Four Year LASIK Update

It's been four years (almost four and a half) since I had my LASIK surgery done.  I'm pleased to say that my eyesight is holding strong.  Every now and then, when my eyes get tired, I have a little trouble but nothing much different than when I wore glasses.  Not a day goes by that I'm not thankful for having LASIK surgery!

do it yourself lasik

A friend of mine referred me to this site today. It's too bad I didn't find it before I had a professional surgeon do my lasik surgery. I could have done it at home in the kitchen.

Lasik at Home

When you go there, make sure you click on the tab that says "Four Easy Steps."

I Didn't Think I'd be Nervous

For the most part, thinking of having major surgery performed on my eyes didn't phase me. Through all the pre-surgery meetings and tests, I stayed pretty calm and could even joke about it. It wasn't until I entered the cold operating room and laid down on the table that I began to get a bit nervous. As I was waiting for Dr. Motwani to arrive, all these thoughts of "it's now or never", "what if I sneeze" ... all those crazy thoughts began to race in my mind and I started to shake a bit. I think I actually surprised myself.

All the Tests

To determine if I was a prime candidate for Lasik surgery, Dr. Motwani and his staff ran me through several different exams and tests. Not only did they test my prescription (which I knew was way high), they also tested to see how much tissue I could afford to lose and what the topography of my eye looked like.

One of my favorite tests was the Wavelength test and having to focus on the hot air balloon. Then the lights flashed red and it felt like a flashback to the 1960s. Of course, I only lived for about eight weeks during the 1960s but you get my point :-)

Prolate Ablations

The original corneal shape is prolate, i.e. a dome like the side of a ball. When you re-shape a cornea for myopia, you create a bucket or divot like shape in the cornea, causing it to become oblate. This creates a completely different light entrance pattern at the periphery, causing night glare/halos and contrast sensitivity loss. Even if a wavefront laser pattern perfectly smooths the center cornea, the oblate overall shape of the ablation can still lead to contrast sensitivity losses and night glare/halo issues. A prolate ablation much more closely resembles the dome like shape of the natural cornea, especially in the area of pupil dilation, and therefore acts much like the normal eye with the additional advantage of corneal smoothening by the excimer laser. That is what accounts for the high 20/15 rate of this procedure. Further advantages are less central tissue removal, and excellent overall regression rates.

Source: Dr. Motwani San Diego Lasik Surgeon

Custom Ablations

These are various forms of laser ablation patterns that allow for a higher degree of 20/20 visual results, and a higher amount of better than 20/20 results (usually measured as 20/15 vision rates). Many of these use wavefront analysis to determine how to shape the cornea. Since 2002, Dr. Motwani has pioneered a custom system that allows for more prolate cornea, Aspheric Ablation. This was originally intended to decrease night glare and halos, and to decrease losses in contrast sensitivity, but this procedure also gave some of the highest 20/15 rates from any custom excimer laser system. Since then, a 68% 20/15 rate has been achieved for single eye visual acuity, a more rigorous test than bilateral visual acuity. Most other custom systems have 30-40% 20/15 rates.

Source: Alpha Laser Eye Center, San Diego Lasik.

Laser vs. Blade Microkeratomes

The micro-keratome is a device used to make a flap in he cornea. Over the past few years, a laser micro-keratome, the Intralase, has been introduced and heavily marketed as “All Laser LASIK.” The Intralase still makes a flap, usually has longer healing times (as much as 24 hours of discomfort vs. 3-6 hours), and longer visual rehabilitation (as much as 48 hours instead of overnight), and is also more expensive. Furthermore, the Intralase does not make a smooth cut, but actually makes multiple perforations in the flap, and the flap has to be raised forcefully with a forceps.

For the past several years Dr. Motwani has been using what he considers the most advanced blade micro-keratome, the Moria M2. This device makes very smooth, quick, reliable, corneal flaps with a flap complication rate of 1-2 flaps per year. Because of the extreme reliability of this device, the extremely smooth flap beds, and the faster rehabilitation times, Dr. Motwani continues to recommend blade over laser micro-keratomes until such day as the discomfort and rehabilition times can be brought on par with the Moria M2.

Source: San Diego's Alpha Laser Center.