Look Ma, No Glasses

(Warning: A very lengthy but detailed post of my lasik adventure)

I remember when I was 15 or 16 and I came across a documentary on the tube showing the latest breakthrough to cure myopia. I watched as a patient is fixed with steel clamps on the top and bottom of his eyes to force them wide open. I gaped as the camera creeped in closer to the eyeball and the pupils dart restlessly. A laser is then directed at the pupil and burns it to, um, 20/20 vision. I was both amazed and horrified. The thought of never having to depend on glasses again filled me with longing; but the image of laser beams shooting into my eyes just couldn't convince me. 

And on the 8th of May, I was that patient with darting pupils tensely waiting for laser beams to fry my eyes. 

I've always wanted to do lasik, just too chicken to  plunge into it. The fear of losing vision on both eyes held me back and of course, who am I kidding- those laser beams! Still, what gets to me is the tiresome routine of putting in contact lenses in the morning; eyedrops during the day; and remembering to take them out before bed at night. Making sure I pack enough contact lens solution before my work trips and never being able to hand carry my bag into flights because my lens solution bottle always exceed 100ml. 

Long story short, Vinnie convinced me to do the procedure in India. Top doctors for a fraction of the cost. After much searching, I was recommended a certain Dr Rupal Shah from one of V's friends who is a doctor. Further digging revealed her publications and works; equipment used, and most importantly, she performs the more advanced form of lasik. 

(Which is the SMILE Lasik, or Small Incision Lenticule Extraction, is a non-invasive form of Lasik. A small incision is created on the cornea and a refractive Lenticule is then carved and removed to correct vision. 

A better explanation can be found here 

http://drrupalshahlasik.com/?page_id=21)

THE CENTER

We took an early am flight from Calcutta to Bombay, and then a 20-min taxi to the Lasik center. It wasnt easy to locate the center. Actually, scratch that. It should have been easy to find the center except for the fact that we didn't know what to look for. An unassuming apartment building of 4 levels- all housing medical-related centers. An eye center, a dentist's clinic... you get the idea.

The door to the dingy little lift opened, and a series of broken tune of a jingle greeted us mechanically. The lift took a few seconds before it launched itself upwards grudgingly, to the ire of Vinnie, hehe. I was surprised to note how small the reception and waiting room is, patients and their companions filled the area (8-10people). A sign outside the door requests we take off our shoes. 

Once I stepped in, a large glass partition on one section gives a clear view of the ongoing operation (!!!). I stared, transfixed on the screen showing a close up of an eyeball being prodded and poked with pointy instruments. Eeks!! Vinnie started making childish jokes about arming the lasers till I shot him the look. 

Forms filled and 20-30 minutes later (after I was sufficiently fed with images of eyeballs being prodded), I was called in to the Opthal Room. Here Dr Shah introduced herself and did some tests on me. They were pretty much run of the mill tests - reading increasingly small alphabets ("please open your eyes wider") until she proceeded to apply some drops on my eyes (which I presume to be numbing drops, they felt heavy immediately afterwards). With a little flashlight and another device, she did more tests and later asked me if I felt anything. I said not really and she said well the instruments were actually touching my eyes and that's the sort of sensation I will feel during the operation! Wow. 

We then sat down and Dr Shah gave us the run down of the operation. Basically, myopia is a result of the directed light being focused in front of the retina. A convex lens is placed in front of the eyes to properly direct the image onto the retina. Short term solution. 

What lasik does is to carve a lenticule within the cornea; which is then removed to permanently adjust the imaging. Wonders of wonders, that tiny bit of tissue (100 microns or so) is the bloody pea under the pillows!

There are 3 types of operation that one can opt for, depending on budget and lifestyle. 

The first is a conventional lasik - a flap is created, lenticule carved and removed, flap close and heal. Recovery time is longest with this operation, not to mention complications post lasik (rubbing of eyes accidentally can bruise the flap and affect healing).

Second, the Femto lasik, or bladeless lasik. An improved version of the conventional lasik without using a blade. A flap is still created though, but only a single laser is used for the flap and carving of lenticule. Rs 90,000 or USD1,400

Third, the SMILE lasik. The major difference with

SMILE is a flap isn't required. The lenticule is carved, and a small incision is made for the removal of the lenticule. Being the least intrusive with a small incision created instead of a flap, recovery is quicker, and complications are less likely. It is $500 more expensive than the Femto lasik, however, at Rs 125,000 or USD 1,950.

I've pretty much made up my mind beforehand and went for the SMILE lasik. Even then, I was a ball of nerves and overwhelmed by a sense of paranoia. What if the surgery fails? What if I lose vision on both eyes? Dr Shah was very comforting to talk to and she assured me that blindness is out of question - she has also performed the operations on her daughters. 

THE OPERATION 

A wait of about 30-40 minutes ensued with a small man dispensing eyedrops on my eyes every 10 minutes - these are the antibiotics. 

I was finally called in and was asked to remove my glasses. I sat on the chair just outside the laser room and a lady tucked my hair under a shower cap. It's now or never but never is not an option - I will never forgive myself for chickening out now!

