Laser eye surgery

[J]

Off topic I know, but it does have some relevance to survivalism. In a post apocalyptic world, a minor problem such as short sight could become a life threatening one, since glasses might not be readily available. Therefor, a cure would be most useful from this point of view. I'm not too worried about this though; some of my main reasons are that they are useless in the rain, of which there is a considerable amount in Britain, are easily knocked off in large crowds (concerts etc), and if I lost them whilst snowboarding, I'd be fucked.

Does anybody have personal experience of laser treatment? It has been in the news here in the UK recently, apparently some of the companies offering the surgery have not been informing patients of the risks. I've read the literature of one of the major high street chains (Boots), and it would appear to be 100% risk free according to them.

I am considering having LASEK surgery. It is a slightly more up to date version of PRK, which has been around for 10+ years, and is safer than LASIK, the latest 'instant fix' solution. Basicly, an Excimer laser is used to re-shape the cornea by removing tissue, and the eye is allowed to heal. It's a simple technique, and involves no cutting of the cornea, only the top layer of cells (which re-grow naturally) are cut by the surgeon. This is as opposed to LASIK, in which the cornea itself is cut to produce a flap. This introduces a new set of potential complications.

My main concern is night vision problems. There seems to be a distinct lack of information available about the true percentage of people who have these problems after surgery. The internet has many accounts of people who have had surgery gone wrong, but little independant research. Since it is claimed that 1000,000+ people have it done every year around the world, this is surprising to me.

Anyway, for those of you who are interested, the only really useful scientific website I have found is here:

<a href="http://www.northerneye.co.uk" target="_blank">http://www.northerneye.co.uk</a>

The author is an opthalmologist who carries out these procedures, so obviously he can't be completely unbiased. But he does appear to be honest about the risks, and gives some useful information backed up with references.

If anyone has any information, in particular copies/links to scientific studies, please post here or contact me by email if you wish (tehjuice2000@hotmail.com). Remove the obvious dyslexic spelling mistake to reply, I'm paranoid about spam bots that spider boards such as this one.

There was a report published by the Which? consumer group recently, but I'll be damned if I can find a copy. If anyone has this and could scan it in, I'd be most grateful!

[Stoic]

My father is due to go for an apointment to have Corrective Laser Eye Surgery and at a few grand per eye, he too has worries about the % rate of it being sucessful.

I'll let you know how it went for him after his appointment.

[10fingers]

Apparently the success rate is pretty high for laser eye correction. The thought of someone shooting a laser into my eye makes me a little nervous though. If something went wrong there may be no way to fix it.

[shooter3]

They give you a Valium. Put eye drops in your eyes. Then they put a thing around your eye to keep it open(the only part that hurts, and not much). Next they put the keritome on your eye to slice off a thin layer(You can see it buzzing across you eye).

The actual laser cut takes about 4 seconds, you get to smell burning eyeball. He puts the flap back on and your out of there.

You wear an eye shield to bed for 5 days, so you don't wreck it.

You will see better immediately, but the best vision won't show up for about two months.

If it isn't 20/20 they will do it again(no charge).

One time in 800 there is a problem(What happened to me). The first time my left eye was over shot. This made nessesary a reversal. Which put in an astigmatism. The third try gave a smooth cornea, but for some unexplained reason the vision still has a problem. It really sucks, but it's still better than glasses and I'd do it again tomorrow.(Accually they are waiting for FDA approval of a new machine that can correct it, but I must wait 6 months to a year).

After the second treatment I was seeing 20/15 even with the astigmatism. The bottom line is; If your eyes are real bad(can't function without glasses) and they are stable(Your at least 25 years[sometimes eyes have a big change between 18-25yo] old and the prescription hasn't changed much for a year or two) then I wouldn't wait for a second. I'd have it done.

Word of caution; My friends had it done for $2500.00 per eye. They got screwed. The average price in the US(excluding New England) is $800.00 per eye. I paid a total of $1500.00 for both eyes.

If it's costs more than $2000.00 in england it might pay to come over here to have it done. I heard Canada does it pretty cheap also. Don't worry about night vision. You do get a star burst around your eyes(It's pretty cool), but it goes away after about 2 months.

Do it!

PS. Just looked at your link. I had Lasik. I would bet the machine I'm waiting for is the Lasek.

<small>[ February 22, 2003, 12:07 PM: Message edited by: shooter3 ]</small>

[J]

Stoic, cheers, I'd appreciate it. Good luck to your father :)

Shooter3, sorry to hear about your problems with it :( Is your vision fairly clear as well as in focus? And it's interesting that the star bursts went away after a couple of months, that's another thing I want to find out about. I could put up with almost anything so long as it's only temporary. I currently get minor star bursts with my glasses, but only because they're covered in scratches. They don't bother me in the least, in fact I've only just started thinking about them from doing this research.

