Wednesday, 16 March 2011

Park Avenue Laser Epi-LASEK review: Five weeks after laser eye surgery


Helloooo anyone still there? I thought it was about time I did a follow-up post after my laser eye surgery which I had about five and a half weeks ago. I had my 1-month checkup last week and everything seems to be going swimmingly so far. I know a lot of you are interested in how it went because you're either considering having laser eye surgery or you've already had it done, so here we go...

[Previous posts: Getting laser eye surgery and My laser eye surgery consultation]

One week before surgery


I phone up Park Avenue Laser to upgrade to the "Platinum" package which is $1,000 more expensive than the plan I'd originally chosen, making the surgery $6,000 in total. The difference is that I'll have Epi-LASEK instead of LASEK, so instead of having the epithelium of my eyes removed by the surgeon, it would be removed using an automated tool, which apparently means a cleaner cut and thus shorter healing time. I decide if I can stretch to the extra cost I should just do it just in case the healing process ends up being really uncomfortable.

Day of surgery


At the surgery centre, I'm given countless eye drops as well as Valium to take. Everyone has to wear showercap-style hats and paper booties to cover our shoes before going into the operating room. I'm given more eye drops, including numbing drops. There are lots of instructions on what to do and what not to do. The Valium starts making me sleepy. My husband is given instructions on what to do and say at certain points during the surgery (e.g. to count down the remaining seconds on the laser because it will supposedly be more relaxing for me than hearing the doctors' muffled voices through their masks).

I'm feeling very relaxed at this point, probably due to the Valium. I keep dozing off even during the drama and shouting that occurs in the room around me (more on that later). When everyone's ready, the surgeon tapes a patch over my left eye and then clamps my right eye open with an instrument but I literally cannot feel anything due to the vast amount of numbing drops I've had in my eyes.

The surgeon uses another tool on my eye, but this time right on the centre. He then drops a solution (presumably something to loosen the epithelium/skin of my eyes) through it. He removes this tool and brings forward another while telling me that everything will go dark for a few seconds. Something is pressed hard onto my eyeballs (I assume the automated tool that cuts the epithelium). I can definitely feel the pressure on my eyeballs but it's not painful. Everything goes dark, then the tool is lifted away. There is some swabbing and then I briefly see a round piece of my epithelium being lifted away.

At this point, my right eye is ready to be lasered. I'm put back under the machine and given instructions to focus on the right dot once it appears. The total laser time per eye will be 40 seconds. The red dot appears and I hear the laser going to work (a repetitive click-click-click sound) but I swear the red dot's darting around. I don't know whether this is my own focus moving or the red dot moving, but nevertheless, I move my focus back onto the red dot. The laser stops abruptly, there is some huffufle, and I'm told the laser stopped after detecting movement and we have to try again. Whoops.

I try extra hard to stay focused on the red dot. I had prepared myself for the smell of burning flesh that other people have reported post-laser surgery, so I'm surprised to smell only the faintest whiff of singed hair for just a second (and I have an ultra sensitive sense of smell). Before I know it, voices tell me I'm doing "really well" and start counting down to zero. I've felt absolutely no pain or discomfort at all during the whole procedure. The laser just feels like a light with a clicking noise.

A bandage contact lens is then placed on my right eye and it's all done. The whole procedure starts again with my left eye (while my right eye is patched). This time the laser completes its work in one go.

I'm told to sit up, and look around. The first thing I notice is two random people from the street standing in the corner, less than a metre away from me, with their outdoor coats still on, and who have been watching the whole time. I think "What the...???" (Park Avenue Laser are really big on having potential patients watch surgeries to see how simple and painless it is - but still, I'm annoyed that these people were just allowed in when everyone else had to wear all this protective gear. What's the point then??). The surgeon tells me to look outside the window and read what's on the road sign across the street. Previously I couldn't even see, let alone read it. My sight is much better than it was before without my lenses/glasses but I still can't read the sign completely clearly. I'm prepared for this though. I'm not expecting 20:20 vision immediately after the surgery.

A doctor puts collagen punctal plugs into my tear ducts to help with the dry eye symptoms that I'll get post-op.

I'm given more instructions which I know already, e.g. keep my eyes closed for as many hours of the days as possible until I come back to have the bandage contact lenses removed, remember to take all the pills and eye drops I've been prescribed, continue to use artificial tears regularly etc.

