My LASIK Surgery Experience by John

DISCLAIMER: I am not a doctor or an expert on LASIK. I am writing about my personal experience and the advice and suggestions I give are purely mine and should not be mistaken for that of a professional. My goal is to be honest and help others make an informed decision on LASIK surgery as well as possibly help those who have had the procedure.

ORIGINAL POST - MENU
Posted 1/20/04

The Bottom Line
About Me and My Surgery
Timeline
Summary
Vision Quality
Links

THE BOTTOM LINE
Here's my quick summary for those wondering whether they should have LASIK done or not ... My answer is DO NOT ... Wait for better procedures.

Here's a great summary regarding LASIK that I wish I had read before getting the procedure done. It is from the Caster Eye Center website (a noted LASIK firm in Los Angeles):

"The results (of LASIK) are very impressive, but it is impossible to tell you exactly what your results will be. No guarantees can be made about the outcome of excimer laser surgery in any individual case, because each person responds in a slightly different way. If you will only be satisfied with "perfect" 20/20 vision without glasses after excimer laser surgery, then please do not have the surgery. Avoid any doctor or clinic that promises you a specific result, because that simply is not possible."

I think this is a fair and accurate assessment of LASIK, in terms of what to expect with the quality of vision. Overall, at 12 months post-op, I am OK with my LASIK results -- not terribly thrilled nor horribly disappointed. I was very excited about my procedure and really expected my vision to be as good as it was with glasses (hopefully even better) and was not told this expectation was unrealistic by anyone I encountered throughout my LASIK process. I was also not prepared for the short-term side effects which resulted in lots of anxiety and suffering for me as I dealt with those problems and constant fluctuations, especially over my first three months post-op. If you are happy with your vision while wearing glasses or contacts, stick with them, at least for now. Wait and be patient for something better to come along. The technology is improving and should become more reliable and produce less side effects. But right now, it's just not worth the risks and the significant chance that your eyes will be worse for the rest of your life.

My goal with this website is to be extremely honest, clear and direct and present a message I wish I found when I was doing research before I had my procedure done. I send special thanks to Ron Link at surgicaleyes.org for helping me get my story out.

In more detail, here are my reasons for recommending against having LASIK today:

1) Recovery Period: Just about every website I checked out while doing research before my procedure, as well as my own doctor and laser surgery facility (Sight Solutions in Mt. Laurel, NJ), downplayed the recovery period. They almost make it seem like you walk in, get your eyes lasered, and walk out with eagle vision. (I've noticed recently that Sight Solutions has changed their marketing message, adjusting it to much more realistic expectations). This has not been the case for me and some other LASIk patients I've talked with since my procedure. The say the initial recovery time is generally around four weeks, but your eyes may fluctuate significantly for 3 to 6 months total. I say you should plan on at least a year, as I feel that my vision and eye comfort is still changing now 12 months post-op. During this recovery time, you are very likely to experience halos, ghost images, dryness, headaches (probably from the dryness and eyestrain), light sensitivity and other visual annoyances. And all of this fluctuates, from day to day or even hour to hour. If I knew how tough this recovery period was going to be for me, I would have certainly waited for a procedure with less side effects. The problem is, everyone is different in their healing time, and no doctor can really tell you how long (or how well) you will heal.

2) Risky Procedure: The procedure is imperfect. For every one or two positive LASIK story, I've heard a nightmare story of permanent halos, loss of vision, etc. Of course, I only heard these after I had my procedure (maybe because I was so into doing it, I ignored anything negative). It also makes sense that there are more negative stories on the Internet as someone who is very upset about a bad LASIK experience is more likely to be inspired to write about their experience then someone who is satisfied. However, even if the operation is a success, there are several side effects that may be permanent (I've read conflicting information about whether these effects last many months or are actually permanent): decreased night vision quality, loss of contrast sensitivity, light sensitivity, eye dryness, flap weakness, loss of overall image quality, conflicts between LASIK eyes and cataract lens implants, and other unknown long-term effects. I did a good amount of research before I decided to get LASIK done, including checking out many websites. I should've spent even more time researching, though, but I was thrown off by how different people's experiences were (from great to terrible). Don't dismiss the wide range of stories, because that's the kind of variable results LASIK can produce.

3) Better Technology: I was told by my doctor that LASIK, which is FDA approved, would not improve significantly anymore as it has been refined and that there is no reason to wait for it to get better technically. That may be true, but what I've since discovered is that there are new procedures being developed that are much more precise in correcting the eyes with a far less chance of negative side effects. These Wavefront Analysis procedures usually refer to the Topography of the eye, which as far as I understand, may also be able to help people who have permanent negative side effects from LASIK (for details about this, check out: AllAboutVision.com). I should also note here that my surgery center, Sight Solutions, has recently gotten wavefront anaylsis equipment which should be online by June. The LASIK procedure as it exists today is relatively imperfect (consider that 15-20% of patients need to have a second surgery done (an "enhancement") to get their vision to at least 20/40. Also keep in mind that, statistically, LASIK is considered a success if you achieve 20/40 vision — what's so good about almost seeing as well as you did with glasses?! In talking with people who have had the surgery, it seems that the more severe your myopia and/or astigmatism, the greater the chance that you'll need an enhancement or still need to wear glasses. Overall, LASIK is not as good as I thought it would be. I think the people who say it's great are either not that picky about their vision and/or hated glasses so much, they just wanted to get rid of them.

