Monday, November 5, 2012

My Vision For The Future

Dr. Goel poses with his latest patient
I went under the knife last Friday. A laser knife, to be exact. I had some money left over in my medical spending plan at work which was about to expire, so I took the plunge and treated both eyes to Laser-Assisted In-Situ Keratomileusis, known as LASIK vision correction surgery. Let me warn you up front that there are a couple of disturbing images of my eyeballs below and some graphic descriptions of what transpired. So if that sort of thing turns your tummy, then skip this post!  But for those of you who are considering undergoing such a procedure, my recent experience may interest you.

Surgical assistants Chelsey Keys and Krystle
Vaughn administer numbing drops to my eyes
Sanjay Desh Goel, M.D. is a highly respected, board-certified LASIK surgeon who was recommended by my ophthalmologist, Marc Honig, M.D.  Dr. Goel is the executive director of a LasikPlus franchise in Towson, Maryland, in the Baltimore County seat. He has performed over 65,000 refractive correction procedures over the past thirteen years, using laser technology, so I trusted his expertise with my eyes. Both of them. At the same time.

Going without my contacts for two weeks prior to the surgery was the most uncomfortable part of my ordeal, as day-to-day driving with my eyeglasses was something I hadn’t done in decades. But contact lenses tend to flatten the eyeball as they’re worn, and in order to get an accurate correction reading for the laser beam, the eyes needed time to return to their spherical shape. So wearing old-fashioned glasses became my new reality. I could hardly wait for the surgery.

Dr. Goel slices the epithelium layer

The appointed day was extraordinarily chilly. Last week’s hurricane seems to have swept autumn away and ushered winter into the mid-Atlantic region. I wore cozy, comfortable clothing chosen specifically for its sentimental value: some black velvet yoga pants by Obermeyer that my best friend, Kari, picked out for me on a ski trip several years ago, a white ribbed-knit cotton top layered beneath a black and white, wide-collared Boston Proper sweater with a snowflake motif which was in a box of gently-used clothing I received a few weeks ago from Kari’s mom, Joyce, and, for good luck, some exquisite silver earrings that were a surprise birthday gift to me in September from my cousin, Ruedi, in Wyoming.

Exposing my inner cornea
The entire refractive procedure lasted less than ten minutes.  Using a femtosecond laser microkeratome device affixed to my eye with a suction ring, Dr. Goel carefully sliced the epithelium layer of my cornea from the side almost, but not quite, all the way through, producing a flap of uniform thickness with a hinge, which was then folded back to expose the inner layer of my cornea. Once this was done to both my eyes, they were covered with cotton gauze and I was guided over to an excimer laser machine, where Dr. Goel proceeded to ablate each cornea using wavefront-guided technology to correct my distance vision to 20/20. Having accomplished that, the good doctor repositioned my corneal flaps back into place, where natural suction of the eyeball will hold them firmly without sutures or glue until they seal in a week or so.
Peeling back the epithelium layer

Peeling the epithelium back and ablating the cornea deep inside instead of on the surface is a neat trick designed to fool the eye into believing it did not just have surgery. With initial refractive surgeries years ago, where the outer surface of the cornea was ablated, the eye’s natural wound response produced new cells. Trouble was that these new cells were opaque, causing one’s vision to become hazy. But ablating the cornea down inside and then replacing the corneal flap over top as if nothing had happened tricks the eye into believing there has been no injury. I was told to expect some haziness in my vision for a few weeks because of corneal swelling associated with the procedure, but that will subside as healing is completed. Indeed, I was able to drive to my own post-op appointment the very next day, without eyeglasses or contacts!
I must wear protective shields to
sleep at night until the epithelium
has re-sealed itself

I experienced no pain, not even right after the numbing drops wore off. I felt a little out of sorts the next day, as if I had been shaken up in a minor fender-bender. But except for some mild eye soreness and bloodshot sclera (the whites of the eyes), my vision is just as good as it was before the procedure, but without the aid of eyeglasses or contact lenses!  I’ll be putting antibiotic and anti-inflammatory drops into my eyes for the next week, and I’ll be keeping my corneas moist with artificial tears almost constantly for the next three months, since the introduction of moisture is critical to proper healing and my own tear ducts have temporarily slowed their tear production, a typical response following this kind of eye trauma. Until the corneal flaps have sealed themselves, I must avoid all dust, debris and wind, so today at the stable where I keep my horse, I performed my early-morning volunteer rounds wearing goofy-looking safety goggles. Only one of the 40 horses seemed unnerved by my unusual appearance, however. And I am thrilled to be rid of eyeglasses and contact lenses once and for all.

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