LASIK Surgery: Permanent Vision Correction as a Prep

LASIK Surgery: Permanent Vision Correction as a Prep by Daisy Luther for The Organic Prepper

In an everyday situation, poor vision is just an inconvenience. The modern world has provided us with lots of easy solutions: glasses and contact lenses are readily available.  Personally, I have required vision correction since I was 7 years old. I can barely remember a time when reaching for my glasses was not the first thing I did each morning.

But what if you were at a hotel and smoke alarms were ringing and your glasses had slipped off the nightstand? How would you make your way out? What if someone broke into your home and you couldn’t grab your glasses? Would you feel confident firing a gun or would you be worried it might be a family member because you just can’t see clearly?

And then there’s the SHTF.

In a disaster scenario, bad vision could be an incredibly dangerous handicap. What if something happened to your glasses? What if you lost a contact lens or had no solution to rinse them? Would you be able to function without vision correction?  Have you ever stopped to consider how impaired you’d be? Could you shoot, evade, hunt, or defend yourself? How would you ever replace these items?

Five years ago, my vision was awful.  My prescription was -4 in one eye, and -5 in the other. 20/200 – legally blind without correction.

I coughed up the most money I’ve ever spent on a prep in 2014  and had Lasik surgery. For the first time since kindergarten, my vision was better than 20/20. It’s the best money I’ve ever spent. I had been wearing vision correction since the age of 7 and it took me a full year after the surgery to stop feeling around for my glasses on the nightstand.

I first wrote this article a month after the surgery. It’s been five years now and I wanted to update to let you know how the eye repair has held up.

Choosing a Surgeon

The first step to having Lasik surgery is to choose an ophthalmologist.

I advise great caution here. This is your vision we’re talking about. It’s rare, but negative side effects can occur – things like dry eye, poor night vision, detached corneas, and even blindness. Don’t go to the cheapest doctor for this. Go to the best one.  Seek a surgeon with a great reputation who does nothing but Lasik, day in and day out. Save up your money for a little while longer and go to the very best doctor you can find.

When you see advertisements touting bargain basement prices….”LASIK!  Only $800 per eye! Why pay more?” look into the situation very, very carefully. I’ll tell you why you should pay more: the best doctors do not have surgery sales. They don’t need to – word of mouth referrals keep them quite busy enough.

My surgery cost $4500.  That included 2 pre-op visits, the surgery itself, and 4 post-op visits. I know, that’s a lot of money but when you think about a lifetime of optometric appointments, contact lenses, and new glasses, it does work out to be not so outrageous.

How Does Lasik Surgery Work?

The first step is to find out whether or not you are a good candidate for the surgery. There are several different options in vision correction surgery:

LASIK: LASIK, an acronym for Laser In-Situ Keratomileusis, is a type of laser eye surgery that corrects nearsightedness, farsightedness, and astigmatism. Using a computer controlled excimer laser to reshape your cornea and correct your vision, LASIK offers rapid recovery and minimal discomfort.

LASIK corrects the refractive errorsin your eye. During LASIK, a microkeratome is used to create a thin flap at the top of your cornea. The flap remains attached to the eye, similar to a hinge. By creating a flap, the procedure is virtually painless due to the fact that the epithelial layer is not removed as with PRK.

PRK (Photorefractive Keratectomy): PRK is an alternative way of performing laser vision correction, and a good choice for many people who have been told they may not be an ideal candidate for LASIK. The PRK procedure uses the same type of excimer laser as LASIK. And, just like LASIK, PRK is able to correct nearsightedness, farsightedness, and astigmatism.

Unlike LASIK, PRK does not require our surgeons to create a flap on the corneal surface. In the LASIK procedure, an instrument called a microkeratome or IntraLase creates a surface flap on the cornea, which is gently lifted back by the surgeon to give access to the next layer of the cornea, the stroma.

The stroma must be accessed for the treatment since the stromal portion of the cornea does not regenerate, thus making your treatment permanent. Our surgeons then use the Visx Star S4-IR to apply your specific treatment plan to your cornea. Even though the microkeratome or IntraLase is a very precise instrument, some corneas are too thin to safely create an effective flap. In those cases, PRK may be a better option.

Since no flap is created in the PRK procedure, the surgeon uses a special instrument to remove the surface cells of the cornea to access the stromal layer where the treatment must be performed. The surgeon then uses the Visx Star S4-IR to apply your specific treatment to your cornea.