4) Unrealistic Expectations: Before you make your decision, assume you will still need to wear glasses after the procedure for critical activities like night driving and watching movies. If this bothers you, don't get the procedure. Currently, because I still have a slight astigmatism, I wear glasses for driving, working on the computer and watching TV. I can say that my vision was consistently better in all light conditions with my glasses before the surgery than now with glasses after the surgery, especially in low-light conditions. There have been days of regret in which I feel if I had to do it all over again, I would've bought a nice new pair of stylish glasses and waited at least another few years to see if the promise of better technology came to fruition.

ABOUT ME AND MY SURGERY

About Me: My name is John. I am a white male in my mid 30s, in good physical shape. My vision before correction was 20/100 (left eye) and 20/400 (right eye) with astigmatism. My actual numbers are:

Right: -5.00, +1.75 X 10
Left: -3.50, +1.25 X 160

I wore glasses since second grade and always hated them. I was used to the routine of wearing them, but was often self-conscious about them. For example, I would take my glasses off whenever I met someone for the first time. When I first heard about LASIK about five years ago, I decided then that I wanted to get it. I play ice hockey, tennis and I have kids. I thought it would be great not to deal with glasses (which seemed to get scratched up within a month, given my activity level). I waited until May 2002 to have my procedure done, knowing that the price would come down (which it did) and that (hopefully) the technology would improve.

My Surgery: I had my surgery done May 3, 2002 at Sight Solutions in Mt. Laurel, NJ by Dr. Greg Scimeca. It cost $3600 for both eyes, including all my post-op visits (of which I've had many extra ones, so far) and lifetime enhancements. The full fee for the top plan they had was actually $4800, but my health insurance gave me a discount. I just finished paying off the fee over one year, interest free. Sight Solutions did do an Orb Scan before my procedure and my doctor also did a thorough evaluation, including dilating my eyes and measuring my pupil diameter. Before the procedure, I was given an anti-anxiety pill before the procedure (I don't remember exactly what it was) and also was given a 15 minute back massage by a Sight Solutions staff member. I should add that the people at Sight Solutions really do their best to make the experience comfortable and positive (they must be aware that fear is probably the biggest negative selling point they must overcome).

The procedure itself did not hurt, but was very uncomfortable, especially having the speculum stretch your eyes open. When the flaps were lifted and everything got very blurry, that was unnerving, even though I was expecting it. I could also smell my right eye burning when it was lasered (it smelled like hair burning). I found it difficult to stare at the blinking red light, which my doctor asked me to do as the laser was being applied, because as the laser activated, the red light appeared to melt away! My doctor assured me that if my eye was misaligned, the computer-controlled laser or even himself would have paused the procedure. Immediately following my surgery, I went home and slept. I did not have any anxiety before or during the procedure. However, my anxiety hit me hard a few days after my procedure.

TIMELINE

1Day Post-Op
The day after my procedure, I had a follow-up and I was told I was reading 20/20 and 20/15, but it was like reading the chart through a fog in the low light of the examination room. I've since heard this referred to as "LASIK 20/20," meaning you can read the lines on the chart, but the quality of your vision is not as good as it was. The next day, on my way to church and under bright sunlight, the leaves on a nearby tree never seemed sharper. I was escastic! Over the next several days, my vision seemed to gradually improve, but low-light vision was awful.

1 Week Post-Op
I had my surgery on Friday and was back to work on Monday and it was not easy. I work on computers and the screen is not as sharp as it was before my procedure, plus it seems to glow a lot more. By the end of any day, my eyes can really hurt or be dry. It's been very, very difficult and I feel I have not been as productive as before the surgery. Sleeping extra (8-10 hours a night) and taking Ocuvite (lutein supplement) seems to help.

2 Weeks Post-Op
The best word I can use to describe my recovery experience to date is "torture." My problem is ghost images and halos, which should clear up in the next few weeks (I hope!). I'm trying to stay positive and I keep praying that everything clears up, because if my vision doesn't get better than it is, I will be extremely upset that I did this to myself. I also had a few very bad days ... I saw "Star Wars: Attack of the Clones" with my son a few days after it came out and could not enjoy the movie at all because of all the halos (which are much worse in low light). The next day I really think I had a bout of clinical depression (no appetite, lethargic, couldn't stop thinking about how dumb I was to do this, etc.). Since then, I've talked to my doctor and he told me none of his patients have ever had permanent halos and that he did take into account my pupil size (he measured me at 5.5 mm), all of which made me feel better. I was not prepared for such a long and difficult recovery period. I can't wait until my eyes are back to normal, so I myself can feel normal again. This has been one of the hardest things I've been through. I have a lot of anxiety, only because I don't know what kind of vision I'm going to end up with. They say that health is everything and now I know what they mean. When your body feels wrong (whether it's because of your eyes or other health issues) it really affects your entire life in a bad way.

1 Month Post-Op
I ran into a complication. I was working on my computer and noticed whenever my focus changed from the screen (up close) to an object farther away (more distant) I had a feeling of pressure and discomfort in my eyes. I tried to tolerate this for a day or two, but it seemed to be getting worse, so I made an appointment with my doctor. He checked my eye pressure and found that it was elevated. I was at about 27, when my normal is around 15. My father has a history of Glaucoma and this, combined with the anti-inflammatory drops I was taking, increased my eye pressure. My doctor gave me less strong anti-inflammatory drops. I was checked the next day and a week later and my pressure had returned to a normal range. Halos and glares are pretty much gone, except at night. Overall, I still have a slight prescription in both eyes (.5 with some astigmatism), but my doctor thinks this will improve. My night vision is not so great, and I feel that I must be extra careful at night. I still seem to be somewhat sensitive to light and dryness is a daily problem.