I entered the laser room and was asked to lay on a flat bed that later revolves into the large laser machine. Heart thumping, my eyes were cleaned with alcohol and they covered my left eye. Dr Shah initiated a little chat to calm me down. What does my name mean, she asked. Awfully conscious of the spectators across the glass window, I said my surname meant an emperor, which earned an impressed comment from her (heh) then she asked me to focus on a green light under the laser. 

Then they fixed a metal clamp over my eyes to keep my eyes wide open. This was slightly uncomfortable but bearable. Dr Shah told me this will be the most uncomfortable part of the surgery. More eyedrops on my right eye and in a rush of panic, I asked how long the entire procedure is going to take. Dr Shah replied, only 10 minutes in total. 8 left now - it's been 2 minutes since I walked in. 

I was asked to focus on a white light next. Dr said this is going to be 25 seconds and asked me to count it down. Halfway through it I just kind of lost focus on the white light but the doctor told me to try and focus anyway. I was awfully tense but Dr Shah's calm voice was very comforting as she led me through. 25 seconds over, and I was revolved out of the machine. I was almost bursting from nerves but it isn't over. I felt a small pressure on my eye which I took to be a small instrument going under my cornea to remove the lenticule (gulp). There was no pain involved whatsoever. 

I could feel a small tissue being removed and as soon as it was removed, I could see the white light better. I didn't have time to marvel on this fact; my left eye was up next! It wasn't so bad this time around but the clamp felt more uncomfortable on my left eye. 

It was all done in a jiffy and when I raised from the bed, I even posed for a photo with the good doc. I could immediately see - not just shapes but some details - as if looking from slightly frosty window. Just slightly. I didn't need help to find Vinnie, who was in the waiting area. He looked at me and I looked at him. I asked for my sunglasses and he was surprised. He thought they were just prepping me for the operation, definitely did not expect the operation to have completed in that 10-15minutes! He's even taken some shots of the surgery via the broadcasting screen.

The eek factor here is off the roof.

My Sunday best

I was given a pill (must have been painkillers), and asked to wait for a bit. Later, we went into the Opthal room again and Dr Shah tested my vision again. Dr Shah was really happy with my operation, from a -8.75 Diopter to pretty good vision (to almost a level where I will be able to obtain an international driver's license)! She told me my vision will gradually get better in one to one-and-half months and that I was the best patient of the day (hehe, yes I just have to include that bit).  I was asked to come back again tomorrow for another check up. 

POST-LASIK

In the first couple of hours, my eyes sting a little whenever I try to see. I find it easier to keep them closed. We got on the taxi and stopped at four different pharmacies before Vinnie could find the right eyedrops for me (as prescribed by the clinic). Back at the hotel, I dozed and woke up every hour for the eyedrops. It is worth noting that I managed to get my hands on nasi goreng from room service to comfort myself after the self-induced stress. 

By evening, I was walking by the poolside, and even went out in the evening for dinner with Vinnie's friends. My vision was better, though it takes more effort to focus on my phone that day (yes, was ready on my phone and all). At night, my vision felt like I was looking through smudged lenses. I could see, but the lights seem exaggeratedly scattered. 

***

As I type this on my phone, it is Day 5 since the operation, and I think I am close to 20/20 vision. I am confident I can drive at night (halo vision or not, they weren't obtrusive). They do tend to get a little dry especially after waking up.

***

THOUGHTS

A few issues i wish had been different with the center. 

- were we given a map of the center, getting there would have been easier. Instead, we resorted to calling the center and then passing the phone to the driver. 

- if only the glass wall isn't there. That made me very nervous. However, in retrospect, I suppose that forces the staff to be extra careful and to put on a more professional appearance in full view of patrons. 

- it would have made things really convenient if the clinic dispenses eyedrops too. I was lucky to have Vinnie with me. If I was alone, post operation, and I STILL have to look for eyedrops? Not nice. 

Saying that, these issues are negligible to the operation in the scale of things. I'd recommend Dr Rupal Shah to anyone who wants to go through lasik. 

***

Was it worth it doing the operation in India? I'd say yeah, everything was handled professionally and I felt extremely safe throughout. A similar operation in KL would have cost double (MYR6,300 PER EYE or USD 2,000!!). That's shockingly expensive. I mean, I want the best for my eyes, but if I can get better rates for top doctors and reputable center, why not?

When I was reading up on the operation from lasik patients, the most common reaction was the exhilaration of waking up in the morning with a clear vision. For me, it was the opposite. Waking up with a good vision isn't an alien feeling, as I sometimes nap or fall asleep (short sleep!) with my contact lenses on and waking up with a clear vision isn't a new feeling. However, what struck me as pretty damn awesome was I DIDN'T need to take off my contacts now before I go to bed. 

Some say they wished they've done lasik sooner. I think I am in just the right mindset (wishing I don't have to deal with contact lenses or spectacles again) and the time is probably right for a safe, and relatively affordable surgery. 

It still baffles me that 18 years' of messing around with contact lenses and spectacles can be undone in 10 minutes. There's a real sense of elegance in the procedure: complicated surgery, simplified.