Strange that in the US you have to be 25+ years old, here in the UK it's over 20 and stable sight for two years. I'm just coming up to 21, and my sight's been stable for at least 3 years. In the UK, the prices range from £495 per eye for PRK/LASEK and £750 per eye for LASIK, right up to £1250 per eye for LASIK at Boots for some reason.

From what I gather, by far the most important thing is the skill of the surgeon. There is no license required to do the procedure in the UK, so in theory, a GP could legally do it! That's very worrying, and if I do go ahead I will be checking the surgeon's credentials and past experience of doing the procedure. If he's done less than 1000 people, I'll find someone else.

LASEK is safer than LASIK because there is less to go wrong. It is also less dependant on the skill of the surgeon; operating a microkeratome requires a lot of skill and it can easily go wrong if the surgeon's inexperienced. It was actually developed in the UK and Italy, so it might not be available in the US yet.

[shooter3]

J. That 25yo thing was just my opinion. I think 20 yo and stable for 3 years is good enough. If you were going to get a big change it would have started by now.

Apparently the starburst is caused by cloudiness during the healing process.

Acording to my DR. complications are mostly due to other medical reasons. With Diabetis for example, the cloudiness doesn't always go away.

In choosing the opperator you are right to pick someone with at least 1000 ops under his belt.

Good luck. (Although it's mostly skill).

[Arkangel]

J, my mate Gary had one of these ops a couple of years ago. He's (was) in the medical profession, so should be able to give you some pointers. I'll make sure he contacts you about it.

I had a Radial Keratotomy 13 and 11 years ago. (Left eye 1st), and it has been fantastic. I had the most severe op they could perform with that technique, but have not had ANY side effects, not even the starburst at night. As I've mentioned elsewhere, it is mainly down (as Shooter says) to the skill of the surgeon.

[J]

I've been doing some more digging, and found the following sites:

<a href="http://www.eyeworld.org/contents.html" target="_blank">http://www.eyeworld.org/contents.html</a>
<a href="http://www.bsrs2000.fsnet.co.uk/new_page_6.htm" target="_blank">http://www.bsrs2000.fsnet.co.uk/new_page_6.htm</a>
<a href="http://www.surgicaleyes.org/" target="_blank">http://www.surgicaleyes.org/</a>

All of these have references to scientific studies. The first one in particular has already answered some of my questions using the search engine to dig up articles, and the surgicaleyes site is a huge forum, mostly full of people who have had problems. Not a good place for positive stories, but I'm not looking for those at the moment, just info on complications. There are quite a few doctors/surgeons who post there, which is extremely useful. Also, many of the people there seem to be digging up all kinds of research.

Arkangel, cheers, that'd be great. Having the RK must have been a big decision, but it sounds like it was well worth it for you.

Edit: just found the Which report:

<a href="http://www.lasik-eyes.co.uk/pdf/healthwhich.pdf" target="_blank">http://www.lasik-eyes.co.uk/pdf/healthwhich.pdf</a>

<small>[ February 23, 2003, 07:55 AM: Message edited by: J ]</small>

[Ezekiel Kane]

On a side note, laser surgery brought the eyesight of a friend of mine from (if i remember) 20/100 to 20/10. And they give you the *ahem* appropriate medication.

[ssblood88]

Some bad things can happen when getting eye surgery... I have heard of people losing all depth perception permanetly over it:(

[stickfigure]

My Mom got Lasik about a year ago, she had to go back a couple of months ago to get it done again (for free). She has had Coke Bottle Glasses since she was 6 know she only wears reading glasses, which is due to age. I have to get PRK as I am in the Air Force and at a high altitude the incision can reopen due to pressure. I spoke with my Optomitrist and he recommends Lasik to people with really strong perscriptions and PRK to people with lighter ones. PRK can be more painful with a longer recovery time, with Lasik you can see a few hours later and the next day. But everyone I have known to get it is really happy, a lot of people go to Canada where it is cheaper and the Doctors have more experience. I hope I was helpful, Good Luck!

[Tuatara]

My sister is an optometrist. Her opinion is that the technique is too new, and there is not enough info on the longterm effects of laser surgery. She's told me that the cornea of a 25 yr old, after laser treatment, looks like that of a seventy yr old. There may be issues later in life with cataract formation. Remember that this technology has only seen widespread use in the last 10 years. (pun not intended :D )

[nbk2000]

I've heard of an average 1% failure rate. Failure being defined as anything between no correction and total blindness. <img border="0" title="" alt="[Eek!]" src="eek.gif" />

Considering how even low powered laser pointers have all these warning labels on them about loss of sight hazards and all...the thought of having a laser powerful enough to vaporize tissue aimed DIRECTLY into my eyes...uh uh...NO!

Maybe if it has been around for 50 years, and it's a one in a million chance of a fuck up, but one in a hundred with the only two eyes you'll ever have? And with no artificial replacements if they are damaged? Not worth it.

RTPB Plan for failure.

Just 'cause the surgeon has been previously successful doesn't mean he'll be sober and focused the day he does YOUR eyes.