I drop my old glasses into the recycling jar knowing that I'll never need them again. This feels great.

We go home. I have a bite to eat and pass out from the Valium.

One day later


I wake up, accidentally move my head too fast and feel a sharp pain in my eyes as if I've left my lenses in overnight and my eyelids have stuck to then. I put some artificial tears in. The pain lasts for just seconds. I take care to take all the medication and drops I've been told to use. These include ibuprofen pills and anti-pain drops which I use, but I don't really feel like I need. There's no pain whatsoever. It just feels like I'm wearing old contact lenses (which I guess I am).

I go back to the surgery for my 1-day post-op checkup. All is fine.

At home, I still have more Valium tablets which make me woozy, which is great for forcing me to sleep weird hours.

Three days later


Up until now, I've spent most of my time in bed with my eyes closed, on the phone to friends or listening to audio books. I have an appointment at the surgery to have my bandage contact lenses removed, but after inspection they decide my epithelium needs another day to grow over completely. My eyes still feel fine... just a bit like I'm wearing old lenses.

My eyesight is good. Not sharp, but fine for walking around.

Four days later


I go back to the surgery and my eyes are ready to have the bandage contact lenses removed. After having them removed, my eyes instantly feel very naked and dry, and my eyesight is substantially worse. I'm told this will be expected until the skin of my eyes fully heals and smoothes over.

The winter air is so dry in New York. Even with a humidifier going full blast and constantly using lubricant eye drops, my eyes still feel uncomfortably dry.

Five days later


I go back to work (picking up a humidifier for my desk en route) because apparently my eyes should have healed enough to allow me to work now. They haven't. Everything on my screen is a big blur no matter how large I make the text. I literally cannot read a single thing on my screen. It's frustrating because I can't even see anything if I put my face right up to the screen. I don't get anything done. I swear my eyesight is worse than yesterday.

Six days later


I go to work again but my eyesight is definitely worse than the day before. It almost feels like how I was before the surgery, without my glasses (except now I can't see distance or close-up). I'm a bit worried at this point so I call the surgery and am told to go in as soon as possible. I'm there within an hour, and during the checkup the surgeon tells me the surface of my eyes "looks like crap". Apparently my eyes are extremely dry (despite me using drops constantly) and this is slowing down the skin of my eyes healing.

One of the doctors puts new punctal plugs into my tear ducts to help with my dry eyes, this time permanent ones. This hurts like mad. Afterwards when I move my eyes to the side, I get a sharp pain in the inner corners of my eyes (I get this for days afterwards).

I struggle to find the correct subway station to get back because my sight is so bad and I can't read the signs. When I leave the office later that evening, it really feels like being shortsighted and not wearing glasses. All I can see is glare from street lamps and store signs and not much else.

Two weeks later


Up until this point, I've been going to work but have frustratingly managed to do very little because it's still difficult to read anything on my screen, especially after midday when my sight blurs considerably. But exactly two weeks after the surgery, I realise I am still managing to read my screen okay-ish in the afternoon. I feel that in hindsight I should have taken more time off work because I probably just slowed down the healing process by attempting to go back to the office too early.

I go to the cinema for the first time and have absolutely no problems seeing detail on the big screen. But I do notice that the "EXIT" signs on either side of the screen have halos around the red, lit-up lettering.

The dryness of my eyes is barely noticeable now. But I'm still using thick artificial tears as frequently as possible (every hour or so) as a precaution and to help the skin of my eyes heal over quicker.

Three weeks later


There's been a turning point. My eyesight has suddenly become sharp overnight, particularly in my right eye which feels just as sharp as it was when I was wearing contact lenses. My left eye seems a tiny bit shortsighted still in comparison. The dryness has been basically eradicated. I'm only using the artificial tears out of habit and precaution rather than necessity. I am pretty much back to efficiency at work.

Four and a bit weeks later


I have my 1-month post-op checkup. I can almost read the bottom line on the chart but it's mostly just shapes and I can only guess the letters. So I'm not quite 20:20 yet. The doctor is pleased with the way the surface of my eyes have progressed and has no concerns that I haven't achieved 20:20 vision yet. He tells me that the reason my sight has been a bit off until now is that they overcorrected my vision in order to compensate for the natural deterioration that my eyes will get over the next few years (so that I won't need an "enhancement"). My eyes have just been adjusting to that over-correction.

