LASIK Surgery

Two years ago, after a great deal of introspection and research, I decided to undergo LASIK surgery. I was 34 at the time and I had worn glasses for the vast majority of my life. My vision was 20/600, which means I could see at 20 feet what most people could see at 600 feet. I was very nearsighted. Without glasses I was unable to read anything further than about 5 inches from my face. Today, my vision is 20/20 in both eyes and the wonder of living life without glasses has not worn off.

Deciding On LASIK

My optometrist and I had spoken about LASIK and other vision correction surgeries for close to five years. At first his knowledge of the surgeries was superficial and his advice was to wait for a few years. Later he advised me to wait until my eyes settled down since most reputable surgeons require a candidate's prescription to be stable for two years. That was four years ago. I started to read up on the procedures available and talking to people who had the surgeries.

Most of the people I talked to had either PRK or LASIK surgeries. Most reported similar experiences, with LASIK seeming to have shorter recovery times. My optometrist started performing patient screening for a local franchise of The Laser Center and began learning a great deal about LASIK. I spent a great deal of time researching on the web; reading about the various positive and negative outcomes.

Two and half years ago, during a routine exam, my optometrist announced that my eyes had been stable for two years and he thought that I might be a good candidate for LASIK. He recommended The Laser Center in Austin, mostly due to the fact that only one surgeron was performing operations there and his success rate was extremely impressive. I contacted The Laser Center and scheduled a battery of test to determine if I was indeed a good candidate.

Elective Refractive Surgery

I arrived at The Laser Center armed with a checklist of questions and a paper entitled "Ten Reasons Why You Should Not Have Eye Surgery" ( or something very close ). I would be making a majority of my decision to trust my eyes to these people based on their reaction to my questions. They were delighted that I had brought so many questions with me and we proceeded to spend over an hour going through each question. The people at The Laser Center were very forth coming and provided as much historical data on previous surgeries' results as were available ( three years ). Before the first test to determine my suitability for surgery, I was ready to trust these people.

Next came a battery of tests, the purpose of most I forget. The one that stands out in my memory produced a topographic map of my eyes. It measured the thickness of my corneas and the amount of variation seemed alarming until I noticed the key. The apparant hills and valleys were absurdly small features on my corneas and completely normal. The final verdict, my corneas were thick enough to make me a good candidate for surgery. Thin corneas might tear during the procedure which increases the amount of time required to heal dramatically and increases the possibility of infection. Thick is definitely better.

LASIK or Maybe I Shouldn't Have Asked

Excerpted from http://www.fda.gov/cdrh/lasik:

LASIK stands for Laser-Assisted In Situ Keratomileusis and is a procedure that permanently changes the shape of the cornea, the clear covering of the front of the eye, using an excimer laser. A knife, called a microkeratome, is used to cut a flap in the cornea. A hinge is left at one end of this flap. The flap is folded back revealing the stroma, the middlesection of the cornea. Pulses from a computer-controlled laser vaporize a portion of the stroma and the flap is replaced.

You can imagine that reading about it and experiencing it might be two very different things. And you'd be right.

My surgery was scheduled for 11:15 am on January 9th. My wife and my optometrist accompanyed me to the clinic. My wife was going to drive me home afterwards and my optometrist just plain kicked ass (he's semi-retired now, otherwise I'd be shouting his name to the rooftops). We got there early and spent about 20 minutes in the (posh) waiting room before I was taken to prep. Preperation involved taking a sedative, a final check by the staff eye doctor and a brief visit from the surgeon. The surgeon was brief but positive and then I was lead into a darkened room to wait my turn. There was quiet classical music playing and three other people in the room mellowing out with their sedatives. One by one we lead away to the operating suite. My optometrist came and got me and it was my turn.

