Considering LASEK!

[alexmustata]

Hello!

A month ago I was walking in the superkmarket and noticed my eyes were irittating me ( a slight burning sensation ). I wore my soft contacts for about 6 years, almost daily, with no issues so far (Proclear Compatibles, high water content). I've also noticed in the last few months that the contacts got stuck to the eyes and were hard to take off.

Decided to take an eye exam (had my last one 6 yrs ago). Diopters haven't changed much : 0.25D ( both eyes ) in this 6 year period . So my diopters now are -4.00 and -4.75. (6 years ago : -3.75 and -4.50). They measured my cornea and it's about 510um in both eyes. All the other tests indicate I have a normal eye , suitable for Lasek/PRK but the eyes are a bit dry. After applying numbing drops (atropine I guess) 2 x times they took a Schirmer test and I scored 7mm on the left eye 0, and 15mm on the right one. The doctor said the left was a bit at the limit and I'm scheduled for another Schirmer test next week.

What do you think guys? I have perfect crisp vision with contact lenses, and even with the old scratched glasses I currently wear. Should I take the risk? I'm considering PRK/Lasek . The doctor performing the operation is a highly experienced PhD University proffesor . The operation will be performed on the Carl Zeiss Mel 80 Excimer.

I'm currently 29 yrs old.

Thank you!

[LaDiva]

If you have dry eye, do not have lasek surgery, and if you don't have dry eye, do not have lasek surgery. (Not a typo.) I had PRK and should not have. My doctor knew I had dry eyes, and why he recommended eye surgery, I do not know. (He is a Mayo Clinic Grad, so pedigrees are relative.) Unfortunately, I didn't know any better, and was so excited about being able to see without glasses, that I didn't check closely before hand. Try wearing your glasses for awhile and see if your eyes feel better. Best of luck to you. Believe me, you don't want to live with severe or moderate dry eye the rest of your life. For some reason, nothing beats our original parts!

[MartyM1985]

Don't do it. It's not worth the risk. Your entire life could change overnight.

I am currently recovering from a really bad dry eye event/episode/instance (not LASIK induced), but I still face the notion that I could never be able to go outside without sunglasses on, ever again, for my entire life. And I'm not even one of the "bad" cases on this site.

I try not to think about it, but I wonder how the hell I'll ever take my wedding pictures or stand at the altar if the wedding is outside. I'm not engaged or anything, but stuff like that crosses my mind every now and then.

Just ask yourself if you want to take a chance on becoming disabled, cause that's what you are risking if you get LASIK.

[Guest]

All the other tests indicate I have a normal eye , suitable for Lasek/PRK but the eyes are a bit dry.

Bear with me, this is long... but I think it's important for someone in your situation to fully appreciate what might happen if you go ahead with this procedure... sure, odds are that you'll be fine... but since you already have issues with dryness, maybe the odds of a good outcomes aren't as good as they should be...

Your eyes being a "bit dry", to me, is a red flag. Sure, you might be one of the lucky ones who has pre-existing dry eye (even only a bit), and then goes on have a wildly successful LASEK/PRK experience... BUT, since you already have some dryness, I bet your risk of ending up with bad dry eye afterwards are MORE than it would be for someone who had perfectly normal, eyes with absolutely no pre-surgery dryness.

Do not underestimate how negative of an impact dry eyes can have on your life. Sure, for most people dryness of the eyes is no big deal, but if you are unlucky, it will change your life forever.

Can you handle it if you end up like me? Not everyone can. They say the risk of suicide is higher in the post-refractive-surgery population, and I bet it has a lot to do with those who come out of it with a bad outcome and then face doctors, friends and family who don't understand, then the patient feels more and more isolated and depressed, and then, well, they end it all. I've managed to avoid that, but are you confident that you would also be able to do so if you were unlucky as I was?

Picture needing drops every 15 minutes since without them you'd have to quit your job...

