These Eyes

Posted by melodieshouse on September 23, 2008

Last Nov. I posted that I was looking to get laser vision correction (see Long Time No Post). In Jan. I posted that I hadn’t gotten it done yet and reported on how my preop exam went (see Doctor My Eyes). Well, I know it’s been quite a while since then, but I want to say that I *DID* have my eyes corrected on 2/25/08 and I’m ready to relate my experience.

The procedure I had done was Supralase, a no-touch PRK technique that was patented by Dr. Douglas Rampona of First Colonial Eye Center in Virginia Beach. Dr. Rampona leans away from LASIK because the corneal flap that’s cut results in more complications. However, he makes it clear that healing time is longer for surface ablation (PRK/Supralase) than for LASIK and there’s more immediate post-op discomfort. However, statistics show that over time (1 yr and beyond), the surface procedures result in better correction. Some people who are poor candidates for LASIK due to higher degrees of myopia (nearsightedness) or astigmatism, or who have thinner corneas, can have PRK/Supralase. I could not have LASIK because my right cornea was a little thin and slightly conical. Cutting a flap could cause serious issues like ectasia, where the cornea bulges from internal pressure against a thinned cornea.

My surgery was scheduled at 3:45pm on a Mon. afternoon. Most patients have the procedure scheduled Fri. afternoon so they can lay low over the weekend before returning to work Mon. Since I’m a SAHM and my husband is self-employed, we could be more flexible. The surgery was done in-office and no fasting or special prep was required. I could have gotten a couple Valium to take the night before and just before coming in but I declined. I wasn’t particularly nervous, but I was excited to finally “Get ‘er done!”

After getting post-op instructions, Dr. Rampona’s personal cell phone number (yep, that’s right), a pouch with some post-op eyedrops and supplies, watching a final video and then talking with Dr. Rampona about what to expect, they gave me a surgical shower cap thingie (nurse called it a party hat LOL) and in the operating room I went. I sat in the reclining chair with a headrest, was given a teddy bear to hold (to help keep my hands still), and my legs were covered with a striped blanket (it was cold in that room). I was tipped back, and numbing drops were put in my eyes. Starting with the left eye, Dr. Rampona used a wire speculum to hold my eyelids open, moved the VISX laser machine over me, and I found myself staring up the barrel of the laser with an orange light up the other end. The VISX is a tracking laser, so even though I was supposed to focus on the light and try not to move my eye, the laser can follow small movements and would stop if too much movement was made. When the laser is on, the machine whirs loudly and makes a loud snapping or popping sound, like a rapid series of electronic zaps, because the laser pulses instead of emitting a steady beam. The ablation was done in 2 parts – 1 brief session only 5 or sec. long to remove the epithelium or thin outer layer of the cornea (this is done with a brush in PRK), then the actual corrective procedure, which was about 35-40 sec. long for my left eye. When the first part was done, my eye was squirted with ice cold water and then Dr. Rampona rubbed my eye back and forth with something like a little squeegee. As the procedure was going on, a nurse was calling out the time every 5 secs. Dr. Rampona was telling me through the noise that I was doing great. I could feel little bursts of air on my face every time the laser pulsed, and I started to smell a burnt smell like singed hair or a zapped bug (the cornea is protein and is being burned off in microthin increments). When it was done, the machine was moved away, lots more ice cold water was squirted in my eye, I was squeegeed some more, a medication was dropped in, and a bandage contact was applied.

Then it was my right eye’s turn. Some more numbing drops were added and it was pretty much the same process again, except the right eye took longer, like about 50 secs. Even though it’s a very short time, it feels much longer when it’s you staring up at that laser. While my right eye was being done, I remember thinking to myself along these lines: “Lord, I wish it would hurry up and be over with! Is it done yet? Now? How about now?” I started focusing on my breathing, taking slow, deep breaths because I was getting tense. Dr. Rampona kept telling me I was doing great, and held my head in his hands for the final stretch.

When all was done and I was sat up, it was like I was trying to see underwater (everything was wavy) *BUT* I could read the clock on the wall, and I could see Dr. Rampona’s face! Praise God for the gift of science! Then, believe it or not, Dr. Rampona examined my eyes with a bright light to make sure the laser did it’s job (it was more uncomfortable than usual b/c my eyes were *VERY* light sensitive from being lasered). I was sent on my way with my first post-op exam the very next morning, which my husband would still need to drive me to/from, and a 5-day followup, which I could drive to/from myself if I could see comfortably enough (it turns out I was not).