Blurred Impressions of Something Scary

The sedative administered before the procedure is important because three very unnatural things are about to happen. I entered the surgical suite and was situated on a padded table with a cluster of vaguely industrial equipment around the head. Vaguely because I wasn't wearing my glasses at the time. They don't waste alot of time, and in very short order they began prepping my eyes by placing numbing drops in them and cleaning around my eyes. Because blinking can be disruptive during the procedure, they then insert a lid speculum into your eye ( this is addition to taping your eyelids open ). That is the first unnatural thing. Next a suction cup is attached to your eye to hold the eye still while the microkeratome is used to cut a flap in the cornea. That is very unnatural, but didn't hurt. The flap is then lifted and folded over in preperation for the laser. At this point, my vision was very blurry and I was directed to look directly into a small red light directly above me ( the aperature for laser ). The laser used in my procedure incorporated an eye tracker which provides feedback to the laser and will also shut the laser off if your eye moves too far out of axis.

Staring at the red dot, the surgeon announced that the eye tracker had locked on and the laser would be firing it's preprogrammed sequence for some number of seconds. I don't recall the exact number, but it was less than 60 seconds. During that time, the laser buzzed but I didn't notice any visual artifacts. I was struggling to look at the red light, terrified that I'd wreck my eyes by moving at the wrong time. I also had a vague impression of a burnt smell, which of course was the ablated tissue from my eye. The third unnatural thing.

The surgeon counted down the last few seconds and the laser shut off. He then inspected the work done by the laser and spent a great deal of time folding over and smoothing out the flap in my corena.

The first eye ( the right ) was done.

I was shaking like I was caught in a blizzard without a jacket. I had no idea how I would endure the left eye. The discomfort of the ligature and the fear of loosing my sight due to moving during the procedure were overpowering.

And then the coolest thing happened. My optometrist, who had accompanied me into the suite and observed everything so far, reached out and patted my foot and murmured a few words of encouragement. That's all. I felt a sense of relief that just flooded me. I can't explain it since I was defintely under the influence of the sedative, but I stopped shaking as much and the team went to work on my left eye. While uncomfortable, the left eye was no where near the ordeal that the right eye was.

Less than ten minutes in the suite and I was being led out. My doctor and the staff doctor examined my cornea flaps and gave care directions to my wife since I was still pretty shook up. I had antibiotic eye drops and steroid drops and lubricant drops and a pair of clear eye shields that I would need to wear for weeks ( to prevent me from touching or rubbing my eyes and disrupting the healing of the flaps in my corneas ).

On the car ride home, I was blurrily reading the roadside signs.

Without glasses.

Recovery

The first two weeks I was certain that I'd had a bad outcome and my anxiety during the procedure was the cause. But in reality my eyes were healing and my expectations hadn't been realistic. My vision was blurry but already far better than it had been without glasses. After two weeks, my vision was 20/20 in the right eye and 20/15 in the left. I would have good seeing days and bad seeing days, but I think those might have been related to the muscles around my eyes re-learning a lifetime of movement to accomodate my new accuity. My doctor was unable to explain the descrepency between my right and left eyes. We think the difference might have been induced by my anxiety during the right eye, but it's only a theory. We recommended back to the clinic that they review the amount and type of sedative given since I might not have received enough.

The two biggest post-procedure complaints most people have are dry eyes and haloing at night. The dry eyes stems from the nerves in the cornea which are severed when the flap is cut. Those nerves provide feedback when the eye became dry and take time to grow back. For the first six months afterwards I used eye lubrication three or more times a day. Two years later I don't have any need for supplimental lubrication.

Haloing ( or flaring ) at night happens when viewing a bright light ( such as oncoming headlights in traffic ). For me, the haloing is no worse than what I had experienced with contacts. There is an interesting retouched photos on Surgical Eyes which attempt to show what it's like to experience haloing. The photos are not representative of how I see at night; the halos I see are much less pronounced.

Two Years Later

It's been just over two years and I could not be happier. I can wear cheap $5 sunglasses and not worry if I loose them. I can SCUBA dive without worring about loosing contacts during a dive. My pistol and rifle shooting improved. I can read the clock across the room when I wake up in the morning. Practically every aspect of my life improved, including my self-esteem.

