To Lasik or not to Lasik

On Thursday, I did it. I had a laser treatment on my eyes. After checking around and getting advice, I decided to do it. There are over 70 laser clinics in Holland, the one I went to is one of only 14 that got the latest equipment called Allegretto™ Eye-Q Laser 400 from WaveLight Laser Technologie AG. WaveLight's laser is the most precision laser on the market today. This clinic is also ranked as amongst the top 7 here.

I had an initial extensive eye examination. This is to check my cornea, thickness and shape amongst others. One thing that came out was that the glass lens for my right eye was over prescribed. It should be -3.25 rather than -4! So beware, the equipments used by high street opticians are not that accurate.

Then I had a long discussion with the doctor. After all I always thought Lasik is the way to go. Lasik or Laser Assisted In-Situ Keratomileusis is also normally referred to as a flap procedure or better known as ‘deep cut’ procedure. The surgeon cut a very thin flap of the corneal tissue. The flap is lifted like a hinged door, revealing the stroma, the middle section of the cornea. Then a laser procedure is used to remodel the corneal stroma by vaporising some tissue. After the laser procedure, the flap is carefully repositioned, remains in position by natural adhesion until healing is completed. The patient doesn’t feel any pain and can go home or work straight away. This is what majority of people are doing right now.

But my doctor didn’t recommend it. He convinced me that PRK which is a more traditional method is the best one for the longer term. It is painful, but safer and better for the eye. He said people are just engrossed with Lasik here Lasik there because of the sale pitch and big publicity, but if given the choice many doctor would recommend PRK.

PRK or Photorefractive keratectomy is better known as 'surface' procedure. The difference from Lasik is that the top layer of the epithelium is removed, so no flap is created. The laser is then used to reshape the front portion of the cornea. So in layman’s term, Lasik creates a flap and trims the inner portion of the cornea, PRK only involes the outer cornea; hence there is less overall change to the eye with PRK. Military pilots cannot get Lasik, they have to get PRK. There have been some studies that say pressure changes could possibly cause the flap to pop off again. The only negative about PRK is healing time and pain. It takes longer. This is because the outermost surface of the eye, the epithelium, has to heal and grow back which normally takes a few days.

So on Thursday I went for the PRK. I was laid down on this laser bed (see photos). The epithelium layer was first scratched off. Then a cool laser was fired to shape the front of my cornea (last photo). After that a temporary bondage contact lens was laid on the eyes for protection, to be worn for a few days. The whole operation took about 10 minutes. The laser treatment itself was about 5 seconds for each eye. I didn’t feel any pain at all because of the drips provided to numb the eye. I immediately could see the effect. For the first time I could see clearly without wearing glass.

But as I said the PRK is a more painful method. Lots of drips and medications were provided. It really felt sting in my eyes on the first night. I needed to put all sort of drips. My eyes were literally watery and flowing. The best way to get through the day was by sleeping. I had to wear protective goggles for sleeping to prevent rubbing my eyes. The next day I went for the normal follow up. My doctor said the tears were very good to the eyes as it helped the healing process. Looking at my eyes, the doctor said the healing was really going well and the epithelium has nearly grown back completely. The pain was because the epithelium layer scratched off before the laser operation is like an open wound. Once it grown back the pain would then be gone.

You can see the video made for Dutch TV about the PRK procedure in the link below made by the clinic that I went to. It's in Dutch though but you should get the gist of it.
http://player.omroep.nl/?aflID=4083476
The room in the video is where I had the operation and the same doctor did the operation on me. You can see the eye check up procedure around the 6th minute in the video, the PRK procedure starts in the 11th minute. Worth watching. The prices here range from €1000 to €1800 per eye. The clinic I went to is more in the upper range. I know it is a lot cheaper to do it elsewhere especially in the Middle East, Singapore or Bangkok. But it is own individual choice. One has to look at what machine and experience the doctors had. They may have done a thousand operations but quality what really counts. After all it is your eyes. My eyes are still not 100% perfect yet but the vision will slowly improve as PRK takes time for the vision to be perfect. So if you want a less painful procedure go for Lasik. I decided on PRK. This is the traditional and most proven method without permanently cutting the inner cornea of the eyes.