I left about 5pm. My husband and I stopped to eat at a Mongolian BBQ buffet on the way home. I wore sunglasses from the time I walked out of the dr.’s office, even indoors and at dusk b/c I was *VERY* sensitive to light. While at the buffet everything quickly turned very hazy and my eyes started to bother me. They started to feel really hot and tired, like the worst case of eyestrain ever, along with some scratchiness. I took my first dose of eyedrops while at the restaurant. I had been instructed to just go to bed and sleep as soon as I got home because I wouldn’t feel like seeing, which was quite true. When we got home, I took a pain pill (demerol 50mg great stuff), taped my eyeshields on that were provided in the zipper pouch, put in some lidocaine drops (also provided), and went to bed. I dozed for a bit, got up and took my 2nd 2hr dose of drops (keeping them in the fridge was a great tip – makes the drops more soothing instead of stinging), and went back to bed. My eyes were burning and watering quite a bit by this time and keeping my eyes open made it worse. I pu in some more lidocaine, but found it really didn’t make any difference.

(2/26): The next morning my hubby took me to my post-op appt. I had to return the lidocaine (it’s only allowed the 1st day). The epithelium was already starting to heal. It grows from the outer edges of the iris inward, but not evenly, meaning it can be patchy as it’s starting to close up. This is where the haze comes from, and I was told the haze would be worst somewhere around days 3-5 when it was nearing the end of the healing process, then it would suddenly improve. I was told to remove the bandage contacts after 5 days. They’re just soft contacts used to cover and protect the cornea while the epithelium grows back.

The rest of the week I had to wear sunglasses constantly, even indoors. I was that sensitive to light. If I went out anywhere during daylight, I had to close my eyes outdoors until I got in the van, and then I looked down most of the time. For the next couple of days I took a demerol pill at bedtime, because it took the edge off the irritation and helped me relax so I could sleep. (BTW, narcotics don’t have a very strong effect on me. I get more of a buzz from drinking a Sam Adams than from taking 2 vicodin or a demerol. I still get the analgesic effect, fortunately. Unfortunately, narcotics are next to worthless when I get migraines, but that’s for another post).

(2/29): I went to my next followup on Fri, 4 days postop. My vision was quite hazy but I could see thru the haze. I think I was reading the eyechart at about 20/40 for the left eye and 20/50 for the right. Before the surgery my combined vision was 20/200 – I could barely make out the giant “E” at the top of the eyechart Dr. Rampona told me the epithelium was almost done healing over and to take my contacts out Sat. night. He would see me again on Sunday morning at 11 (yep, that’s right). My husband took our 2 oldest kids down to North Carolina to attend his oldest daughter’s wedding on Sat. I didn’t go b/c my eyes were still bothering me quite a bit and I really didn’t feel like traveling. That evening and the next morning (Sat) my contacts were starting to feel like they had grown to my eyeballs and I really wanted them out in the worst way. I called Dr. Rampona’s cell# Sat. morning and asked if I could take the contacts out earlier. He said no, I must wait until bedtime and he’d see my Sun. Crud, I thought. On Saturday it seemed the haze was getting a little better and I printed out a Snellen chart from a program I downloaded online. On Sat. evening my vision was approx. 20/30 in the left eye and 20/50 in the right.

(3/1): Sat. night my hubby returned from NC and while we were getting ready for bed, I doused my eyes really good with artificial tears and attemped to remove the contacts. The left one came out fairly easily, but the right one was another story. I spent probably 1/2 hour trying to pull down and remove the contact. I swear I felt it slide down, but it seemd to pop back up everytime I tried to grasp it on my lower lid with my fingertips. The white of my eye turned red from my efforts. I got my hubby to look in my eye with a flashlight and he said the contact was not there, I was just dragging the front of my eyeball. I insisted the contact was there, I could feel it. He insisted it was not. I kept rewetting my eye and trying again, but to no avail. So I went to bed.

(3/2): Dr. Rampona and his wife were at the office Sun. morning. Before he checked me I told him my saga. He just looked at me and smiled. He checked my eyes and when he got to the right I asked if it was gone and he said it was gone. I said, “So I nearly gouged my right eye out over nothing?.” I have no idea what happened to it. Never found it in the sink or on the counter at home. It might have fallen out sometime before I took it out.

I was told that I was legal to drive, but it may still be beyond my comfort level. It took me probably about 10 days before I felt OK to drive. The light sensitivity waned after about 2 weeks, and around that time I turned my computer’s screen res back up to 1280X1024. I started out at 800X600 (eewww!) about 3 days post-op (I had a hard time staying away from my ‘pooter) and upped it to 1024X768 the first weekend. About 3 weeks post-op I was seeing pretty good, about 20/20-20/25 in the left eye and 20/25-20/30 in the right eye. I did have some problems with dryness and was put on Restasis about 6 weeks post-op. I didn’t need glasses anymore, not even for reading or nighttime driving! It remained this way for about 4 months, but then I noticed some regression, and the last 3 months have been somewhat of a roller coaster ride, especially the last month or so. To be continued…

For more information, FAQ’s, and the D’eyealogues forum where patients discuss their experiences with laser vision correction, go to LaserMyEye.