2 Months Post-Op
My eyes continue to improve, although very slowly. My prescription has also improved. I now only have a slight astigmatism in both eyes (.50) and no myopia. My doctor says the astigmatism could still heal and correct itself. In doing some research on the web lately, I've discovered that this slight "residual refractive error" is essentially a result of the inaccuracy of LASIK. When the doctor enters the correction for the laser, he or she is actually entering a best guess over correction (based on an algorithm), since everyone's vision will naturally regress towards it's original level. The way you heal, the laser used, and many other factors affect the outcome. This is one of the negative risks of the procedure. If my prescription does not improve, I will unfortunately still need to wear glasses for night driving, watching movies and other critical activities. It would suck having to spend all the money and go through this recovery ordeal only to end up with glasses. Besides my refractive error, my other major problem is dryness of my eyes. I notice when I put drops in my eyes, my vision seems clearer momentarily. I am close to where I want to be, but am still upset that my vision is not yet crisp and comfortable. I don't think I will ever trust medical technology to the extent I did when I made the decision to do this.

2.5 Months Post-Op
I've had a rough few days. My eyes have been itchy and bone dry. I was given free samples of Visine Tears by my doctor and they are the worst drops I've used yet. I did some research on the web and discovered that preservative-free tear drops are recommended, as those with preservatives can interfere with the healing process. I'm going to try TheraTears. Today I'm having one of those "I wish I didn't do this" days. It's tough to concentrate and live your life when your health is bothering you and the dryness of my eyes is driving me nuts. I also did some more research today, trying to find answers for my dry eyes and ran into another batch of negative information regarding LASIK. It seems the consensus is while the procedure works perfectly for some people, there are just too many complications that occur too often. The bottom line is, glasses and/or contacts are really not bad – especially compared to the annoyances you must endure with LASIK. Please, think twice before getting this procedure!

2.6 Months Post-Op (7/18/02, a few days after the above entry)
I just went to another Laser Surgery website and they suggested using wetting drops every waking hour for 2 months post-op! That's the first I've heard of that. They suggested to do otherwise could result in slower healing and regression. It makes sense, but my doctor did not suggest this amount of wetting. I'm going to give it a try in these last two weeks before my 3 month checkup hoping it may cure my remaining astigmatism. I am trying to stay positive, but every time I look around and see any kind of distortion from my astigmatism (which is very slight but still noticeable) I am reminded of my predicament. This really sucks. I would not recommend LASIK to anyone unless you are a superior candidate (low to moderate prescription) and your doctor is A1 quality. It's not as good as they make it out to be! Just stick to glasses/contacts.

3 Months Post-Op (Aug. 1)
Today I had my official three month post-op visit with Dr. Scimeca, the doc who did my LASIK procedure. There was some good news as my right eye is now "plano," meaning no myopia or astigmatism. My left is lagging a bit behind and is now plano with .50 X 60 astigmatism. My doctor feels that this astigmatism is winding its way out (though the amount of .50 did not change since my last check a month ago, the angle went from 160 to 60). I hope so as that little bit of astigmatism does effect the sharpness of my vision. The doctor did prescribe two pairs of glasses for me, one for distance (driving, etc.) and one for my computer work (I've used computer glasses for the past 3-4 years and it really helps lessen the strain of staring at a screen all day). Even with the glasses, it seems that my vision is still not as crisp as it was before I had the operation. I still can see a slight bit of haloing and ghosting, especially in low-light conditions (like when there's only one 60 watt light on in a room). My eye dryness has been especially bad lately, even though I am using TheraTears as much as every half hour. I hope this is simply because I am not done healing and that things will be crisp in a few months and the dryness disappears. I am trying to maintain a positive attitude, but some days it is really hard. Even though I did not like glasses, my vision with them was very crisp and good, and I wasn't constantly aggravated by what I saw. Now everything is a little off and it drives me crazy sometimes!

3.5 Months Post-Op (Aug. 16)
I've been using the glasses my doctor prescribed for me just about whenever I drive (day or night) and at night when I am home (under lower light conditions, like with one light on). I find that my vision is more crisp with glasses. Hopefully, I will continue to heal and my vision will crisp up on it's own. Working on the computer is much better now that I use my special "computer glasses," which I used before my procedure (although with a different prescription) as I work on computers a lot and it really helps relieve the eyestrain. I have discovered that I am a perfectionist about my vision and, because of that, should not have had my procedure done. Ultimately, it was my bad decision, but some responsibility is on my doctor who I feel should've discouraged me from getting the procedure done when I told him of my high expectations at one of our pre-op meetings (I told him I expected my vision to be as good as I had with my glasses and he said he was confident he could achieve this). My vision now is not as good as it was with glasses (even when I wear my new prescription glasses) and I am very disappointed about that. Worse than my vision, though, is my anxiety over this situation getting better. It's tough not to think about my vision problems because I see them all the time!

