Friday, February 16, 2018

A Photographer’s Review of LASIK: The Ultimate Upgrade?

Like pretty much all photographers, I rely very heavily on my eyesight, not only for shooting but also image processing. Being a professional photographer, my life quite literally depends on my ability to see. Therefore, the idea of having my eyes cut open, lasers pointed at them, and then have them stitched back together is sort of a terrifying thing to think about.

I contemplated for years whether I should get the surgery or not; part of me was tired of constantly having to shoot through my glasses, but the other part of me was terrified of damaging my vision. After years of contemplation, research, and broken glasses, I decided it was time to go for it.

In this review, I will not only speak about my personal experiences in getting LASIK, but I will also talk a bit about what LASIK is and how it works.

So, What Even IS LASIK?

LASIK, commonly called laser eye surgery, is a surgical procedure that uses a laser to correct nearsightedness, farsightedness, and/or astigmatism. In LASIK, a thin flap in the cornea is created using either a microkeratome blade or a femtosecond laser.

The surgeon folds back the flap, then removes and reshapes the corneal tissue underneath using an excimer laser. The flap is then laid back into place, covering the area where the corneal tissue was removed. The end result is (hopefully) corrected vision that will no longer require you to wear glasses or contacts to correct your vision.

Qualifying for LASIK

Not everyone is a candidate for LASIK; you will need to have a thorough eye exam before you will qualify for the procedure. Your doctor will need to ensure that your eyes are healthy enough for the operation. He or she will evaluate the shape and thickness of your cornea, pupil size, refractive errors (myopia, hyperopia, and astigmatism), as well as any other eye conditions.

The moistness of your eyes will also need to be evaluated, and a precautionary treatment may be recommended to reduce your risk of developing dry eyes after LASIK. If you are not a candidate for LASIK, there are other procedures such as PRK that may be better suited for you.

The Statistics

If you are anything me, the idea of losing your eyesight is just unthinkable — so unthinkable that I refused to even think about getting LASIK for years because of the small off chance that it would ruin my vision. This fear is reasonable and to be expected, especially from photographers who specifically rely on their vision.

However, if you start to look into the statistics of it all, the chances of anything going wrong are exceedingly low. According to a study done by the University of Los Angeles:

1. Over 95 Percent of People Are Happy with Their Results, with 90 percent having achieved 20/20 vision or better.

2. Less Than 0.5 Percent of People Have Serious Complications. Around 0.3 percent of people have serious complications that include dry eyes and infection. In many cases, the surgeon can treat the issue and take care of the problem.

3. LASIK Makes Up 96 Percent of Refractive Procedures. There are a lot of refractive surgery options out there, including PRK. However, most people still opt for LASIK. In fact, 96 of people who get refractive surgery go with LASIK.

4. Around 700,000 Procedures Are Performed Each Year. This makes LASIK not only the most common refractive surgery but one of the most common surgeries overall.

About Me

I was nearsighted, meaning that I could see fine close up but seeing things far away was difficult. I started with 20/200 vision according to the Snellen eye chart. The Snellen eye chart is the chart that many people are probably familiar with; it’s used in most doctors’ offices as well as the DMV. It is used to test visual acuity and is scored using 20/20 as the reference point of “perfect” vision.

In my case, it was 20/200, which means that I could only see at 20 feet what someone with normal vision could see at 200 feet. So effectively, I had vision that was literally ten times worse than normal people. With nearsighted people like myself, the goal of LASIK is to flatten a cornea that is too-steep; with farsighted people, it is the opposite. In cases of astigmatism, LASIK works by smoothing out an irregular cornea into a more normal shape.

Pre-Operation

Because my eyes are very important me, I decided to go all out on my laser eye surgery. I started by visiting a retina specialist to do a full and thorough exam of my eyes. This is not required, but I wanted to make sure my eyes were healthy and didn’t have any pre-existing conditions that might cause complications during the LASIK procedure. After seeing the retina specialist, it was determined that my eyes were 100% healthy and there was nothing I should be concerned about in terms of general eye health.

I then went to the LASIK specialist to see if I was a candidate for the procedure. During the consultation, they tested things like the thickness of my cornea, the dryness of my eyes, and the overall shape of my eyes. At the end of the consultation, I was told that I was a candidate and that everything was good to go.

Deciding on the Type of Surgery

There are a million different types of LASIK: Bladed LASIK, Bladeless LASIK, Topography-Guided LASIK, and many others. I decided on a procedure called Custom Wavefront LASIK, which means that they first do a full custom 3D scan of your eyes to get a very detailed 3D image of your exact eyeballs, then they develop a custom correction plan based on those scans.

It is much more precise than the standard procedure and it personalized to your eyes. It was also the most expensive option that my doctor offered, which is not usually a good reason to purchase something. In the case of my eyes, however, I wanted the best possible option, even if it cost more money.

The Operation

I arrived at the doctor’s office around 10 a.m.; I remember being extremely nervous about the procedure. The nurse gave me an Ativan to help calm my anxiety, however, the first Ativan wasn’t very helpful, so I was given another about 15 minutes after the first. After another 15 minutes, I was given a third Ativan because my anxiety just wouldn’t subside. Three Ativan later and they were not legally allowed to give me any more, even though the anxiety was still pretty strong. I decided at that point to just push through the fear and get the procedure over with.