As I grow older I'm told I will become farsighted and will require reading glasses. Until then I should enjoy 30 or more years of good vision. I think I can live with that.

-ejo

Comments:

Mar 1, 2008
Michael Heidemann
Las Vegas NV

This is an open letter to Lasik of Nevada, Dr. Rothman and staff. I am writing this letter in order to best describe my experience with Lasik of Nevada, their staff, and Dr. Rothman the surgeon.

Approximately 3 months ago I went to Lasik of Nevada office to get a price on having both my wife and my eyes corrected with lasik. I had been to Valley Eye and had received a quote for a total of $1000. to have both eyes corrected for the prescription needed. I thought I would get a second opinion. While at the office of Lasik of Nevada I spoke with the office manager Pat. Although there were postcards throughout the office (Lasik of Nevada) offering lasik eye surgery for less than $300 per eye I was told that it only represented operations that required very slight specific corrections. Their regular price was over $1500. per eye for the average correction my wife and I requested. When I told Pat that I was able to get this surgery done with my prescription at Valley Eye for $500. per eye he said he could negotiate a price of $800. per eye. In that price he offered the same 1 yr enhancement program that was offered by Valley Eye. He mentioned plugs and agreed to have permanent ones installed in my eyes in the $800. per eye charge. This included all visits to the on staff optometrist, and other follow up visits that would be necessary.

I agreed and both my wife and I had the surgery and were charged the agreed upon $800. an eye for the surgery. After having a good experience with our surgeries I had my 35 yr old daughter flown in from Austin Texas on the last week of January, 2008. She was examined and again met with Pat the office manager to obtain a price. He said that he would honor the same price and conditions that were given to me 3 months earlier.($800. per eye including 1 yr enhancement and plugs) I agreed and set up an appointment to have my daughters eyes lasik procedure done March 1, 2008.

We arrived on March 1 at the appointed time. Lasik of Nevada requires that you pay for the procedure at the time of the surgery. I reached for my wallet and was told that the price I was quoted was not valid. This was 15 minutes before my daughter was to receive her surgery!!!! They had fired the office manager, Pat with whom I had made the agreement for my daughters surgery. After several minutes of backroom discussion between the Dr. and office staff my daughter and I were brought into a small room with Dr. Rothman and his new office manager. Dr. Rothman spoke to both my daughter and myself about the price of the surgery. He said that “the price I was quoted was far to low and that he would not honor the price his office manager had quoted me.” He also said “the office manager, Pat, with whom I had made the agreement was no longer working there and he simply would not honor the agreement of his employee.” This was even though both my wife and myself received this price as it was agreed upon 3 months earlier without problems for the same surgery. I was taken back by the fact that this agreement was made with his office manager who was the only one I was aware of negotiating prices both 3 months prior and up to 2 weeks before my daughter was to have her surgery preformed. I could not understand why he would not honor his own employees pricing when earlier both my wife and I had the same person, Pat, give us the price which we paid for the Lasik surgery at Lasik of Nevada. While in the small room Dr. Rothman said that “he was uncomfortable discussing prices and wanted me to continue the discussion with his current manager.” While still in the room with my daughter and I Dr. Rothman said that “if he was uncomfortable he would simply not do the procedure.” He was very uncomfortable discussing the price any further and said he didn’t want to do the procedure if he had to honor his employees quoted price.” He was not willing to give an inch and the feeling both my daughter and I had was it was “either his way, or the highway.” The Dr. offered no compromise himself. There appeared to be no consideration for his patient (my daughter) it was all about the money. It appeared as a strong arm tactic since the change in price was not mentioned at earlier visits but was revealed 15 minutes before surgery. Dr. Rothman left the office acting like he could care less that my daughter had spent hundreds of dollars to get here from Texas. She also missed week of work.
The Dr. left us in the room with his office manager. She said that a new charge of $250. For the optometrist had now been imposed to replace the previous $150 charge for this service before. I said that I would compromise and pay the additional $100. Even though I had agreed earlier with Pat (the past office manager) that the price would not be higher than I had paid before ($800 per eye). She did not want to give an inch and said that the additional $250. would have to be paid. I agreed to pay the additional $250 to try to compromise. She continued and wanted to remove the 1 year enhancement feature saying that I would be charged $499. per eye if any were needed. This would mean that it would be a minimum of $1200. more than the original price I was quoted a month earlier if enhancements were needed. In addition she wanted an additional $200. for permanent plugs (which the office manager Pat had included in the $800. per eye) bringing the total to over $1400. more than the original agreement. I said that I would pay the additional $250. beyond the quoted total price but would insist that the balance of the agreement with Pat remain (1 year enhancements and plugs)