4.75 Months Post-Op (Sept. 22)
The problems I've been experiencing for about the past month or so has been very dry and red eyes. I'll wake up in the morning and both my eyes, but especially my right one, is very red. Also, my eyes tend to be dry all day, but especially at night and if I've been working on the computer a lot (which I do often as that's a big part of my job). Artificial tears and gels help, but only temporarily. My doctor has put in collagen plugs several times which block your tear ducts and keep your natural tears covering your eyes longer. The collagen plugs dissolve after about a week, so they are not permanent. The doctor offered to insert silicon plugs which are permanent (but can be removed usually), but I'm not interested in any artificial permanent changes to my body anymore! My doctor believes the redness of my eyes is a result of lack of tears washing away particles and allergens. I've been using antihistamine drops including Alocril. These seem to help somewhat, but every morning the redness is back. Also, before I had the procedure done, I could read a book without my glasses. Now it seems I need my glasses to read. I understand that LASIK can induce early presbyopia (meaning you need reading glasses) — a condition I was not warned about! In general, it seems the LASIK industry is really glossing over all the potential problems (probably so they don't scare everybody away from it), but if these people really cared about your eyes, they would be more direct and honest. I found out from my wife that one of her friends also had LASIK done with my same doctor and experienced really awful regression. She was seeing very well for about a month after the procedure and then spent a day at the beach in full sunlight. The next day her vision quality had dramatically decreased. She thinks it ways due to the sunlight exposure. I've also read about more horror stories on the web. Please, if you are considering LASIK, don't do it. There is a chance you'll be extremely happy with your results. But there's also a significant chance you will experience complications and your vision will never be the same. Your eyes are one of the most complex and critical organs you have — I'm sorry and feel like such a fool that I didn't see how big of a risk I was taking by under going LASIK and now I really regret it!

4.75 Months Post-Op (Sept. 27)
I saw my doctor (Dr. Greg) early this week (probably my 10th visit so far!). I've been waking up with very red eyes and my eyes are a bit redder than normal throughout the day. Dr. Greg believes this is due to the fact that my eyes are producing less tears than normal (a side effect of LASIK that he says is temporary) and that allergens and particles are not being washed away like they usually would. We've tried several anti-allergy drops, including Ocuflux (I think), Alocril and Alamast. The Alamast (which is a mast cell inhibitor, so it does not dry out the eye even more like the other drops) has been the best. My doctor checked me to be sure the drops were working well and also inserted collagen plugs to help alleviate the dryness. He also looked at me flaps, which he described as excellent, and noted that had a reduced tear film and irritated follicles. He gave me another sample of Alamast and more Bion Tears (I must say, he is very good about giving me free samples of drops). He also made special arrangements for me to get a two month supply of HydroEye, a nutritional supplement that is supposed to help improve your tear film and relieve dry eye symptoms. The company's website is: http://www.sciencebasedhealth.com/SBH/index.asp and you can buy their product online (I'll let you know how it works). I do give me doctor credit in that he really does seem to care and still is confident that things will turn out fine for me. I appreciate that and all the free samples he's given me. I just think he's a little too enthusiastic about LASIK and that he should've really detailed how long and tough the recovery period could be. That information would 've at least allowed me to prepare better mentally for this tough period, or more likely, I would've decided to wait for a better procedure with a quicker recovery time. Anyone who wants the procedure must realize there will be a price to pay: a potentially long and tough recovery period and the chance that you'll be disappointed with your results with no way to undo the surgery. Before you take on LASIK, ask yourself if you can live with that and be honest!

5 months post-op (Oct. 3)
I just had probably my best week post-op. I think I've undergone some more healing. I'm noticing less halos in low light conditions and better sharpness overall. I also did not have any appreciable dryness. If things stay like this, I will be really happy. I've done a lot praying (and so has my wife and kids) and I think it's paid off! Also, I think the HydroEye supplement I've been taking for about the past week has made a HUGE difference. At this point, I would recommend at least trying them. The link is above. Ask your doctor if he can provide a free sample, as my doctor kindly did. Also, I got an email from another person who had a bad experience. His cornea was too thin to have LASIK, but this was discovered after the procedure was done! Now he has very bad halos and distortions. If you still want to get this done, be absolutely sure your doctor is A-1 and make sure he/she follows all of the most stringent screening procedures (some weblinks below provide a list of screening procedures). My impression is it that many doctors are overly enthusiastic about LASIK (and/or they money they can pocket from it) and are treating patients too liberally. This is surgery with a relatively high risk (1 - 50%) for long-term side effects. Notice the 5-50% range? That's the other problem. That's the range I've come up with after checking out at least 20 LASIK sites. It is very difficult to predict how well you will do, since there are many factors that will affect your final outcome. Wait until a better procedure comes along!

6 months post-op (Oct. 7)
This morning I had my routine scheduled 6 month follow-up with Dr. Scimeca. He said my tear film looked good and better than it had before. I give the HydroEyes supplement credit for improving that. He also said the flaps look good. I asked him to check my refraction (prescription) and it has changed slightly. I now have astigmatism in my right eye (which my doctor said I had before, but according to my notes and the prescription he gave me, I did not at the 3 month mark). The angle of the astigmatism also changed in my left eye (I believe it is now 75) and my doctor said this is normal as astigmatisms tend towards either being vertical or horizontal (which is what mine are doing). My doctor suggested I wait until my one-year follow-up (six months from now) before I update my eyeglasses prescription, though I may go sooner than that. I am reading 20/15 with both eyes on the chart, which sounds impressive, but there is still a noticeable amount of a glare/halo effect. In fact, I told my doctor how my two remaining side effects are dry eye (again, much improved since taking the HydroEyes) and glare/haze/haloing in certain low-light conditions. He asked me if this happens when I wear my glasses and I said it didn't matter. He said it probably means my pupils are dilating beyond the treated area. I said that he told me the laser he used has a blend zone (which he says is 8 mm wide, with the flap being cut 8.5 mm wide) and that he told me he checked my dilated eyes and that they were 5.5 mm. He said that he had to use some light to check my dilated eyes and that under even less light, my pupils may dilate more. He also said continued healing may improve the situation. He reiterated that my pupils were within a good range to have LASIK. I am not completely satisfied with his answers, because I was told I would not have glaring or halos and I still do at this point. I suppose I must wait and see as my recovery progresses (the informed consent I signed says glares and halos usually improve substantially over 6-12 months). Also, I get the impression that my doctor is very gung ho about LASIK. He kept emphasizing that I am seeing 20/15 now, better than I could before, while I pointed out that the 20/15 does not measure the quality of the vision (or lack thereof with the halos I experience). He also pointed out that I was seeing 20/25 and 20/20 with my glasses before the procedure, although my chart showed that a newer prescription got me to 20/20 in both eyes. I have the impression that my doctor is annoyed with my perfectionism and I think that is an issue I have to address. In some ways, it is nice not to have to wear glasses. At the same time, however, it's difficult to adjust to not having them (after wearing them since 2nd grade!) and the fact that the quality of my vision is not as consistently good (through all levels of light) as it was with glasses. For these reasons, I generally cannot recommend anyone getting LASIK unless convenience is far more important to you than consistent, quality of vision. I also wish my doctor would recognize that perhaps LASIK isn't perfect.