Picture having your eyes deteriorate a few years after surgery to the point where not only do eyedrops no longer work, but your eyes hurt too much to even keep them open for a full waking day, so you now must spend as many as 4-5 of your WAKING hours with your eyes shut and a cool cloth over them to calm down the burning eyes.

Picture going many months like this...

Picture months of not being able to tolerate looking at a computer screen, months of not even being able to tolerate reading the newspaper or a magazine... months of not being able to stand watching TV since it hurts your eyes too much...

Imagine months of not even being able to handle the staring you do when concentrating on preparing food or cooking (tip - learn to cook in a slow cooker if this happens, since you can just toss everything in there without chopping it up, and there are no cooking fumes in your kitchen to hurt your eyes)...

Picture needing to wear motorcycle goggles during all waking hours (indoors and out)... http://www.wileyx.com/MOTORCYCLE/index.aspx Hot stuff, huh? err... except I'm not a motorcycle chick hehe... I'm more of a fancy dinner and out to the ballet kind of gal (but I try my best to rock those motorcycle glasses at the concert hall!!!)

Picture months of not being able to work more than 4 hours a day, and never 2 days in a row since your eyes need "recovery time" before you can work again...

Picture having to pull over on your drive home from work because your eyes are now hurting so bad you can no longer even force yourself to keep them open to drive (and since drops don't work at the moment, your only choice is to allow the panic to well up and cry... there... eyes are now wet enough to finish driving home, thank goodness)

This is what I went through... it took a very long time and many treatments (at least 20k worth of eyedrops and prescriptions since my original LASIK procedure... by now, probably closer to 30k when you take my trip for treatment to the Boston Foundation for Sight into account) to have my eyes improve enough to be able to work like a normal person, watch TV, read etc. But I still wear motorcycle goggles during most waking hours, I still have my eyelids stick to my eyeballs most nights, I still have to do many things to baby my eyes enough to be able to live a "normal" life. I've had my upper puncta surgically burned to scar them shut several times (a procedure known as cautery), I get 13 vials of blood drawn every 3 months that they use to make blood serum eye drops from (I don't make enough tears to get all the "good stuff" that my tears should be providing my eyeballs with, so I artificially provide some of what's missing via blood serum drops used 4 times daily). And of course, there's the regular eye drops that I use all day long, every day, year after year.

If the worst case scenario happens to you, can you afford it? Will you be able to figure out how to be happy even if your life will likely never be "normal" again? (You only live once and all that...)

Going to the best doctor in town and having the most awesome laser for the procedure does not necessarily protect you from an outcome like mine - they simply do not know why people who are supposedly perfect candidates end up like me - they have NO IDEA.

I was supposedly a perfect candidate just like you... my only problem was that I could no longer tolerate wearing contact lenses since my eyes felt dry if I wore them (but with no lenses, my eyes were normal as could be)... I'd almost forgotten about having contacts sticking to my eyes when I tried to remove them, until you mentioned it, it's been many years for me now...

And one more thing... don't make the mistake I did of thinking people like me on the internet are possibly exaggerating or mentally unstable etc... don't make the mistake thinking people like me on the internet aren't really as bad as we say we are. Sure, some may be exaggerating, since some people do that in all walks of life and this is surely no different... but, there are those, like me and others on this forum, that are real, and are telling it like it really is. We are not exaggerating or mentally unstable and just "seeing it all wrong" etc.

Did you know that before my surgery, I mentioned to my surgeon that I'd read about people on the internet who "claimed" to have had severely dry eyes that were totally screwing up their ability to work and function normally? I asked my surgeon if this really could happen. He said no. He said as long as you were properly screened, as I was, it could not happen. Permanent dry eye from LASIK does not happen, according to him. Now who was I to believe? Random strangers on the internet? or a well-trained doctor who was the most experienced, most expensive guy in town? I chose to believe the reputable doctor's opinion, of course.