My left eye is still not as sharp as my right eye.

At home, I watch the DVD I was given after my surgery. I guess there's a video camera in the laser machine because the film is of the complete surgery, with my eyeball filling the entire screen. When I watch it, I feel sorry for my husband having had to sit through the surgery watching this in real life. He must be traumatised. The procedure is gruesome. The worst part is the instrument that they push onto my eyes (at the point where I feel pressure on my eyeball and everything goes dark) which cuts the epithelium. It's pushed onto my eyeballs so hard that when it's lifted off, it leaves deep impressions in the whites of my eyes. Another horrible bit is seeing where the epithelium has been taken off, and you can see the leftover edges where the circle of skin has been lifted off. I can't believe that my eyes were able to grow all that skin back under the bandage lenses in just four days! The human body is an amazing thing. I was going to post the video on my blog, but it would only put everyone off having laser eye surgery. So it's best you don't see it!

Five and a bit weeks later (now)


My right eye still sees great, I can really notice that "hi-def" treatment I had. Everything's really sharp and crisp. My left eye is still not as sharp as my right, but seems to be slowly catching up. My left eye was the one that had a slightly higher prescription before the surgery.

Overall thoughts so far


I'm really pleased with the results of the laser eye surgery so far and have no regrets. I just hope my left eye become sharper and that I don't need an enhancement later on. I hear it can take eight weeks or more to achieve the best vision. I love not having to wear contact lenses or glasses. It seems strange to think that I used to put foreign objects into my eyes every day and touch my eyes to get the lenses in and out all the time. That doesn't seem healthy when I think about it.

Honestly, there's been no pain at all. The punctal plugs were probably the most uncomfortable bit - and they weren't even part of the surgery!

The dryness only lasted the first two weeks (but it was quite severe during that time due to me having naturally dry eyes anyway, and also the dry air in New York). I'm glad I went for (Epi-)LASEK because since having the surgery, I've seen "dry eye" forums online where people rant about not being warned about the severe permanent dryness they've been left with after LASIK.

There is some glare and halo-ing around lights. This only happens when the lighted object is on a dark background, like the red EXIT sign at the cinema like I've mentioned, car headlights, street lamps etc. It's strange because the halo effect is similar to seeing lights while shortsighted, except everything else that isn't a bright light on a dark background is still really sharp. For example at night, car headlights have faint haloes around them, but the characters on the number plates are super sharp and clear. I'm not sure whether this is permanent. It's not really that bad or uncomfortable, but definitely noticeable. So far, I haven't had any light sensitivity in bright light.

If I could go back and change anything, I wouldn't have gone back to work so early. I would have waited at least a week and a half after the surgery. I didn't get much work done and it probably just slowed down the healing of my eyes.

It's great to wake up being able to see, and to skip one step in my pre-bedtime regimen. I feel liberated. I wish I could live certain parts of my life again with my new eyes.

Park Avenue Laser is a bit of a weird place. The surgeon, Dr. Chynn, is obviously very experienced and good at what he does but he's constantly shouting and swearing at and demeaning his staff, even when there are patients and/or customers around. I can't even describe the full extent of it! I'd read reviews saying the same thing before I went there, but I thought people were just exaggerating! All the other staff are great and really helpful, especially Dr. Chynn's "fellows", Dr. Puri and Dr. Almeida, and the receptionist, Liz. Most of the staff have had laser eye surgery themselves so they know the experience first-hand.

I'll update you next time I have anything new to report about my eyes.

I hope this post has been helpful! If you have any questions from anything I've said above, leave them in a comment and I'll try my best to answer them soon (although don't forget to read my two previous posts as well in case I've already mentioned what you want to know)!

[Update (14th June 2011): Don't forget to read my latest post, Belated update on my laser eye surgery... Good news!]

23 comments:

  1. Yes! We're still here, thanks for the update on your surgery. It's been great to read your experience of everything and how it's turned out for you. I'm 23 this year and plan on having the surgery in Singapore (I don't really think New Zealand's surgeons do that many operations, I'd rather go to a place which has done it many many times hehe) during the christmas break so I can have a longer healing time, thanks for that advice. Otherwise I would've assumed 1 week was enough.