10 months post-op (March 13, 2003)
It's taken lots of time – much more than I ever anticipated – but my situation has finally improved, and has become much less of a day to day issue. My lingering side effects include dryness and slight glare under low-light conditions. To be more specific, I would say I notice that my eyes are dry probably at least once a day. I am using drops perhaps a few times a week and gel at night. I continue to use the HydroEye, which seems to make a difference. The problem with drops (and the reason I'm not using them more often) is that they only provide temporary relief (maybe for a half hour) and it seems like using them too much can make things worse. The gel at night seems to help moisturize them. I have noticed that since I got this operation, I never wake up with sleepies (otherwise known as "eye snot") in my eye, something I had almost every time I woke up. This feels disturbingly strange and, though I never thought I'd miss scratching the crust out of my eyes, I do now. I imagine it's a good sign if it comes back. As for my vision quality, I saw my doctor in early January and updated my prescription. I continue to have a slight astigmatism remaining (now -.5 in both eyes). The angle has fluctuated also, and my doctor again has indicated this could be a sign of the astigmatism winding its way out. My vision without glasses is good, certainly good enough to play sports and enjoy social activities without the need for glasses. I generally wear them when watching TV or movies, or reading the newspaper at the dinner table. So, I ultimately got my wish, which was to not have to wear glasses, especially in social settings (I always felt like a nerd wearing them). My vision is especially good in bright light, probably shaper than before with glasses. In low light, though, it is certainly worse than it was before the procedure. Low-light conditions include driving at night with just my headlights (little or no street lights or oncoming traffic), and even in my garage which is a big room lit by one 75 watt bulb overhead. Under these situations, I have a sort of glare or haze going on which causes my vision to be annoyingly uncrisp. I have the sense that even this condition is improving, although very slowly. It also happens inconsistently, meaning I'll drive the same road at night and sometimes I'll have glare and sometimes I won't (it's like when you get a piece of lint or fuzz in your eye). But most of the time, I do see it. Anyway, what I've learned recently is that a lot of the anxiety I've had throughout this process was caused by the conflict between my expectations and the reality. Expectations: I thought the procedure would give me vision crisper than I had with glasses and that the healing process would take no more than a month or so. Reality: Vision that can be as good (maybe even better) without glasses or worse, depending on the light condition and a healing process that is still continuing. The bottom line for anyone considering LASIK is to make sure your expectations are realistic, find the best doctor that you can (a good sign is if he thoroughly tests you to make sure you're a good candidate), and really consider waiting for better procedures to come along, either LASIK or something new (a few promising technologies are coming over the horizon). A few other notes ... I think I may have lost some contrast sensitivity, but this too seems to be coming back. ... I've had no problems with my flaps and I play a pretty rough sport (ice hockey).

1 year post-op (May 5, 2003)
Wow. One year since this all started. I've gotten much more used to my "new" eyes and able to take advantage of not having to wear glasses in social situations, such as going out about town, attending parties, playing sports, and business meetings – it would be a big plus, if not for the side effects. I am still contending with two significant side effects: mild to moderate dryness and slight glare in certain low-light conditions. I was checked by my doctor again today and he said my tear film is still diminshed. He has prescribed a newly FDA-approved eye drop called Restasis, which is supposed to increase the amount of tears you make. I have not noticed much of difference after using it less than a week. My prescription has also changed and I have actually become farsighted (I used to be nearsighted)! I am now plano with +.25 axis 007 astigmatism in my right eye and +.25 with + .75 axis 055 astigmatism in my left eye. The change is good in that I suppose it means I'm still healing and things could get better. I plan to update my driving and computer glasses with the new prescription. I asked my doctor if there was any new technology that could fix my night vision problems and also sharpen up my vision and he recommended wavefront analysis, which the surgery center he uses just got. I have an appointment in early July to have the analysis performed, after which he'll inform me of my options. He said he wouldn't be able to lift the flap at this point, so he would either have to cut a new one or laser the surface of the cornea (LASEK). It's also possible I'll choose to wait further for other possible solutions and/or continued healing. My doctor also mentioned I might not have the option for further treatment if the correction is too small for the laser. The main goal with the analysis is to find out what the problem is. All this will be covered by my LASIK plan (thankfully) which promised lifetime enhancements. I must add that my doctor (Greg Scimeca) and surgery facility (Sight Solutions) genuinely seem to care and I'm happy to see that my doctor keeps up with the latest technology. I'm hoping they can ultimately deliver on the promise of clear vision without glasses (or side effects)! I'll update this page after my wavefront analysis in July.