Moral of the story? Consider the source when asking for an opinion on the risks of something. That "reputable" doctor was going to make good money from people like me so it would be tempting for him to choose to only see the positives in refractive surgery, and ignore or downplay the negatives... he had a super fancy office in a downtown highrise, and I bet he was paying a small fortune in rent each month... plus all his equipment for performing refractive surgery to pay off... he NEEDED people like me to keep on coming and it certainly would be tough to be overly conservative in judging who was a good candidate and turn too many of us away, wouldn't you agree? Guidelines said someone like me was a perfect candidate, contact lens intolerance be darned... so he went for it...

That being said, in this forum, I doubt you'll find anyone telling you it's a good idea to have refractive surgery since there is no-one here, that I'm aware of, who has had an outcome they are happy with. However, this is still a good source of info on some of the worst-case scenarios that can happen to someone... especially someone like you who already has eyes that are a "bit dry."

Think about all this... really consider if you can handle the worst-case scenario... just in case it happens to you. If you can't handle it, then don't have the surgery. If you think you COULD handle the worst-case scenario, then all you have to decide is if the risk is worth it to you... or would you rather just save the money and splurge on the most kick-ass pair of glasses that you makes you feel like you look amazing? How many freaking AMAZING splurge-worthy pairs of glasses could you LASEK/PRK money buy you? I bet a lot!

[Rebecca Petris]

There was an article published awhile back. It was by one of the most prominent LASIK surgeons of our time (and one of the key apologists to the FDA in that hearing back in 2008) and basically saying there's no reason why lasik and dry eye can't be best buddies, except of course in extreme cases. I started writing an editorial, but it just got too emotional for me and I had to leave it. Disturbing on so many levels. It's nothing new, it's just the way it seemed to set an official stamp on something really abhorrent to me.

But the reason I'm mentioning it now is this: today's reality is that the refractive surgery industry (suffering from the economy) has for years been heavily, actively marketing laser surgery as a remedy for contact lens intolerance (which in turn is all about ocular surface health). It's not about getting rid of glasses: it's about getting rid of contacts. This has been happening for maybe 10 years quietly but by now they've removed all pretense and are aggressively pushing it as perfectly acceptable practice. It all flies in the face of medical evidence as well as common sense, but that's OK because money makes the world go 'round.

Sorry to sound so cynical. Somebody tell me, please, that there are still some dissonant voices in ophthalmology-land, that they're not all chanting from the same hymnbook.

Meantime... AlexMustata:

I have perfect crisp vision with contact lenses, and even with the old scratched glasses I currently wear. Should I take the risk?

If you're looking for encouragement to take risks with your eyes (no offense, but most people who ask the question really are looking for a little help to get over their last hesitations) you won't find it in this forum. Try another type of forum. This one's full of people who know too much about how bad it can get.

EDIT: I'm sorry... I re-read that and realized I probably sounded unwelcoming. Sorry about that - not my real intent. Everyone here will be most happy to share reasons why not to get laser surgery, me included... we here have seen a lot of harm from laser surgeries.

[alexmustata]

Bear with me, this is long... but I think it's important for someone in your situation to fully appreciate what might happen if you go ahead with this procedure... sure, odds are that you'll be fine... but since you already have issues with dryness, maybe the odds of a good outcomes aren't as good as they should be...

Your eyes being a "bit dry", to me, is a red flag. Sure, you might be one of the lucky ones who has pre-existing dry eye (even only a bit), and then goes on have a wildly successful LASEK/PRK experience... BUT, since you already have some dryness, I bet your risk of ending up with bad dry eye afterwards are MORE than it would be for someone who had perfectly normal, eyes with absolutely no pre-surgery dryness.

Do not underestimate how negative of an impact dry eyes can have on your life. Sure, for most people dryness of the eyes is no big deal, but if you are unlucky, it will change your life forever.