Once I got into the operating room, I was asked to lie down and several numbing drops were applied to my eyes. Then, my eyes were held open using a lid speculum (just imagine that scene from A Clockwork Orange) so that I was unable to blink. As my eyes were being held open, a nurse was irrigating them with both numbing drops and some moistening drops to keep them from drying out.

The doctor then used a suction ring on the front of my eye to prevent my eye from moving while he cut the flap. This part was a bit uncomfortable and I remember feeling a huge amount of pressure on my eye, to the point where my vision would go in and out from blurry, to complete darkness, multiple times.

Once the doctor cut the flap open, he then folded it over, exposing the cornea, then let the laser start its work reshaping the cornea. The laser was completely painless, and looked pretty cool; kind of like a blurry laser light show. I could also smell something that was reminiscent of burning hair.

Once the laser was finished, the doctor folded the flap back over the cornea and then used a little tiny squeegee to press the flap back into place. I could actually see this little squeegee as it went across my eyeball like a little window cleaner. I remember kind of laughing about it because I thought it was so ridiculous.

After the first eye was finished, the doctor moved onto the second eye and repeated the process. Each eye took about 5 minutes, so the entire procedure was done in under 15 minutes, including prep and everything. After the procedure, I could tell my eyesight improved immediately. My eyes were still very foggy from all of the drops and numbing liquid that was still in them, but I remember immediately being able to make out details that I would normally need my glasses to see.

The doctor then cleared me to go home, instructing me to avoid using my eyes too much for the rest of the day, to avoid strenuous exercise for at least a week, and to use antibiotic drops 3 times a day to keep my eyes from developing any infection. In all, about a 1 hour and 15 minutes had elapsed from the time of getting to the doctor’s office and getting into my Uber to go home.

Post Operation

After arriving home, I stumbled over to my bed and slept for a few hours. I woke up and noticed some of the fogginess had disappeared and my eyesight was getting clearer. I still wasn’t allowed to use my phone or watch TV, so I just laid in bed with my eyes closed for another few hours until I could go back to sleep.

Three times a day, I would need to put both antibiotic drops and artificial tears in my eyes to keep them from developing an infection or drying out. I was also required to wear eye shields at night to keep from scratching my eyes in my sleep and reopening the flaps.

The day after the operation, I was told to come in to see the doctor for a post-operation evaluation. They checked to make sure the flap was healing okay, that I wasn’t developing any kind of infection, and tested my vision. My vision at this point tested at 20/30; so, already just 24 hours after the procedure, my vision had improved significantly.

As days passed, I could notice my eyesight getting better and better. I started to notice details that I couldn’t even see with my glasses; things like individual leaves on trees, the LEDs in stop lights, and textures of things like walls, carpet, and sidewalks.

Today

It has now been almost two years since my operation and everything has healed up perfectly. Last time I had my vision tested, it was 20/15, which means my eyesight is actually better than what is considered to be perfect vision.

Researchers from the U.S. and Germany recently conducted a study and literature review of 97 peer-reviewed clinical studies of LASIK vision correction that were published between 2008 and 2015. A total of nearly 68,000 LASIK-treated eyes were reviewed and 90.8 percent of people in that study were able to achieve 20/20 or better; luckily I was in that percentile.

Some people report having frequent dry eyes after the procedure, but I have never experienced this. I do, however, experience some slight haloing at night from direct light sources like street lamps or car lights, but these halos are not any worse than what I would see when using my glasses.

Total Cost

Overall, including my visit to the retina specialist, I paid around $6,000 for my new eyes, or about the price of a new flagship camera body. There are certainly ways to get LASIK for much cheaper, either by opting for a less expensive procedure or even traveling to another country where the cost of surgery is significantly lower. But for me, I wanted the best possible results and was willing to pay for it.

My doctor is considered to be one of the best in the world, was on the original FDA study, and is known for doing the operations of celebrities and the ultra-rich. I was very fortunate that my doctor was in the same city as me, but had he not been, I would have traveled somewhere else to have the procedure done by an equally qualified doctor. This, of course, is not necessary, but it really helped put my mind at ease that I was getting the best that I could get.

Would I Recommend It?

It really depends, if you are able to get by using glasses or contacts than it might not make sense for you. However, if you absolutely can’t stand shooting with glasses, or putting contacts in every day. LASIK really can change your life forever, I couldn’t imagine going back to using glasses every day and I am extremely pleased with my results.

If you are someone who is terrified of the possibility of damaging your eyes like I was, you really shouldn’t. The chances of having negative results are extremely low, and in very small chance something does go wrong it is almost always correctable. Keeping that is mind, in my opinion, there is a lot more to gain getting LASIK than there is to lose.


About the author: Carsten Schertzer is a Los Angeles based wedding and engagement photographer. The opinions expressed in this article are solely those of the author. When not photographing weddings he can be found teaching workshops, educating, or traveling. You can view more of his work on his website or follow him on Instagram. This article was also published here.


Image credits: Header illustration based oh photo by Victor Freitas


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