--------------------------------------------------------------- Date: Wed, 17 Mar 1999 21:40:08 +0100 From: Thomas Gramstad Reply-To: thomas@ifi.uio.no To: naked-eye@ifi.uio.no Subject: A LASIK operation Hi, I've taken the LASIK operation, and in this message I'll tell you about the operation, and the result. First I'll tell how I came to decide where to take the operation. This part may not interest you if you are not in Europe or Norway. If so, you can skip to the juicy part with the headline THE ACTUAL OPERATION. First I went through all the web sites I had tracked and linked (see http://www.ifi.uio.no/~thomas/lists/eye.html). It became immediately clear to me that the PRK operation not only was not an option for me (it only works up to about -7, -8, and I was more than that), but furthermore, that even if it had been an option, I would not have elected it, because of the long recovery period, the pain and discomfort associated with that method. So, LASIK it was. The next problem was that apparently noone in Norway (I live in Oslo) did perform LASIK. I started my search in the fall 1998. So it looked as if I had to go abroad. I discovered that the best alternative then seemed to be the Wellington Ophthalmic Laser Clinic in Dublin, Ireland. The surgeons there may be the most experienced ones in Europe. I was in contact with them by E-mail (woclinic@iol.ie), got their brochures etc., and it all looked good. (Now they also have a web site at http://www.well-eyeclinic.com/.) My problem was that it turned out to be very difficult to find a travel companion whose schedule was compatible with mine. While I was struggling with that problem, I almost accidentally learned that there actually is a Norwegian doctor who performs LASIK operations, namely Dr. Thor Brevik in Trondheim (who, by the way, is trained by the people in Ireland). Even better, he regularly travels to other Norwegian cities to do operations. So I was able to take the operation at Norsk Synskirurgi at Majorstua in Oslo, close to where I live. I was able to operate the one eye on friday 12 Feb, and the second eye already the day after, saturday. This is unusual, normally they prefer to have a week or more in between. In this case that would have had to be a whole month, because that would be the next time Dr. Brevik was in Oslo. But that was unacceptable to me, I've never been able to get used to contact lenses, and wearing glasses, one eye without glasses and one with would have been very uncomfortable. Luckily, I saw quite well on the first eye on saturday, and the check of the eye went well, so it was possible to operate my other eye the day after. And that brings us to the juicy part, I'm sure you're all longing to hear the gory details... THE ACTUAL OPERATION The operation takes only about half an hour from you enter till you leave. You lie down on horizontal chair. The first thing they do is to put your hair in a hairnet so that it is out of the way. They stick two strips of plaster over your eye lashes for the same reason. They sterilize the skin around your eye with alcohol or something. Then enter The Spider. That's a thin spiky metal device that is used to prevent you from blinking. It is placed on your eye and forces the eyelids to stay open. Next, your eye is placed within a cap-like extension from the microceratome, so that vacuum may be created. When vacuum is created, you can't see anything. (I forgot to say -- the other eye is covered up and isolated from the operation procedure, so whenever you see anything during the operation, it is with the eye that is being operated). So for about half a minute it's all dark and you hear a humming sound and you feel something scrape against your eyeball. No pain, just a scraping presence. Then it stops, the pressure is normalized, the cap is removed, and you can see again. As you probably know, the microceratome is an advanced knife, and is used in the LASIK operation procedure to create a flap in the cornea. This flap can then be set in the "open" position so that the laser can be used "under" it, in the inside of the cornea. After the laser surgery, the flap is put in the "closed" position, and you have no vulnerable area on the outside of the eye. This is the great improvement of LASIK over PRK, and is why the recovery period and normalization of sight is so much shorter, and no pain. Unlike PRK, which is done on the outside of the cornea, and so leaves the eye exposed and vulnerable to the external world. (I think PRK probably means Primitive Keratotomy, not PhotoRefractive Keratotomy...) Anyway... I was in the middle of my LASIK operation... so they had made the flap with the microceratome, and removed it, and I could see again. Then they put the flap in the "open" position, using something like a pair of tweezers -- no, it looked more like the thing you use for making soap bubbles. When the flap moves you experience this visually as if somebody is suddenly holding a jellyfish in front of your eye and you're looking through it. Then your vision is more hazy, and they roll the chair under the laser. You are told to focus your eye on a blinking green dot. The laser is now applied to your eye, in a series of very brief pulses. You see a red light accompanying each pulse, but the actual wavelength used for surgery is a much shorter, high-energy wavelength which is not visible. The laser part takes only about a minute or two. Laser surgery can be used against astigmatism and longsightedness (but not the age related form of longsightedness) as well as nearsightedness. In my case, I was -11 and -12, and I also had some astigmatism. They corrected the astigmatism as well, that was just a quick adjustment of the laser. And that's it. The rest was just putting the flap back in the closed position, removing the spider, the plaster, the hairnet etc., being given the eye drops which are to be used for a week, and an eye cap to have in front of your eye the first 5 nights while you sleep (to avoid touching your eye in your sleep), and go home. THE RESULTS I went for a control the day after, and had the other eye done. Already on sunday my vision was quite good. I was on work on monday without problems. In fact, the results were rather amazing. I was told that because of my high degree of myopia, I could expect to end up around -1, not 0. There are limits to how much you can remove from the cornea, it must remain a stable anatomical structure. In my case, my cornea was 600 micrometer thick, well above the average 500, which was good because it meant that more of it could be removed, thus getting closer to normal vision. 124 micrometer was removed. Now, 4 weeks after the operation, all is going as planned, all controls have gone well, indeed the last control indicated that I'm at -0.5 and -0.75, though I can't be sure about the final end result until 3 months after the operation. Compared to using glasses, things appear to be bigger and closer than they used to, and perhaps a little less sharp, like a picture where you increase all the pixels. It's a great relief not to be dependent on glasses any more. It was great being able to buy and wear mirrorshades. In short: I'm happy with the result and would definitely recommend LASIK to anyone who is fed up with glasses or lenses. Make an informed choice: possible risks, side effects or less than perfect results are described and discussed in various articles linked to from my web page (http://www.uio.no/~thomas/lists/naked-eye.html). The basic LASIK operation costs NOK 32 000 (about 4000 dollars, the prices are in the same range all over the world). Not everyone can be operated, whether one is a candidate has to be determined by some tests in advance. If you want more information about Dr. Thor Brevik, you can call him at +47 7351 3050 (work) or +47 9426 8971 (cell phone). Thomas Gramstad thomas@ifi.uio.no ---------------------- ADDITION, JANUARY 2000 Almost one year after the operation, I've had no bad experiences or side effects, and I'm still very happy with the results (which have neither changed not fluctuated). I'm about to buy -1 glasses, not because I really need them, just as a luxury in order to have knife sharp distance vision. By the way, I just received an E-mail from Stian Pedersen of Synslaser AS, a clinic in Tromsų and Trondheim. He tells me that Synslaser AS has performed LASIK operations in Norway since 1996, thus being the people who were first to do this in Norway (contrary to my claim above). Clearly this has been a well-guarded secret :) -- or maybe it's just that when I did my research about a year ago, talking to a lot of eye surgeons in the Oslo region, well, people in Oslo often just have no idea and little interest in what's going on in the rest of the country. Anyway, Synslaser AS has some really informative and stylish web pages (in Norwegian), look them up here: http://www.synslaser.com/ .