Monovision: Presbyopia is the medical term for the natural aging process that affects near vision in people around the age of 40. Most people who suffer from presbyopia use bifocals and reading glasses, which aid the eye in focusing on close objects. Monovision is another treatment for patients with presbyopia.

Monovision maximizes the versatility of your vision. For normal tasks that require near vision such as working on computers, glancing at your watch or looking at your dashboard, monovision is an excellent option. However, if you enjoy activities that require the use of near vision for an extended period of time such as reading a book for several hours, you may need glasses to help reduce eyestrain.

One of the options we investigate for prospective laser vision correction surgery patients wearing reading glasses is monovision: The use of one eye corrected for distance and the other for near vision. This procedure is performed on people over 40 to lessen the need for reading glasses. We find that 90% of our patients can accommodate monovision and most love it when it is done appropriately. It is important to note that if you choose monovision and are unable to adapt, monovision can be reversed by performing an enhancement procedure. Once the enhancement is performed, both eyes will be corrected for distance vision and reading glasses will be required for near vision.

(The above descriptions are courtesy of Griffin and Reed Eye Care)

Your surgeon will advise you about which options will be the best in your situation.

Here are the risks of Lasik surgery.

With any type of procedure, there are risks. The risks involved in Lasik surgery include:

• The greatest risk a patient will face is rubbing their eyes soon after surgery and dislodging the corneal flap
• An infection by not using the prescribed eye drops
• Perforation of the eye caused by failure to insert the “spacer” properly.
• Creation of a washboard corneal surface with intractable irregular astigmatism caused by variations in vacuum pressure during the microkeratome operation.
• Creation of a free, thick, foreshortened, or bisected corneal flap.
• Binding of the microkeratome in the middle of the operation due to entrapment of cilia or conjunctiva in the gear mechanism or misalignment of the gears and gear tracks.

Afterward, some patients may suffer the following side effects:

• Glare
• Seeing halos around images
• Difficulty driving at night
• Fluctuating vision
• Dry eyes

These occur to varying degrees. If you have these issues after surgery, consult with your ophthalmologist to find solutions.

My experience with Lasik

After a great deal of research, I opted for a surgeon about an hour and a half from my home. I found a clinic that specialized in LASIK surgery, had great reviews, and had no complaints lodged against them.

During the initial consultation, the assistant took all sorts of measurements and different types of computer photos showing the topography of my eyes.

Photo Credit: Griffin and Reed

After approximately an hour of different tests, I met with the surgeon. Dr. Maboudi was wonderful. I couldn’t have chosen a better surgeon. Not only did she answer questions, she encouraged them. She took a great deal of time, explaining the procedure thoroughly. I was delighted when she said I was a good candidate for the most basic version of the surgery – nothing fancy required.

Upon the surgeon’s recommendation, I opted for monovision. Because most of my work is online or with my nose in a book, this means that at least for the time being, I don’t require correction for reading or computer work. I do have a pair of pharmacy reading glasses for those marathon days at the computer to reduce eyestrain, but I rarely have to wear them. With monovision, the dominant eye is set for distance (since I always close one eye when shooting, this doesn’t affect my aim at all) and the other eye is set for close work. Miraculously, the human brain adjusts to focus the optimal eye for the task at hand. The adjustment took about 2 weeks, during which I was lukewarm about the decision.  At some point, I’ll probably need reading glasses again, but for now, I’m still correction free.

Once I said yes to the surgery, a date was set. I chose a time when my oldest daughter would be home from college so she could drive. One more doctor’s visit was necessary before the surgery, during which my eyes were dilated with very strong drops – much stronger than the normal optometric dilation drops.  Measurements were again taken, microscopes were used, and calculations were done to ensure the best possible results. (The phrase “Measure twice, cut once” comes to mind.)

The day before the surgery, I started to get really nervous.  Just a hint: if you decide to go for this, don’t read stuff from websites with names like “Lasik Horror Stories” the night before the surgery. Just don’t.

The next morning, we made our way to the clinic. Ner. Vous. You don’t have any kind of restrictions with regard to eating and drinking before this type of surgery, but I kept it light in honor of my jitters.  Once we arrived at the clinic, I was given a mild sedative. Trust me, no one wants to watch lasers coming towards their eyeballs without a sedative.