15 months post-op (July 31, 2003)
I underwent Wavefront Analysis on July 1 at Sight Solutions, the same facility where I had my procedure done. They just got the machine and have used it to perform LASIK with their Visx laser for about a month, with excellent results, according to their tech Bob. I was there to see if anything could be done about my night vision problems (see above). Bob conducted the Wavefront Analysis, which took a few minutes. Basically, you look into the instrument without blinking for about 10 seconds or so, three times for each eye. The machine sends beams of light into your eye. In a perfect eye, the light beams would bounce straight back. In a imperfect eye (like mine) the light waves come back bent. The surface of your eye is measured, resulting in a topographical map of the imperfections of your eye (Bob actually printed out a colorful map of my eye). Wavefront Analysis is superior to previous measurement techniques because it evaluates both lower-order and higher-order abberations (another word for imperfections) of your eye. When you go to the doctor and he refracts you for your prescription, he is only correcting you for your lower-order abberations. Also, he does so in quarters of a diopter (for example, you may have an RX of -4.25 in one eye). The Wavefront Analysis can measure the lower-order correction in 1/100th of a diopter (so -4.25 may actually be -4.34). In addition, Wavefront measures higher-order aberations, such as how the structure of your cornea, lens, etc. screw up the light waves. My results were that I still have a slight prescription (which I knew about) and that I have higher-order abberations of about 20% in my left eye and nearly 30% in my right. Bob said anything above 20% is considered significant. This explains why my right eye looks worse in low-light conditions. This same information can be used to guide the laser to better correct your eye. So at this point, I am considering the possibility of having just my right eye corrected using the Wavefront Analysis. I am also considering LASEK instead of LASIK. In the former, no flap cut is created and the surface of your eye is directly ablated. I am conisdering this because I have dryness issues which I think would be made worse if a new flap was cut. I am in no hurry to do this as the technology is relatively new. I plan to talk to my doctor about it in a few weeks and see what he thinks. My general plan, though, is to wait until maybe the beginning of 2004, after he's had more experience with the new system and I can find out more about the success rate of Wavefront on the Internet. Otherwise, things are about the same for me. My two remaining side effects are dryness and night vision problems. The dryness is intermittment, but when it's bad, it is very difficult to ignore (and drops don't do much). The night vision occurs only under certain low light conditions, but it too is difficult to ignore. I am very hopefully that technology will eventually solve both of these issues to my satisfaction, as it will for other people suffering the same problems. I just hope the solutions come soon!

16 months post-op (September 5, 2003)
I had a visit with my doctor today. He installed long-term collagen punctual plugs to help relieve my dryness. The dryness is intermittment, but when it's a problem, it is annoying. I would say my eyes feel uncomfortably dry at least once a week and a least once a week, they are fine. It's hard to figure. It seems to be getting better very slowly over time, though. I'm trying to stay positive. I considered permanent silicon plugs, but I really don't won't any more permanent changes! Yes, I know silicon plugs can be taken out, but I'd rather just try the long-term collagen at first, which should be completely dissolved within two months. If I still have dryness after that and it seemed the plugs did some good, I will try the silicon plugs. I also discussed with my doctor the results of my Wavefront analysis. The correction is small and he has a concern about pushing the laser to correct my small correction and higher order abberations. Also, he was honest in saying the laser has not been used very much to do such small corrections for patients already treated and he had some hesitations about that. I should add that my doctor, Greg Scimeca, has sincerely tried to help me (he was voted best eye doctor in the area by my local newspaper, so I didn't just go to some quack). He put in the collagen plugs at no cost to me and said he would do the same with the silicion plugs, if I wanted them. It's over a year after my procedure and I think if he was only interested in money (and not my well-being) he would be charging me. Anyway, my approach at this point is to wait for improved technology and for my doctor to gain more experience using the Wavefront technology. Like I told him, I don't want to be a guinea pig. I also don't want to live with the annoying glares I sometimes get while driving at night, so I want to eventually get this fixed. But I will be patient (like I should have in general when it came to getting LASIK). Also, if I were to get the correction done, I would most likely have LASEK done, where no flap is made and the surface is directly ablated. This is more accurate for small, custom corrections like Wavefront. I also really wouldn't want to have the flap recut because I would start all over again with the dryness problem (which my doctor also mentioned as a likelihood). It's really only the one eye (right) that's a problem that I would want done. Anyway, my doctor agreed with me that waiting for better, more accurate (and hopefully less invasive and inconvenient) technology is a good choice. I plan to do some research in early 2004 and see what's available. That means I might not be updating this for a while, so here's my latest advice: if you are planning to get LASIK, be sure your expectations are realistic. You will probably (but not definitely) have vision almost as good as your glasses/contacts (to the point where you really won't be able to tell the difference, especially in bright light) and it will be more convenient; however, be prepared for a potentially tough recovery period and for lasting (perhaps permanent) side effects such as dryness and low-light abberations. If you are willing to make this trade off, be sure your doctor and facility are both A-1 and be sure to get a second opinion. Good luck!