    I hope your left eye catches up the right :)

    Thanks again

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  2. Thank you so much for this post, I've been considering having surgery for quite a while and this has helped me a lot, you have described every phase so well. I hope your left eye gets better
    xxx

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  3. Holy WOW! That's a LOT of $$$! Of course I live in Atlanta where the cost of living is a fraction of what it is in NY. My husband and I just had Lasik done 10 days ago. Amazingly, we had a local Groupon for $900 an eye! Of course we researched the doctor thoroughly and he has a thriving practice and excellent reviews. He only does the groupon twice a year. So far so good. I was 20/20 the next day, and 20/15 at my one week follow-up. Glad to hear yours is going well. It feels like a miracle to see like this!

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  4. Wowzers! I would actually love to see the video! X

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  5. Hey Helen great detailed account of your surgery. Glad you are doing well.=)Angel

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  6. This is such a useful account of your experiences. I'm thinking of getting laser eye surgery in a few years, once I graduate from uni and working, but information is power. Do you mind emailing the video you mentioned? I completely understand if you don't want to for privacy, but I really want to see how the procedure occurs.

    If you don't mind, my email's shimmerdreamz@gmail.com

    Thanks!

    Cassie

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  7. Hey, I had laser eye surgery 5 years ago here in Toronto and never looked back (no pun intended!). Congrats on a life without glasses or contacts! It is worth EVERY.SINGLE.PENNY.

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  8. @Jani: Yes definitely take off as much time as possible if you're having LASEK or Epi-LASEK, and try not to be anywhere where the air is too dry! Good luck for when you finally get it done!

    @Eli: My left eye is much better now thanks! I have my 2 month check-up next week so will update after that.

    @Jocelyn: Yeah it was a lot of money, but the cost didn't even cross my mind when I was making my mind up.. just wanted to get it done! Was so fed up with my short-sightedness and contact lenses. I'm glad you had a good experience too!

    @Lau: I will upload the video when I get a chance. It needs quite a bit of editing though because they literally recorded the whole thing including all the prep and everything... it goes on for aaages.

    @Angel: Hi!!!! Thank you!

    @ShimmerDreamz Sure, I'll upload the video and drop you an email when it's up! It just needs a bit of editing first so I need to find a spare few hours.

    @Make Mommy Chic: I'm with you on that!

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  9. Hi! I was very interested in reading your post, as I had the same surgery myself about six months ago (on my right eye only, the other not needing it). I was quite disappointed with the result, especially since for a couple of months my right eyesight was often blurred at certain times of the day, in the afternoon mostly and glared/ halo-ed at night (which made it difficult for me to drive when it was dark). It is much better now, but still not perfect. I'm quite happy though not to have to wear glasses or contact lenses any more. The only thing I really regret is that my upper eyelid (the one I had surgery on) is slightly drooping now - it is called "ptosis" - and even though the surgeon told me it would probably disappear in a few months, it is still here and I wish I had been told about this apparently rather common side effect...!
    Thank you for this wonderful blog of yours, definitely one of my favorites!

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  10. Thanks for your reassuring post...I had LASEK 6 days agoand, until I read this, was slightly concerned that my vision is really blurry. I guess i just need to be patient! Rhianna

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  11. Of course we're still here :D Great post, thank you so much for all the detail. I don't think I'll watch the video if you do decide to put it up, though, because it sounds like it would definitely put me off!

    I'm definitely going to get it done, just trying to decide whether to go home to Dublin and the surgeon I'd done all my research on or get it done in London. Can I ask who you were thinking of going to before you moved?

    @Sev - wow, I'd never heard anything about ptosis before, thanks for the warning.

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  12. i went to see a dr few weeks ago to get glasses because i can't see well anymore. it turns out it's mostly because i have extremely dry eyes and he wanted to put punctual plugs which i refused before i do the research. he told me that contacts or eye surgery are out of the question for people with dry eyes and that he would only consider it after i wore the plugs for some time to see if they are getting any better. how long do you think you will have to keep plugs in and do you feel any discomfort anymore? do you have them only in bottom corner or under eyelids too? try to drink more water, apparently it can help too as some eye dryness is linked to dehydration. thanks i advance and all the best with your recovery.

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  13. @Sev - I hadn't heard of ptosis before and had to look it up. Didn't know it was a common side effect of laser surgery! Hope your eyesight improves soon! Apparently it can take months to settle.

    @Rihanna - Oh yeah, 6 days after the surgery, my eyes were still really blurry don't worry!!!

