the wheel and it is not recommended to use public transport. If you live nearby and the weather permits, the doctor says you can even go for a walk.
Antibiotic drips are also prescribed, an appointment is made for a repeat examination in a week and you are sent home. You can be on sick leave for the first week, it’s better not to actively do sports for a month, and you can’t let water or other chemicals get into your eyes. But the most important thing is not to rub them in any case, so as not to displace the “flap”.
The recovery process
On the first evening after laser correction, you feel “sand in your eyes”, it hurts to look at the light and you just want to lie down with your eyes closed. However, everything here is individual, some people tolerate these first hours after the surgery more easily, others worse.
I had almost no pain, only a slight discomfort in the eyes, which significantly decreased in a few hours. And in the evening, I could look out the window and look at the neighboring houses, and read store signs and advertising boards, this is probably the most emotional moment. Because you realize that you see better and more clearly than you could see with glasses. In general, in the first days after laser correction, you don’t want to leave the window.
On the first evening after laser correction, I could watch TV and sat down to work a little on the computer the very next day. There are no visual restrictions after the surgery, the only thing, of course, is to follow common sense and not stay up all night playing games. However, it is unlikely that it will be possible because in the first days vision adapts, and the eyes get tired faster because the visual muscles begin to work in a completely different way. This process can take up to 6 months.
According to the doctor’s recommendations, I dripped an antibiotic (which is also an anesthetic) every three hours. I can’t say that my recovery process went very smoothly. After all, if everything was fine with the left eye right away, on the third day I started to see worse in the right one, the image doubled, and the eye became more tired. As the doctor later said, I had swelling in my eye due to a reaction to the antibiotic. When I stopped using it, the swelling began to go down, and in two weeks I could see in my right eye as well as in my left. At this time, I was prescribed only a moisturizing gel for the night and drops.
When faced with such seemingly small problems after laser correction, it still leads to the fact that the brain turns on panic mode and begins an emotional swing from “everything will be OK” to “you probably have to get used to the fact that it will always be like this.” But here you have to stick to the logic that although all clinics advertise quick postoperative recovery, in reality, it lasts much longer. Therefore, when the doctor says that in a month you will be able to do everything the same as before the surgery, then you should focus on this period.
In general, I would like to note that the doctor’s recommendations after laser correction are not complicated, you will not need outside help to follow them. You can go outside the next day, but for the first week, you must wear sunglasses, even if it is cloudy and raining outside. Likewise, you can start working at the computer little by little the next day or the day after the laser correction, if everything went well. So the surgery itself does not really isolate you for a long time and does not require any complex rehabilitation.
Is laser vision correction worth it?
Of course, there is no unequivocal answer to this question. Because, as in the case of any surgery, especially an optional one, you need to weigh all the pros and cons. People who have successfully done laser correction will tell you that it was the best decision in their life and they only regret that they did not do it earlier. Well, those who have faced problems, of course, will say the opposite, because any, even the smallest side reaction on the eyes is very unpleasant. Therefore, it is worth starting with the facts. In the title of the article, I wrote that science should work for you. And if you have a suitable age, have no serious concomitant diseases, have a sufficient thickness of the cornea, and no allergies to medical drugs, then in the case of laser vision correction, science can effectively solve your vision problem. At least that’s what I thought when I made the decision for myself. I hope this material will help you decide on this issue. In any case, reading reviews and articles on the Internet is not a substitute for a visit to the doctor, so if you are seriously considering laser correction, contact professionals.