18 months post-op (November 3, 2003)
I had another visit with my doctor on Halloween (a few days ago). This time, I had him put in silicon punctual plugs. These will essentially last forever and should help keep my eyes moist by blocking my lower tear ducts. It hurt a little bit when he put them in and the next day I felt a bit of soreness and discomfort in the corners of my eyes. They feel OK now and I have noticed an improvement with the dryness, so if you have that problem, I would consider the silicon plugs (again, you can try temporary collagen plugs like I did to get a feel for it). Now that I am 1.5 years post-op I think I can safely say that, overall, my LASIK experience has been a negative one. I do enjoy very good vision (almost 20/20 overall, but not as sharp as I had with my glasses),but the side effects are way more than I bargained for. I continue to have significant dryness (hopefully, these plugs will help with that) and that really is the biggest problem for me as it can affect my entire day, if my eyes are dry the entire time (which they have been fairly frequently). I also have some haloing at night. Though that's a problem too, it's not as aggravating as the dry eye syndrome. I can only hope that technology will eventually help me with the dryness. Finally, my best advice to anyone considering this is don't do it — there is just too much potential for suffering and no way to reverse any potential damage that is done. My lesson learned is that doctors, no matter how sincere they really are (or seem to be), cannot be trusted as they are not performing this procedure on their own body. It's your body and you will have to live with any possible consequences the rest of your life. It's just not worth it.

18.5 months post-op (November 14, 2003)
I had to follow-up with my doctor regarding the silicon plugs. They were uncomfortable in that I could feel them whenever I moved my eyes to the extreme sides (left or right). They got a little less comfortable about a week after they were put in (I guess swelling from the installation went down), but I can still feel them and that bothers me. My doctor (Dr. Greg Scimeca) said the plugs he installed had caps and that I was probably feeling the caps rub up against my eyes. He suggested we switch to "Smart Plugs" which are actually inserted deeper into your tear duct and they don't have caps. The only slight disadvantage to this is they cannot be taken out with jeweler's forceps – he would have to flush them out of my tear duct (and I think into my stomach?) with a saline injection. He said he was confident he could remove them this way, if need be. The plugs are definitely worth having as I feel 95% normal (just a tiny bit drier occasionally, compared to my average before LASIK). While examining me, my doctor also said that the oil glands around my top eyelids were blocked (no doubt from all the extra drops I've been using over the past 18 months). He suggested I unblock them by applying a wash cloth soaked with warm water for 10 minutes per eye or splashing warm water on my eyes from a sink. I recently read about such glands being blocked on the web too. I tried it a few times so far, and it does feel better afterwards. By the way, I am taking Flax Seed Oil now, instead of the more expensive HydroEye supplmement. It seems to be working just as good. I should also point out that Dr. Greg has been kind enough to install the various plugs I've had at no charge for me. He is collecting whatever he can from my insurance, but whatever they don't cover, he is writing it off so I don't have to pay it. Apparently, some LASIK doctors are not this caring — these are definitely the docs to avoid and also the reason why LASIK can be a diaster. However, even with a good doctor like I have, you are still at risk for long-term side effects. Oddly enough, I came across a website where someone said they had the same haloing at night problem that I have, but that it went a way at almost three year post-op. It's nice to hear that this still might clear up for me, but waiting three years is crazy. Watch out, the LASIK industry likes to play down how long-term/permanent some of these side effects can be!

19.5 months post-op (December 19, 2003)
I had Dr. Greg install the Smart Plugs today. These are tiny silicon plugs that block your tear ducts to help keep your tear film from draining too quickly to keep your eyes less dry. These are different than the standard plugs in that they are installed deeper (they actually shrink into your duct upon contact with your body heat) into your tear duct and they don't have a cap, so there is nothing externally to irritate your eye. They are very comfortable, in fact I don't notice them at all. They also seem to be slightly less effective than the standard plugs. However, I stopped taking the Flax Seed Oil for a few weeks, and that may by why my eyes feel a bit drier than normal. I've begun taking the Flax Seed Oil again and have noticed an improvement. I would suggest if you are experiencing dry eye to consider punctual plugs, especially the Smart Plugs. I also recommend you try collagen plugs first (these dissolve after a few days) to see if you will get some relief.

20.5 months post-op (January 20, 2004)
I just got a call from Jamie at Sight Solutions. Apparently one of their potential LASIK patients saw this website and got scared off. Jamie was calling me to see if there was anything she could do about making me feel better. I told her how I had discussed Wavefront correction with Dr. Scimeca, but how we decided it might be better to wait and see what kind of results he gets with his post-op patients. Jamie says only a handful of Sight Solutions' LASIK patient have experienced night vision problems (including me) and that many of those patients have had great results with a Wavefront post-op correction. I believe she said only Dr. Sivalingam at Sight Solutions has done post-op touch-ups with the Wavefront (Dr. Greg has not). So she's going to have the two doctors talk to each other and Dr. Greg may approach me with a recommendation for getting a Wavefront touch-up. I want to note that my experience with Dr. Greg and Sight Solutions has been very positive, despite my negative side effects. The really do seem to care and go out of their way to make patients happy. If you are considering this procedure and live in the South Jersey area, I would recommend both Sight Solutions and Dr. Greg. Jamie also pointed out that very few Sight Solutions patients have experienced any side effects. She added that she was sure Dr. Greg thought my outcome would be good, which is exactly what he told me after my initial consultation. I guess the bottom line here is that it's really nobody's fault – LASIK is a procedure that has certain risks. And, even with today's technology, it is not possible to accurately predict – even though you are a good candidate and you are using an excellent, reputable doctor and facility – if you will have long-term side effects or not. That's why my overall recommendation is not to get LASIK at this time, but wait until the technology improves – both the actual procedure, so there are less side effects; and the technology that predicts whether someone will experience negative long-term side effects, so it is more accurate.