Even if it works fine now, there's no telling what the long term effects will be 20 or 30 years down the line. You'd feel rather put out if everyone who had LASIK 10 years ago started going blind next year...just a few months after you had yours! :p

Depending on the type of eye defect, you may be better off with corneal rings, which can correct near-sightedness, and is totally reversible, with no side-effects or long term consequences.

If you DO decide to go with laser, don't fuck around with some strip-mall (or high street, whatever) shoppe. Go cutting edge! Get refractive laser tomography eye correction. They bounce a LIDAR pulse through your cornea off the back of your eyeball. A computer uses interferometry to calculate all the variances in the geometry of your eye, then laser shapes the cornea to correct for all abberations.

For some people, the results are amazing. They've gone from 20/400 to 20/5! That's the same visual acuity as a hawk! You'd have to go to sweden (or switerland) to get it done.

At the very least, find someone who's not only done a lot of people (any quack can do that), but also does ONLY that. And a specialist who's certified by a governmental agency or something. If any idiot who can buy the machine, and take a weekend course can do it, it's not something you want done to you.

[Arkangel]

Before I had my surgical Radial Keratotomy, one of the questions I had was what experience we had of the long term effects. Although I believe the Russians were the most progressive with this for many years, I was told that the original op was done quite crudely after the war in Japan. Apparently there were few reported long term complications, and that gave me some comfort. BUT, if you're shortsighted, the benefit of this op working is huge, life changing. (in the same way that a failure would be - hence you should have the op done a year apart for each eye)

Also, if you're a contact lens wearer, you're already damaging your eyes using them, so having an op is probably a neutral trade-off of risk.

[Tuatara]

The reason all those laser pointers have warnings is the wavelength used (oh, and arse covering too :D ). Visible light penetrates the eye really well (well, duh!). Other wavelengths may be stoped at the cornea, so retinal damage isn't a problem. When I was building laser based military training systems we had all sorts of issues with eye safety - because we were using 900nm. If we had used 1300nm most of those troubles would have simply gone away, as 1300nm doesn't penetrate the cornea (much). The surgical lasers are usually excimers, running deep UV, so I guess that most of the energy is absorbed at the surface. If I was designing such a device I'd also make sure the beam was on a very short focus, so that any energy that did pass through would be highly divergent.

[J]

Fuck it, I've decided to get contact lenses. I've had one appointment where I almost managed to put one in, but I just keep blinking it out before it settles. I guess it's a matter of practice. I might buy some off the net and practice at home, I figure taking them out will be a lot easier and not much can go wrong so long as I clean the lens and don't practice for longer than 15 mins a day.

After many hours of research, I've decided refractive surgery
is too risky for me. I think there's too much emphasis on making money within the industry, and not enough on research into why problems occur. Maybe in 10 years time I'll have another look.

NBK has brought up a very interesting point though: it is possible to have things called 'Intacs', which are imlants that reshape the cornea and can be removed at any time. I would be suitable for one eye, but the other eye is just outside the maximum current prescription treatable (-3). This is something I may well look into in a few years time. It's currently only available in the US anyway I think.

[Spudkilla]

What you should do to get yo contact to stay in, is put it in your eye, roll your eye around a bit, then relase your bottom lid. Wait a couple of seconds, then let your top lid go. Blink a couple of times. This works for me. Once you get the hang of it, its not that hard. When I first got my lenses, I thought it was hard to get them out, because I would always miss it and stuff.

<small>[ April 07, 2003, 08:53 PM: Message edited by: Spudkilla ]</small>

[Jumala]

Hallo J,
I heared about a new method today.
No laser no cutting but contact lenses weared at night.
They form your eyes own lense so that you can see normal the next day.
You need no glasses or contact lenses over the day.

[Stoic]

J, sorry for the late reply.

My father has successfully had his laser eye surgery operation, and it his vision is now 20/20.

He said for about half an hour after the operation everything was a little blurry. But after that, he could see very clear.

He had to wear eye patches on his eyes to bed for a week after the operation to stop him scratching them or catching them in the night while asleep. - A small trade off for perfect vision.

The total cost for him was £1,999. And had to stay over night, but with the price. The company put's you in up in a 4star hotel.

He had to go back a week after the operation to just have a check up, and to see that everything had healed correctly.

Also after the operation he had a mass of eye drop's to put in 4 times a day. Just to keep the eye free of dirt and whatnot.

Any more questions you have, feel free to ask and I will try to answer them as best I can.

[chochu3]

I would think laser surgery is safe, as I am aware of The U.S. Air force will pay for laser surgery if want to be a fly a jet and have a degree and a do not have 20/20 vision. According to this it must be safe otherwise they could be sued.

[McCarthyite]

I'm giving some thought into other less invasive methods. The Bates method has been around for about 80 years and some people swear by it. It's a set of exercizes and relaxation techniques that are said to improve vision. I hope to try it myself in the near future. Huxley, the author of a "Brave New World", wrote "The Art of Seeing" where he described how the method corrected his near blindness.