Can you handle it if you end up like me? Not everyone can. They say the risk of suicide is higher in the post-refractive-surgery population, and I bet it has a lot to do with those who come out of it with a bad outcome and then face doctors, friends and family who don't understand, then the patient feels more and more isolated and depressed, and then, well, they end it all. I've managed to avoid that, but are you confident that you would also be able to do so if you were unlucky as I was?

Picture needing drops every 15 minutes since without them you'd have to quit your job...

Picture having your eyes deteriorate a few years after surgery to the point where not only do eyedrops no longer work, but your eyes hurt too much to even keep them open for a full waking day, so you now must spend as many as 4-5 of your WAKING hours with your eyes shut and a cool cloth over them to calm down the burning eyes.

Picture going many months like this...

Picture months of not being able to tolerate looking at a computer screen, months of not even being able to tolerate reading the newspaper or a magazine... months of not being able to stand watching TV since it hurts your eyes too much...

Imagine months of not even being able to handle the staring you do when concentrating on preparing food or cooking (tip - learn to cook in a slow cooker if this happens, since you can just toss everything in there without chopping it up, and there are no cooking fumes in your kitchen to hurt your eyes)...

Picture needing to wear motorcycle goggles during all waking hours (indoors and out)... http://www.wileyx.com/MOTORCYCLE/index.aspx Hot stuff, huh? err... except I'm not a motorcycle chick hehe... I'm more of a fancy dinner and out to the ballet kind of gal (but I try my best to rock those motorcycle glasses at the concert hall!!!)

Picture months of not being able to work more than 4 hours a day, and never 2 days in a row since your eyes need "recovery time" before you can work again...

Picture having to pull over on your drive home from work because your eyes are now hurting so bad you can no longer even force yourself to keep them open to drive (and since drops don't work at the moment, your only choice is to allow the panic to well up and cry... there... eyes are now wet enough to finish driving home, thank goodness)

This is what I went through... it took a very long time and many treatments (at least 20k worth of eyedrops and prescriptions since my original LASIK procedure... by now, probably closer to 30k when you take my trip for treatment to the Boston Foundation for Sight into account) to have my eyes improve enough to be able to work like a normal person, watch TV, read etc. But I still wear motorcycle goggles during most waking hours, I still have my eyelids stick to my eyeballs most nights, I still have to do many things to baby my eyes enough to be able to live a "normal" life. I've had my upper puncta surgically burned to scar them shut several times (a procedure known as cautery), I get 13 vials of blood drawn every 3 months that they use to make blood serum eye drops from (I don't make enough tears to get all the "good stuff" that my tears should be providing my eyeballs with, so I artificially provide some of what's missing via blood serum drops used 4 times daily). And of course, there's the regular eye drops that I use all day long, every day, year after year.

If the worst case scenario happens to you, can you afford it? Will you be able to figure out how to be happy even if your life will likely never be "normal" again? (You only live once and all that...)

Going to the best doctor in town and having the most awesome laser for the procedure does not necessarily protect you from an outcome like mine - they simply do not know why people who are supposedly perfect candidates end up like me - they have NO IDEA.

I was supposedly a perfect candidate just like you... my only problem was that I could no longer tolerate wearing contact lenses since my eyes felt dry if I wore them (but with no lenses, my eyes were normal as could be)... I'd almost forgotten about having contacts sticking to my eyes when I tried to remove them, until you mentioned it, it's been many years for me now...

And one more thing... don't make the mistake I did of thinking people like me on the internet are possibly exaggerating or mentally unstable etc... don't make the mistake thinking people like me on the internet aren't really as bad as we say we are. Sure, some may be exaggerating, since some people do that in all walks of life and this is surely no different... but, there are those, like me and others on this forum, that are real, and are telling it like it really is. We are not exaggerating or mentally unstable and just "seeing it all wrong" etc.

