Seeing is Believing

I didn’t think I’d do it. There were enough people telling me not to do it. Some were downright shocked that I would even consider doing it.

I had chickened out of laser eye surgery twice before, due in large part to the horror stories volunteered by well-meaning friends and relatives, as well as published reports, mostly in the US, on things that could–and do–go wrong with such surgery.

Initially I had no intentions of undergoing corrective visual surgery; I sought medical treatment for a recurring eye infection that prevented me from using contacts lenses, which had served me very well for many years. One of the doctors I sought out was part of a clinic that specializes in laser eye surgery.

The prospect of seeing the world clearly without glasses or contact lenses is, to someone who has needed corrective lenses since third grade–which was near the time of the dinosaurs, I suppose–a most inviting thought. So, while treating the relatively minor but irritating infection I underwent tests for laser surgery, and was declared a "perfect" candidate for the procedure.

Then came the scare stories. Someone went totally blind. Another person ended up with a hole in her cornea. Still others cannot go out during the day because of glare from light–any light, including sunlight. And more. Much more. Although these were all incidents read about or that happened to a friend of a friend or a cousin of a neighbor’s brother or something like that, they were enough to scare me away.

Then a colleague in the office underwent the procedure–and it was perfect (well, almost; she said it hurt something awful). Here at last was a real person who could give me a first hand, first person account of what happened. She lived to tell about it–and could see perfectly too. I decided to take a second crack at this amazing surgical procedure.

I went back to the doctor with my bag of horror stories. She laughed off most of it as baseless exaggerations, and explained some of the other points. The facts were there, but for some reason I was not reassured. The idea got shelved again.

It was still that infection that took me late last year to the Vision Laser Center at St. Luke’s Hospital, which has a sterling reputation for state-of-the-art equipment and quality medical care. My attending physician was Dr. Jerome Sarmiento, who underwent fellowships and consultancies at Tufts University and the Harvard Medical School (I checked him out beforehand). I spent a good part of the morning undergoing test after test, and the verdict was that I needed a very minor–emphasis on the very–procedure to drain the infection. Considering deadlines (we always have to consider deadlines), I scheduled the surgery for the next week.

The surgery was painless, except for the clamps to keep my little eyes open. I will spare you the gory details because I don’t know the blow-by-blow of it all; suffice to say that I was back at work the next day.

Dr. Sarmiento had said that I should not even consider laser eye surgery until the infection had completely cleared; he did not want even the remotest threat of infection, since laser surgery involved opening a flap in the cornea. I appreciated his better-safe-than-in-a-hurry attitude and, six weeks later, when I got the all-clear, began discussing with him the possibility of refractive eye surgery.

The technology has developed so much in the last few years there are now several procedures to choose from; having a doctor who is patient and forthright, who will explain everything–pros, cons, benefits as well as some very real limitations and dangers–in as much detail as the patient needs in order to make an informed decision is therefore a must.

Refractive eye surgery basically re-shapes the cornea so that images are properly focused on the retina. Near-sightedness (myopia), far-sightedness (hyperopia) and astigmatism can be treated by any of a handful of surgical procedures, including Radial Keratotomy (rk), Photorefractive Keratectomy (prk) and variations of Laser In-Situ Keratomileusis (lasik). The latter is the most common procedure used today. At St. Luke’s, they have upgraded their excimer laser with the zyoptic technology, an even more precise and custom-programmed method that is used for extremely myopic and other special cases. Unfortunately, however, presbyopia (when you need reading glasses) cannot as yet be reliably treated by refractive surgery.

After an unbelievably lengthy and extensive series of tests and explanations, I was "approved" for surgery. In addition to the pre-op lecture there was a three-page consent form. By this time I was near information overload; I was convinced and ready to go.

Surgeries are usually done on Fridays, so that patients have the week-end to rest and recover. With hindsight bravado I can say I didn’t need the extra day. Except for the discomfort of the speculum desperately stretching to keep the eyelids of my little eye open (I think they have since purchased a smaller size speculum for, ahem, singkit eyes) there was no pain, not even the grain-of-sand feeling that I was told to expect. I went home with my goggles and eyedrops (antibiotics and a lubricating solution), had lunch, took a nap and woke up seeing the world in a whole new–and clear and bright–light. I drove to the hospital for my check up the next day and no, I didn’t hit anyone or anything, and didn’t even miss the parking space.

The following days and even weeks were a period of adjustment; I was warned that zyoptics (Dr. Sarmiento opted for zyoptics because my eyes had a lot of aberrations–and I thought my only aberrations were mental!) could over-correct at first (I told people I had x-ray vision), then regress and eventually settle for the long-term on 20/20. I religiously followed the post-op protocol of eyedrops, goggles, avoiding smoke and excessive pollution, proper cleaning, no swimming (for a month), and went for my scheduled check-ups.

Now, two months later, I am still appreciating my gift of renewed sight. I still have residual astigmatism that makes medium-range vision a bit blurred, but my good doctor assures me that if that doesn’t clear up by the third month I will get a touch-up "zap" that will settle the problem. I have to use reading glasses, of course, but I got myself a funky pair of floral-framed ones that are a conversation piece. I went swimming last week-end and for the first time could see each crack in the tiles and recognize the guy at the other end of the pool waving at me (my niece’s friend).

There are still people whose reaction to my surgery is one of shock; they comment how brave I was to have done the surgery, in other words, how crazy to have taken the risk. What this experience has taught me though is that nothing beats being fully informed: get all the information you possibly can–from the internet, from brochures, from clippings, listen even to all the horror stories. Advances in technology has rendered the procedure of refractive surgery fairly safe and wide-ranging. But it is imperative to find a doctor–go doctor-shopping if you have to–who will be honest with you, who will give you all the facts and explain every aspect and answer every question you may have, no matter how ridiculous (I did ask Dr. Jerome whether being singkit made a difference, and he did try the stretching and measuring and concluded he could make it work). Trust also that your doctor will say no when the procedure isn’t right for you (there is a long list of exclusions). Refractive eye surgery may not be for everybody, but I’m sure glad it worked for me.

See you–and I mean it!