My Lasik Surgery
(May 16-17, 2007 + updates)
1. "During Op" Comments
(after right eye; before left eye)
As I write this, it is May 17, 2007, at 10:41 AM. Yesterday I had my mildly myopic (near sighted –2.5) right eye "fixed" using Lasik surgery at the University of Pittsburgh Eye and Ear Hospital with Dr. Deepinder Dhaliwal as the physician. Tomorrow my more myopic left eye (near sighted –3.25) will have the procedure. Dr. Dhaliwal does only one eye per person per day.
As is the case with all patients, I was not allowed to use my computer last night, and this morning it was permitted. It is not easy to type; I get tired quickly today but short naps are great. This morning I checked emails for 45 minutes and then had to nap for 2 hours afterwards. In short: I'm giddy with delight about my right eye and have high hopes for my left eye this afternoon!
This Lasik technology is simply amazing. I had my right eye (which is set up as my distance eye) done yesterday and it was amazing to wake up this morning being able to read clearly the digital clock on the cable TV box! This is a goal I have heard from many glasses/contact lens wearers.
At 1:30 today I will have my left eye done (being set up as my reading eye). This arrangement is called "monovision" where they undercorrect one eye deliberately. I have done this with contact lenses for the last 7 years and it is highly effective for being able to read on the spot anywhere without reading glasses. For long stints at the computer, however, I liked wearing asymmetric reading glasses for my contact lenses to put both eyes on the same level to be fully-functional reading eyes.
I'd be happy to describe the procedure to anyone who is interested. My ophthalmologist came highly recommended by a colleague, and now I see why. She was excellent at letting me know exactly what was happening and how long it would continue. She is one of only two at the UPMC eye center who uses the bladeless technology, which has a much better prognosis than the blade technology. I was able to see well immediately after they flipped the flap back solidly on the eye where it belongs--in fact I could see the flap as it moved across my eye! I could see the equipment and the eyedroppers, etc., quite clearly after the flap was returned. I could clearly see the second hand on the clock on the wall in the operating room after I sat up.
This is great and highly creative technology.
2. Post Op Comments
I’m writing this a week after the two eyes were done.
The second eye worked out just about as perfectly as I could ever have imagined.
It struck me as much more uncomfortable the second day (no pain, though). After putting the speculum into my eye (that holds it still for making the flap), they had to reposition my face and/or the machine so that my nose wasn't in the way. They said they didn't want to burn my nose. That seemed to take forever and the pressure was getting a little uncomfortable. Luckily it did end! While on the table, just after the flap was made, I told them that if my nose was smaller afterwards that would be good--I'd give them a bonus. They laughed but no luck--it's the same nose as before!
During the surgery the doctor was just as encouraging as before and told me that everything was "perfect!" The flap was perfect, the burn was perfect, etc.
Amazing that my ophthalmologist got it so precisely as I requested. With my right eye, I read all lines to the bottom of the chart (20/15) and wanted to see if I could go lower but they didn't have any lower in that examining room! They said the best vision ever recorded was 20/8 and I asked them only half-jokingly to "bring it on!"
With my left eye, I was actually recorded as 20/15 but the line for 20/15 was difficult. It took several blinks to get through it and a few "Cs" looked like "Os" and vice versa. The slight nearsighted condition was designed NOT to be as easy to read as it ended up being.
My eyes were -3.25 and -2.5 before surgery. And as designed, the left eye is a little fuzzy for distance but I see the computer screen as razor sharp. And my right eye is now razor sharp for distance and fuzzy close up. Therefore, my left eye reads and my right eye watches TV. That's what happens when you get old--you can't have everything!
I requested -1 in my left eye and during my post-operative checkup it was measured as exactly -1.0! Right eye is 0.0, which gives me incredible vision. This is similar to what I had with my contact lenses, but I'm guessing I had closer to -1.25 in my left eye with my contacts. I think -1.0 is perfect for my computer screen. In case you are considering monovision (with Lasik or even contact lenses), you might want -1 for a computer screen (and car gauges) 28-29 inches away and -1.25 or -1.5 for paper that is only 20 inches away.
The Eye and Ear practice has a 4-page list of things that could go wrong, requiring plenty of initials and signatures, and many of them talk about permanent problems that the surgery could cause. There are web sites that talk about many problems that could occur, such as halos, double-vision, puffy eyes, etc. One person, our former acting dean, who did this previously said "it will be great." Unfortunately, the 4-page list did not include any encouragement such as that. I swallowed hard and signed and initialed where required.