Did you know that before my surgery, I mentioned to my surgeon that I'd read about people on the internet who "claimed" to have had severely dry eyes that were totally screwing up their ability to work and function normally? I asked my surgeon if this really could happen. He said no. He said as long as you were properly screened, as I was, it could not happen. Permanent dry eye from LASIK does not happen, according to him. Now who was I to believe? Random strangers on the internet? or a well-trained doctor who was the most experienced, most expensive guy in town? I chose to believe the reputable doctor's opinion, of course.

Moral of the story? Consider the source when asking for an opinion on the risks of something. That "reputable" doctor was going to make good money from people like me so it would be tempting for him to choose to only see the positives in refractive surgery, and ignore or downplay the negatives... he had a super fancy office in a downtown highrise, and I bet he was paying a small fortune in rent each month... plus all his equipment for performing refractive surgery to pay off... he NEEDED people like me to keep on coming and it certainly would be tough to be overly conservative in judging who was a good candidate and turn too many of us away, wouldn't you agree? Guidelines said someone like me was a perfect candidate, contact lens intolerance be darned... so he went for it...

That being said, in this forum, I doubt you'll find anyone telling you it's a good idea to have refractive surgery since there is no-one here, that I'm aware of, who has had an outcome they are happy with. However, this is still a good source of info on some of the worst-case scenarios that can happen to someone... especially someone like you who already has eyes that are a "bit dry."

Think about all this... really consider if you can handle the worst-case scenario... just in case it happens to you. If you can't handle it, then don't have the surgery. If you think you COULD handle the worst-case scenario, then all you have to decide is if the risk is worth it to you... or would you rather just save the money and splurge on the most kick-ass pair of glasses that you makes you feel like you look amazing? How many freaking AMAZING splurge-worthy pairs of glasses could you LASEK/PRK money buy you? I bet a lot!

WOW! I read the whole text and first I want to say I'm glad you're strong and on the way to recovery.

In the last few days I've searched a lot (YOUTUBE, forums, random websites) and I've found a recurring pattern even in the LASEK/PRK types of refractive surgeries are DRY EYES and are quite common after the procedure. Lots of people need to use artificial tears, and some of them for more than 1 year (probably the ones which had dry eye isues prior to the intervention).

If the worst type situation happened to me my life style would considerably go downhill. You're correct. The risk is too high and I need to do more research, wait a year or so and read more about the issues at stake here.

30k is a lot of money to spend only on eye drops and even though I live in a country where eye surgery is considerably cheaper the income is also on a par with the prices healthcare and medicine, so I don't think I'll be prepared for emergeny situations in case something bad happens.

I'll wait and see how technology evolves; maybe I'll do a Visian ICL in a few years. I've heard dry eye issues are inexistent in that procedure. Maybe a better procedure than Lasek/PRK/Lasi/iLasik will that will significantly reduce negative side effects for normal people like you and me.

Thank you SAAG ,Rebecca, LaDiva, MartyM1985 !

[Guest]

Hi Alex,

Glad you found the info in this thread useful. I was 29, just like you are now, when I had LASIK... I'm now 37, and my life hasn't been the same since. But I make the best of things, so most people who know me, probably underestimate the challenges I face every day.

Anyhow, take care, and I wish you all the best with your eyes, glasses, contacts and whatever!!!

[kylix]

I think just waiting some time before undergoing some kind of refractive surgery will be enough coz new techniques have been appearing (like Carl Zeiss Relex Smile which I'm interested in myself, but they have been working on introducing new features/improvements to it, so in the near future it could be really interesting and much better than current LASIKs but also other technologies will emerge and some of them could be real game changer hopefully) and also new drugs could (hopefully will) appear which could really help to mitigate possible impacts.

I suppose the best potential drugs which could really help with LASIK induced dry eye could be MIM-D3 which should in a few months (in this fall) start their phase 3 tests, so in a few years (if everything goes fine) could hit the market and could really have the potential to mitigate the impact of procedures like LASIK (heal impacted nerves faster and better). Moreover in Europe nerve growth factor has been tested (has orphan status so trials and introduction should be considerably faster, now at the beginning of phase 2) and this really has the potential to be ABSOLUTE GAME CHANGER.