    @Lynnie - When I was in London I kept chickening out before even researching doctors properly! But I did think at the time that if I were going to have it done, I would go somewhere "proper" like the Moorfields eye hospital where they would take the surgery and aftercare seriously rather than getting as many customers in and out as possible. I read loads of reviews of chains like Optical Express and they sound really dodgy!

    @Stela - The plugs I have are "permanent" and I wasn't given any information about how long they will last for. They can apparently come out if I just rub my eyes too hard (so I try not to). I don't feel any discomfort anymore with them in. I only have them in the inner corners of my bottom eyelids (the lower tear ducts). I'm not sure if they've actually helped much with the dryness because it's not like I'm suddenly getting watery eyes or anything. My eyes don't really get dry anymore, but I think they were mostly dry before just because of my contact lenses. Yeah I drink a lot of water and coconut water (meant to hydrate better than water) and I've been taking omega 3-6-9 tablets but again I haven't noticed any drastic changes to the moistness of my eyes! Have you tried any eye drops? Hope your eyes get less dry soon!

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  14. Hi, I really enjoyed reading your experiences of Epi-LASEK. I had LASEK at the start of April at St. Pauls Eye Unit at Liverpool Broadgreen Hospital and even though I did a lot of reseach first, nothing quite prepares you for what it's going to be like!

    Luckily I haven't had too much of a problem with dry eyes (although my Dad did when he had his eye surgery about 11 years ago), or glare/halos but I do have some haze in my eyes, which means I'm still blurry now, two months on.

    I would also second your advice to take more time off afterward, I went back to work 6 days after and it was too soon. I spent two days stuffing envelopes and doing tasks that didn't involve read off a computer screen!

    @Lynnie, as Beauty Scribbler said, Moorfields in London have a very good repuation and it's a hospital, not just a clinic like Optimax.

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  15. Thank you so much for posting this! I'm getting Lasek by Dr Chynn tomorrow. Your entry is so detailed so now I really know what to expect!
    Hope your left eye vision improves!

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  16. @Anonymous - I hope your vision becomes less blurry over time. Haha @ stuffing envelopes!

    @GraciesMom - Ooh you'll have had the surgery by now! Hope it all went smoothly and that you recover quickly!

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  17. I found this post through a rabbit trail of searching... very informative! Thanks for sharing. Don't worry about your left eye not being as sharp. Once you hit around 42 you will begin to lose your up-close vision. You will be able to read better with your left eye than your right. I think I will have to give LASEK a little more consideration now. But if I do it, I will only do ONE eye. That way I will still have one eye to read with (this is called mono-vision).

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  18. Your post has been so heartening. I had laser surgery (Wavefront guided intra-lasik) in London four days ago and have been worrying about the quality of my vision. The surgeon tells me it's 20/20 but I find it rather blurry and my eyes feel out of kilter with each other and rather strained. I'm 52 so I had been expecting a loss of close vision and needing to use corrective specs. Oddly this isn't as bad as I expected but I find it varies hugely during the day.

    Anyway, long story short: just wanted to say how pleased I was to read a report that didn't say, "I had brilliant, sharp eyesight straightaway." It's made me feel supported and, more than anything, able to be patient with the healing process and improvements in sight over time.

    Thank you!

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  19. By the way, I went to Moorfields and had the surgery with Mr Gartry. He was excellent and I felt I was in the hands of the best.

    My cousin is an eye surgeon too, and she recommended him - she couldn't do mine as she lives in Scotland. She used to work for Optical Express and so I wouldn't completely write them off, as some of your replies have. But it is worth checking out who your surgeon is, and whether you can specify who you get.

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  20. Did your left eye finally catch up with your right eye? I did the surgery in the same place, Park Avenue Lasek. It has been one and a half month and my right eye is still much worse than the left eye. I started to worry about the significant vision imbalance.

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  21. excellent reading your review of the surgery, i had mine done 6 days ago at Optimax in liverpool.
    hella painful for the first 3 days until the bandage lenses came out, much better now.
    slightly worried still as my left eye is drastically worse than my right, (and i managed to poke me self in the left eye about an hour after the bandage came out, hilarity did not ensue :( )

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  22. I am having the surgery on Aug 5 from the same surgeon, paid $5000. I hope it pays off.

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  23. how are you doing, a year out? Have your eyes been ok? Have they adjusted well? I hope so!

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