The one thing that almost stopped me was an opinion I saw on line that LASIK would not give you vision that is as crisp as contact lenses (but better than glasses). They also said that the quality of vision is not just the numbers 20/20, 20/15, etc, but the look as well. A person could have 20/15 vision but terrible halos and/or double vision. It just means that you can make out the letters on the eye chart. The technicians told me that I would emerge from this with High Definition vision but I dismissed it, thinking to myself that they did not know how wonderful my contacts were, albeit briefly, when they were clean.
I do have a few slight halos at night, which are disappearing. But driving at night is not a problem at all. I barely realize that I have the halos. I have to stop and stare at bright lights to be able to see any halos at all, and every day they get more and more faint. Also, some red spots on the whites of my eyes from the speculum are also disappearing.
So in spite of the expectation for vision only better than glasses but not as good as contacts, I decided to go ahead because my vision with contacts started as outstanding when the lenses were clean, but after about 20 minutes, the contacts began to collect protein deposits and my vision got less and less sharp as the hours went on. I decided to go ahead, assuming that my vision would be better OVERALL--perhaps not as good as the first 20 minutes with contacts, but better than the other several hours before I had to clean them.
Well, my experience after 2 weeks is that my vision is FAR BETTER than it ever was. I have perfectly crisp vision from morning to evening, every minute of every day. It is truly exhilarating.
I'm still giddy with excitement and it's been 14 days now! In general my eyes feel a little dry but not too bad. It's not particularly good to be in front of a fan or vent, but that's improving day by day. The wind in my eyes from walking down the hall is no longer bothering me. But yesterday was terrible--I was in a meeting with a few doctoral students and at the same instant two of us got particles of some kind of dust in our eyes. It took a few vials of non-prescription comfort drops to flush it out. I think our old ventilation system is still breaking down and burping out particles of deteriorated rubber into the air. Today, in contrast, my eyes are much better.
The doctor took me off of steroid drops and anti-infection drops after the first week, as scheduled. Seems like the eyes passed the toughest test. And I have heard that problems with regression (losing some of the correction), rare for my modest correction, occur during the first two weeks. But everything still seems extremely crisp with my distance eye and I'm typing this without reading glasses and too lazy to root around in my computer bag for my monovision reading glasses, which make it even more comfortable for reading the screen all day and for seeing very small print on menus in a dark restaurant.
So I am down to one set of drops morning and evening for my standard prescription for dry eye syndrome and over-the-counter comfort drops when needed (in an area with bad HVAC like the office). Looking forward to being rid of both of them eventually.
As I told the doctor, my two biggest fears are (1) rubbing my eyes (which is now less of a problem but still dangerous), and (2) taking this wonderful vision for granted.
If you or any friends are considering this surgery, you have my encouragement. I'm happy to talk with you or them about it. For those of you in Pittsburgh, I highly recommend Dr. Dhaliwal. I can't remember any better place I put a couple of thousand (per eye) in the past. The outcome is as good as one of 5-6 different types of life events that I cherish. For example, the newly found vision is better than getting an article accepted in a top journal, but perhaps not as good as tenure (but darned close).
Update September 25, 2007
Well, now it’s 4 months post-op and I’m doing what I didn’t want: I’m taking my fabulous vision for granted. It is truly wonderful to live with great vision. I just had my 4-month appointment and I actually measured 20/15 (better than 20/20) in BOTH eyes. This prompted me to request an exam (while I’ll do on my next visit) to see if my right eye is better than 20/15, which I’m betting it is. It is so darned sharp and clear while the left eye, meant for reading, is intentionally a little bit blurry.
Now we’re trying to see when I can stop with eyedrops that I now take once a day. I had pretty moderate dry eye before and it seems to be much improved now. I go back in 2 months to see if I can discontinue the drops. Thank heaven Dr. Dhaliwal removed my punctal plug in my left eye—I was never a fan of that plug.
As I talk to people about this, I’m so surprised that so many are a little squeamish about the surgery. Lots of worry about nothing, as long as your Doctor is very careful and deliberate. Dr. Dhaliwal is the best and I’d recommend her in a heartbeat.
3. Update November 29, 2007
Now it’s 6 months post op. I just had a checkup for my previous dry eye syndrome problem. It appears as if everything is just fine! So that dry eye problem, too, can pass! I do not need any more drops or medicines for that problem, and I have my non-prescription comfort drops in case I’m in a really dry situation or something.
