All my life, I had suffered from astigmatism, associated to a low hypermetropia in my left eye, which gave me a bad sight with this eye, in comparison to my right eye. As I approached 40 years of age, this condition seemed constantly worsen. My accommodation was poorer with time, together with my general sight.
As an ophthalmologist surgeon, a microscope is a vital tool; I decided to wear correction glasses, but this proved to be a bad solution because my visual field at the microscope got narrower, as you must always look close to the oculars.
My next choice consisted on contact lenses. They never worked, in spite of following all the optometrist recommendations. I couldn’t help permanently feeling the lenses in my eye, and performing my operations was harder.
At those times, LASIK, Refractive Surgery supported by laser, had evolved very much, but not enough to correct at the same time astigmatism and hypermetropia. In one eye the Software was able to correct myopia, hypermetropia or astigmatism, but as separate events.
I decided to start waiting for the appearance of new software that would provide safer and faster procedures to correct my condition. Follow-up systems, to monitor eyes that get off center due to involuntary eye movements, were not available then. A second surgery was necessary most of the times to correct those “hipo-corrections”. This surgery was known as “finishing touch” surgery. Also, techniques for personalized cornea carving, like Wafe Front, were unknown.
Once topography clearly showed the cornea anatomy, with curvatures and corneal powers, expressed in different colors, and after a paquimetry measures cornea thickness at different points, which provide surgeons valuable information about safety margins of resections, I chose to get a correction surgery in my left eye; after considering both my own patients’ results and the stability of my refractive defect. Some day in 1998, I contacted a colleague of mine, who has been until now my partner in many surgeries, and asked him to operate my refractive defect immediately after some patients who waited for turns that day.
So, the next is a first-hand description of the procedure, to guide and orientate patients who could be willing to get this Refractive Surgery, so that their knowledge of details helps them get a perfect self-control during the procedure.
I went into the laser room, after a careful eye wash and getting a topic anesthesia (drops).
I was wearing a surgeon robe. Laser rooms are handled in the same way as conventional surgery rooms. Unlike these rooms, laser rooms are much quieter and cozier, lights are soft. The staff consists on the surgeon and two auxiliary nurses. The laser equipment includes a comfortable couch, a binocular microscope visor, and the laser box itself.
Obviously, my colleague didn’t want to give me details of the Refractive Surgery, he only kept assuring me that everything was going right. One eye surgery takes 5 minutes only, which really fade; you only experience an undetermined, short time. Please remember that no sedatives are used.
Head is firmly located by a pneumatic pillow (a plastic pillow, from which air is extracted);
It is placed exactly below the black circular lens, with a blinking red light in its center. You must look at the light all the time, it marks the carving axis. Plastic and fabrics, which are sterile and adhesive, form the surgical field. Then, surgeons place an instrument that keep eyelids still and open.
After that, I started to feel slight sensations, as the surgeon drew some reference marks at the cornea. Then, a suction ring is introduced, it fixes the eye and provides a base and guide for an instrument (similar to a carpenter flatterer) that, by oscillating movements, produces very fine parallel cuts in the cornea (120-150 micras width). Light goes out, I just
Hear a very low sound, like the sound of flies. This motor works for 30 to 60 seconds.
After that, light comes back, you feel a little discomfort due to environmental light, for a short time. Immediately, you “remember” the eye position and your own fixation point. Now, the surgeon removes the cover, no pain is felt, and carries out the laser stage, for about 20 to 50 seconds, depending on corrections to be made. This phase produces a high frequency, repeated hammering noise that suddenly stops when all is concluded.
The operated eye is carefully washed, with a special solution; the cornea is re-located and surgery ends.
You notice from the very beginning an improvement in your sight. After some eye drops and a bandage, you change clothes and go home. A control session is necessary, some hours later.
I hope that this unusual case, a surgeon getting a surgery that he performs himself, knowing all the specific details, provides a valuable information and better understanding of LASIK procedure. This way, you are able to make a decision about being operated or not.
P.S. My sight remains stable from that time on. This surgery helped me operate better and also live better. I drive, read, and see the world without distortion.