Latest Update
For the latest update, go to my new LASIK Home Page

SUMMARY

Overall, I have mixed feelings about LASIK. It's not nearly as good as I thought it would be, but it's also not as bad as it was three months after the procedure. If I could do it over again, I would NOT do it. In hindsight, I would've at least waited for better technology (perhaps wavefront analysis). I should've also spent more time accepting myself as someone who wears glasses and being cool with that, instead of being as self-conscious as I was about wearing spectacles (I always thought I looked better without glasses, and I certainly felt better not wearing them). Some of these feelings come from having worn glasses since second grade, and being one of the only kids in my class to wear them at that time. Unfortunately, with LASIK, there is no way to undo it if you don't like the results – you must live with them the rest of your life. My hope at this point is that technology will find answers to my problems of dryness and poor low-light vision. The little bit of remaining astigmatism is not a big issue, really, as I can get crisp vision with my glasses if I need to (although it would be nice to truly be free of glasses, without any side effects). If all this happens, I'll actually be more relieved than happy. I will update this site as I find time.

VISION QUALITY

Here are descriptions of my vision under various everyday conditions. This section is updated as conditions change based on my continued healing.

Bright daylight: On a sunny day, my vision is the sharpest. It seems that very far distances (such as a several blocks away) may have been even crisper before I had my procedure (when I wore glasses), but it's hard to say. I do appreciate the benefit of not having glasses and it's nice not to have the bit of glare they introduce.

Cloudy day: Vision is good, but generally would like to wear my glasses if I'm driving as the slight astigmatism I'm left with is more noticeable. However, this is not necessary.

Rainy day: Definitely feel better wearing my glasses if I'm driving. Vision is not as crisp and low contrast areas can be harder to distinguish than with my glasses.

Night: I'm still seeing slight haloing or glaring around soft light sources (street lights in the distance, etc.). The degree of the halo depended on the amount of ambient light (and therefore, how large my pupils dilate). The brighter the light, the less the halos (to the point where they are not annoying). However, the problem has diminished (and hopefully will continue to diminish), but it still exists and can be annoying, thought certainly not a safety issue. Note that wearing my glasses does not help and that makes this a problem!

Indoors good lighting: With several bright lights on, things are pretty good. I sometimes wear my glasses anyway just for maximum clarity.

Dimly lit room: A room with one light or several low lights (say 40 watt bulbs) can still produce noticeable glare and halos, not around any particular lights, but just "covering" my eyes. It's like you have a piece of very light fuzz in your eyes that would usually go away when you blink, but it doesn't. This has improved, but has not gone away completely.

No light: Dark room with the ambient light of a digital clock or TV. Generally, it's too dark to notice any problems. However, any tiny LED lights (like the light on an answering machine) has tiny halos around it (they were much bigger right after my procedure). This was definitely not the case when I wore glasses. I can distinctly remember such LED lights as being clear, tiny pin pricks.

Movie theater: Generally good, except in very low light situations. For example, I saw a movie that had opening credits that were white text on a black background. The white text had halos around them. The rest of the movie, however, was fine with no noticeable distortions.

Watching TV: At this point, good. The only problem is dryness if I watch too long or spent a lot of time on the computer earlier in the day. I'm not a big TV watcher, so this is not a huge issue.

* In all cases, my eyes get drier quicker and usually more severe than they used to. Drops are only a temporary help.

LINKS

Here are some other websites that I've found useful:

Hydro Eye Supplement — A vitamin supplement I highly recommend if you are experiencing severe, constant dry eye. After a few days of taking these pills, I noticed a difference. They have been very beneficial and I recommend them. Ask your doctor for a free sample as my doctor was able to supply me with two free months.

Lori's Lasik Experience — This diary of a woman who had the procedure done is straight forward and a realistic overview of what to expect. I have found her experience to be very close to my own. She's also the initial inspiration for this personal web page. [SITE NO LONGER AVAILABLE]

Yahoo Lasik Overview — Solid, basic one-page overview of LASIK. [SITE NO LONGER AVAILABLE]

FDA LASIK Surgery — Offers a good, objective overview of LASIK. Good place to start.

Quality of Vision Complications — Straight forward summary of the quality of vision issues you may face after having LASIK.

Council for Refractive Surgery Quality Assurance — If you're ready to do all the leg work you should do before getting LASIK, go to this site. It offers 50 Tough Questions You Should Ask Your Doctor, plus lots of good information to help you make an informed decision and see you through the recovery period.

Washington Eye Physicians & Surgeons — Probably the most honest and clear description of what you can expect post-op.

ABC News LASIK Surgery Q&A — A knowledgeable doctor chats candidly about LASIK. [SITE NO LONGER AVAILABLE]

Surgical Eyes — The best website for LASIK horror stories, I found this a week after my procedure and felt like an idiot for getting it done.

Lasik Info Center — Another scary site that basically comes to the same conclusion I have: wait for better surgical techniques!

Lasik Memorial — Dedicated to people who have bad experiences with LASIK. Sad and likely to convince you not to undergo the surgery.

Ask Lasik Doctors — Comprehensive summary of complications and problems and possible solutions.

Lasik In America — Questions to ask yourself, and especially your doctor, to determine if you're a good candidate for LASIK. This is critical to the success of the procedure. I would even recommend getting a second opinion and see which doctor puts the emphasis into the evaluation that they should.

Lasik Institute — Good overview of LASIK.

Dr. Maskin — He is a LASIK dry eye specialist in Florida. If you have a serious problem, it might be worth contacting his office (the people there are very nice).

Refractive Source — Summary of all the different vision correction procedures available.

Complicated Eyes — Relatively new site (many pages are still under construction) offering very thorough information on post-op issues and how to deal with them.

eyeForDesign — A link to my own website, if you'd like to find out more about what I do and my creative endeavors.

LAST UPDATED
1/20/04, about 20.5 months post-op (link status updated 3/16/07)