I requested an acuity exam because I easily beat the 20/15 exam (see above). They tested me on the 20/10 scale and I got most of the letters right! I did miss a couple, so the technician said I have "20/10 minus" vision in my right eye. That’s pretty fantastic!
So I’m still taking my great vision for granted, unfortunately. It’s disgusting that I don’t give thanks for this miracle every hour of every day! But when there is a clear day in Pittsburgh, and you can see crisp visions of rolling hills very far away, the appreciation and awe definitely return!
So I highly recommend, for over 40 people doing computer work, -1 in your non-dominant eye and custom Lasik in your dominant eye. That is, as long as your computer is about 28 inches away. [2016 Note: 28? My computer is more like 24 inches and my left eye doesn’t strain until it’s closer than 18 inches away. If your laptop is closer than 20 inches, you’re slouching!] Better yet, test it with inexpensive readers first and choose the correction for your reading eye that you are most comfortable with.
4. Update August 6, 2008
Now it’s a year and three months post op. My current state? Fantastic. Wonderful! No regrets. I can still see perfectly! I still seldom need reading glasses and life still appears very sharp and clear. I do need over-the-counter drops once every couple of months when my eyes feel dry. It is probably not needed but it feels good once in a while. I am thoroughly taking this for granted; shame on me. A colleague had the procedure in upstate New York from a doctor who charged much less than mine but she had some initial problems and could not talk to the doctor. She was only able to talk to technicians (who gave her conflicting information). She says it is better now, but I say beware of the very inexpensive places that cut costs by cutting doctor time.
5. Update November 6, 2009
Now 18 months post op. See above. I never think about it, except that rubbing my eyes is not satisfying like it used to be when I had contact lenses. I hardly ever have to rub my eyes, so that is fine with me! It’s a great trade-off. My vision still seems to be fantastic and success is probably measured by my taking it all for granted. It’s too bad I take it for granted; what a miracle that I should praise every day!
6. Update May 21, 2011; Apr 1, 2012
The years pass quickly. I posted this 4 years post op and posted my subtle “ditto” 5 years post-op. My only problem: I don’t know why everyone doesn’t do it! It is one of my favorite topics of conversation yet I get to talk about it only infrequently. Email me with any questions!
I still have exactly the vision I asked for. Perfect for a presbyopic middle-ager. Wow, no glasses and no reading glasses!
7. Update August 25, 2013
Still wonderful at 6 years and 3 months, and counting. Becoming 60 years old in a couple of weeks. My left eye is happily reading away and my right eye is still peering into the distance with excellent resolution. I use my customized reading glasses only once every few months when my eyes feel lazy. It does make it more relaxing to equalize the eyes and let them both do the work. The left one is 1 diopter weaker than the right one. So with the reading glasses, mine are something like +2.5 on the right and +1.5 on the left. I don’t remember precisely because I got them about 5 years ago and only use them 5-6 times a year. Without the reading glasses, they are still likely to be +0 on the right and +1 on the left as designed, perfectly compatible with reading. I’ve read a dozen novels, in the small paperback format, in the past three months without reading glasses. I haven’t used drops in four or five years, and gently rubbing my eyes feels good again. Life is grand!
8. Updates October 7, 2014; July 22, 2015; April 8, 2016; Oct 4, 2016
Sorry, this is probably getting boring to read. Everything is still great at nearly 10 years, and counting. My left eye is happily reading away and my right eye is still peering into the distance with excellent resolution. Still not using eye drops; never need them. The reading glasses are still very infrequently used, but make me relax more while at the computer. Also, when there is harsh light or glare nearby the reading glasses help. I can work longer without getting as tired. When both eyes share the work, it allows the left (reading) one to work half as hard. I should remind myself to use them more often. But the screen is so clear even without them!
9. Update October 2016:
So I’m testing limits of this fabulous vision: I do find that tiny lettering is hard to read but I never have trouble with menus, even in slightly dim restaurants. To calibrate, I can barely make out the black-on-silver printing on an Energizer AAA battery. I can easily read the white on black printing on the right side, however. On a Duracell AAA battery, I can read most of the smallest words if I work hard. I managed to read (with one error) “Do not compact improperly or charge or dispose of in fire.” But my 10-power jeweler’s loupe reveals that the word “compact” is actually supposed to be “connect.” Not bad for a 63-year old without reading glasses!