It cost over $500. to have my daughter flown from Austin Texas to stay for the week to have her surgery. She had been without her contacts for 2 weeks and suffered a fall from a horse which cracked her ribs from not seeing as well thru glasses. This happened because she was required to wear her glasses and remove her contacts for 2 weeks prior to surgery by Dr’s orders. No consideration was given to my daughter……..Dr. Rothman and his office manager remained firm counting on the expenses ($500 airline tickets) and inconvenience of having to wear glasses would cause me to cave in to their demands.

I told the office manager that if this is the final word on how they are going to treat me that I would simply write a letter so that others would have the ability to see how their office and staff treated one of their patience. I write this letter so that anyone considering surgery with Dr. Rothman or Lasik of Nevada will protect themselves from there pricing procedure. You cannot count on what you are told even if you have been thru all pre operation procedures and given a price by the office manager. I was not offered a copy of the contract at the time the price was set by the office manager Pat, on either my previous visits or on my daughters visits. I’m not sure, but I don’t think this is standard practice with all Lasik offices. I wasn’t worried about it since the first 2 operations with the same company and same office manager in charge were honored at the price quoted and the procedures quoted for that price. I trusted what their office manager said and the pricing and procedures that were promised would be honored since both the procedure and price were honored twice earlier. It was only on the day of the operation that the paperwork was revealed. Don’t count on their staff for pricing. Talk directly to the doctor and make sure that you get a signed statement from him as to what you will get for the money. (I doubt he will discuss it with you since he appeared to be uncomfortable with discussing it with me in person except 15 min before surgery) Insist upon a written contract since in my case if the office manager quits they may not honor the price or procedures that were discussed. If they can change the price and procedures included on the day of the operation as they did with me you should take that into consideration before having Lasik of Nevada do your surgery. You should be able to trust your doctor and their staff to be competent to give you a price, procedure for that price, and have it be exactly the same on the day of surgery. I have lost my faith in both Dr. Rothman and the staff of Lasik of Nevada. Let the buyer beware.

Mike, Kim, and Holly Heideman Las Vegas, and Austin Texas

On Monday I intend to submit this to the local newspaper and include it on Craigslist, medical blogs, lasik blogs, and to the general internet. This has caused my family a lot of grief………..I have tried to represent it just as it has happened to the best of my ability. My daughter will be writing an open letter of her own to Lasik of Nevada. My younger daughter is a nurse practitioner in Las Vegas. News travels fast among Health professionals.

Posted by mike heidemann on March 01, 2008 at 09:50 AM CST #

LASIK is really very safe and helpful if the person really eligible for surgery.Nice article which clearly explains how the LASIK goes on and many more information.And one can enjoy 20/20 vision after the surgery without wearing contacts or eye glasses.I had my eye surgery a year ago and now i have no problem with the vision and i must say my doctor has done a great job. http://americanlasiksurgeons.com/

Posted by Henry on July 16, 2010 at 11:05 PM CDT #

Post a Comment:
  • HTML Syntax: NOT allowed
About

ejo

Search

Archives
« April 2014
SunMonTueWedThuFriSat
  
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
   
       
Today
Bookmarks