So in my opinion (and this is actually what I've been doing) just wait some time for new technologies (which are definitely better than the old ones) and new drugs (just in case they are needed) to appear is enogh, though it could mean wait ~4 years. But I've been waiting and would recommend others the same.

[Cristi]

buna alex o sa ti trimit un private message cu nr meu de tel
.. am facut lasik acum 2 ani la oculus si de atunci am probleme fouarte mari cu ochii

[DCRdryeye]

Hi Alex,
I have't read everyone's post about your questions because my eyes are aggravating me today.

You are on a MAJOR site dedicated to thousands of people who's live's have been turned upside down through LASIK surgery, and you're considering having it done (especially when you already have minor issues of drying and redness?

Please take the advice of those whom have been through it. We don't want you to experience the same.

You have a chance to avoid it. Take it.

[alexmustata]

Hi Alex,
I have't read everyone's post about your questions because my eyes are aggravating me today. No offence, to you, but do you have any common sense at all?. You are on a MAJOR site dedicated to thousands of people who's live's have been turned upside down through LASIK surgery, and you're considering having it done (especially when you already have minor issues of drying and redness?

Please take the advice of those whom have been through it. We don't want you to experience the same.

You have a chance to avoid it. Take it.

I'm sorry about your problem!

I was considering having LASEK not LASIK. AFAIK there are major differences between the two procedures being that in the later they need to make a flap and so they cut significant corneal nervs thay may never heal or reconnect through other paths. In LASEK they only cut the epithelium (which by the way is able to regenerate itself - that is what happens in the PRK procedure) and put it back after the excimer reshapes the curvature of the cornea.

I decided to pospone the procedure until I get more information.

[elaw65]

Please do not do it I wish I had looked harder on the forums before undertaking lasik. Keep your own eyes.

[Peatear3]

Please do not do it I wish I had looked harder on the forums before undertaking lasik. Keep your own eyes.

Hi Alex,

I didn't have surgery directly on the eye, but did have a form of elective surgery with debilitating consequences (i.e. severe dry eye). Before the surgery, I consulted three different specialist surgeons in three different states before having this procedure and I was assured by all three doctors that the likelihood of medical complications was incredibly low. One doctor even said that I was just as likely to die in a car accident as to have any complications.

Just because a doctor is confident doesn't mean anything (although it may mean that they are a good salesperson). If something goes wrong, you can walk back into their office and say "but you said I'd be okay, and I'm not!", but that's about it.

Prevention is better than cure - and we can only pray about the "cure" part. So little is known about how to address dry eye ... and I've joined a long list of people who are willing to travel all over the country to find the best doctors who can *attempt* to fix this mess.

I thought the surgery statistics (success rates) would be in my favour, and maybe they were, but somebody has to be in the minority. Think about how much you value your ability to hold down a job and support yourself. I've already lost my job, I don't have a partner to support me, and it will be an interesting battle to see if I can rejoin the workforce and support myself in future. The worst thing is that this whole thing was preventable and I could have easily lived my life without the surgery.

However, I'm trying to keep a positive outlook. SAAG wrote an incredibly moving post above and I can only wish I could be so convincing and encouraging at the same time.

[LaDiva]

I did have PRK, and now have severe dry eye. The severe part didn't show up until about two years after the surgery. Would I have gotten severe dry eye anyway? Maybe. Maybe not. Life becomes extremely difficult, and everything revolves around taking care of your eyes. I never feel well and do not have the active social life I once had. I could no longer work full time, and so retired. My eyes hurt, all day, every day. I must be careful about what I eat, where I go, what I do and for how long. Dry eye is a profound disability which OTC eyedrops do not fix. I hope someone finds a cure, for if they don't, I truly hope not to live a lengthy life. I completely agree with everything Peatear has said. Do not let anyone slice up your eyes.