When they deemed me sufficiently mellow, I was led to the surgery room. It looked like something you’d see if you were abducted by aliens – lots of sleek, modern machinery with computer screens attached surrounded this huge padded chaise lounge-type chair. The chair was similar to one you’d see at the dentist’s office, with the exception of a cushion that fits snugly around your head to help you stay still during the surgery.

My oldest girl, she of the cast-iron stomach, opted to go into the observation area and watch the entire thing. My eyeballs were broadcast on a giant tv screen for her viewing pleasure. Here’s a picture she took of my humongous peeled eyeball:

My youngest chose to stay in the waiting room and read a book, blissfully oblivious to the cornea being peeled off of my eye.

Here’s what they do during Lasik surgery.

The LASIK surgeon first creates a thin corneal flap by using an instrument called a microkeratome or IntraLase. Due to safety concerns with many microkeratomes, we use the Hansatome Microkeratome or IntraLase. The flap remains attached to the eye, similar to a hinge. This portion of the operation is fully automated and takes about 12 seconds. The flap is then temporarily lifted back and computer-controlled pulses of cool laser light gently reshape the inner cornea. During this part of the procedure, the computer controls the laser and directs the reshaping of the cornea, based on the patient’s unique corneal map.

The flap is then placed back into its original position. After the LASIK procedure, light rays focus more precisely on the retina, improving vision.

And here’s a picture for those of you who are more visual:

Numbing drops are administered once you’re in the chair. Despite this, I felt initially panicky and really wished for a better sedative. The staff was calming, however, and the surgery began

They put a little gadget in around your eyeball that keeps you from blinking or moving your eye. I watched the laser coming towards the first eye to make the corneal flap.   There’s a slight burning sensation like you’ve had something splash into your eye. When the flap is made, they peel it back – you can’t feel this at all. You are supposed to fix your gaze on a red dot.

First, your vision is like a kaleidoscope, then, it goes completely dark and you know what it must be like to be blind. You can see a little bit of light and some shadows, but you can’t make out anything distinguishable.  The correction on the first eye took 18 seconds of a loud pulsing laser. I could feel some slight pressure, but that was it. Then the doctor replaced the cornea and did something that felt like a tiny little squeegee was going across my eyeball to get the bubbles out from under the cornea. The entire process was repeated on the other eye.

I was moved to a recovery room and sat there for a few minutes with my eyes closed – I’m not sure how long. The surgeon came in and checked my vision. It was blurry but still…unbelievably within a half hour of surgery – 20/20 in both eyes!

The recovery from Lasik surgery

They taped some big round shields over both eyes, gave me enormous sunglasses to cover them, and sent me home, where I slept nearly constantly until the next morning.

In the morning when I took off the shields, I couldn’t believe my eyes. Literally. My vision was perfect, aside from some on and off blurriness. We had to make a post-op drive to allow the doctor to perform a check-up on the corneal flaps. The surgeon was pleased that things were healing nicely and sent me on my way. I had 3 types of prescription drops and some saline drops to use over the next week.

My eyes felt scratchy for a few days afterward, sort of like they do when you’re coming down with a cold. For a week, I had to sleep in these odd-looking ski-goggle type glasses so that I didn’t inadvertently rub my eyes in my sleep, potentially dislodging the corneal flap before it had time to heal.

During the first week, I slept a little more than usual and was more sensitive to light. My eyes weren’t quite adjusted yet to the monovision, which caused some minor headaches. You must use drops from single-use containers without preservatives to treat the dryness without the risk of infection.

But I felt perfectly fine. So fine, in fact, that I  was able to go on the vacation I’d had planned with my daughters to see the Redwoods up near Eureka, California.

After the first week, you no longer have to use the prescription drops multiple times per day and you have the pleasure of getting used to the new normal – you, with perfect vision!

If there’s been any downside at all, it’s driving at night. The headlights from cars coming at me have sort of “halos” around them. However, before, the glare from my glasses made it hard to drive at night, so it’s really not that much different.

Are You Medically Prepared?

I feel like this surgery was one of the most crucial preparedness investments I’ve made and I strongly recommend it to those who have seriously impaired vision.

It’s important to take care of your medical, optical, and dental health while these services are readily accessible.

Are there any procedures you should undergo?  Have you opted to have any preventative or corrective work done to make your life easier should the SHTF? Please share your stories and advice in the comments section below.