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LASIK "The Next Frontier"
cpjmazz - 11/25/2007 6:50 PM
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Category: Educational
Comments: 8
LASIK "The Next Frontier"My story begins back in `97 when I first spoke with my primary optician about LASIK. Having been nearsighted (myopic) w/ astigmatism since the 7th grade and first using contacts while diving at age 16, I wanted input about this new concept in vision correction. My initial consult yielded the recommendation for ~2 years of unchanged vision for consideration of the procedure.

At the time I was reluctant about contacts let alone any physical surgery/manipulation of my eyes so I was happy with my findings & decided to postpone any further investigation. At least diving w/ contacts provided better vision & visibility... without them it was like diving in merky & soupy conditions not uncommon to the Long Island diving experience :)

Early Summer 2007 was a time for reinvestigation: I heard about a newer addition to the LASIK portfolio, a concept called "no blade" or Intralase LASIK, which ultimately yields a safer operative experience and quicker recovery time. So, having held off for nearly 10 years I opted for a 2nd evaluation. After learning of my lattice degeneration progression w/ "holes" conditions I went to a retinal specialist who identified that despite this update, I was still a candidate since my vision changed very little since my last visit. I was recommended, Dr. Eric Donnenfeld, who later gave a though eye exam, reaffirming my eligibility for the procedure.

After several medical consults, talks w/ friends who underwent LASIK w/ the microkeratome, and support by my family, I decided that my time had come for getting the procedure. I took off from work Thanksgiving week & underwent the procedure on Friday, 11/23/07. Since my goal is to inform & educate other divers I will delineate some of my experience here:

PRE-OP: Aside from the 2-week ban from wearing contacts (which I rarely wore except during free-leisure sports like diving & biking) there were no dietary restrictions, however, I was required to bring a driver. The pre-operative consult took me step-by-step through the procedure which was estimated to last 5-8 minutes per eye. The consultant recommended that patients take 5mg, Valium so considering the novel situation I decided this was necessary... following a quick iodine prep (something to consider for those who are allergic) and 2 rounds of anesthetizing drops I was ready to be seated in the reclined seat. NOTE: if you bring someone with you, they have the opportunity, with your consent, to watch the entire procedure on a TV screen & behind a glass window.

OPERATION: hmmm, it happened very quickly but here goes! There were two rotating units suspended above the head region. The opposing eye is covered and you`re told that a device will be placed over the eye to be operated on, which will "create pressure." Basically they have a tool which prevents your eye from shutting (calmly think Kubrick) and another circular unit that is placed directly over the eyeball. The first machine maps out and emits many focused and precise laser pulses which penetrate the eye at a designated depth, creating a layer of bubbles which join to create a thin, corneal flap. This process lasts about 15 seconds and sounds somewhat like a playing card rattling against bike spokes. Once this is finished the circular tool presses directly on the eye w/ suction to detach the corneal flap... the machine swivels back and the second is aligned above the same eye. A tool is used to peel back the flap and the second machine emits a second laser which reshapes the cornea and purposely over-corrects your vision. This might last another 30 seconds per eye. The flap is `seated` back on the treated cornea and the process is repeated on the second eye.

POST-OP: Once the finish working on the second eye you`re in a complete state of disorientation. Initially, vision is completely blurry so I had to be helped by the (cute) medical attendant up and out of the operating room. I laughed when they told me the sensation was equivalent to opening your eyes underwater. I was directed to a small room to evaluate the immediate outcome of surgery and correct placement of the flap. Of my many questions I did ask "HOW LONG DO I HAVE TO WAIT BEFORE I CAN GO DIVING?" To my surprise I was told 2 weeks from the date of surgery!!! I`m baffled by the technology available today for laser correction... I was told the laser is so precise that the healing time is greatly reduced hence the short down time for diving.

1st NIGHT: Following surgery my eyes were extremely tender, teary, and photosensitive yet I was able to see fairly well. A clear set of plexi lenses were taped over my eyes along with a set of sunglasses; thankfully they were more contemporary than the traditional oversized "grandma glasses" which are angular in shape and wrap around. The ride was a challenge as all the bumps in the road sent me into a frenzy. I slept for about 3-4 hours which is highly recommended (stay up late the night before surgery if you`re considering LASIK). An anti-inflammatory drop & antibiotic drop are administered 4x daily... not too bad on the eyes. As you`re going through all of this for the first time you begin to catch onto things which initially you don`t of my greatest concern (aside from eye soreness) was weather my post-operative follow-up with my personal optician was covered in the price of surgery (thankfully it was!). By the end of the day I was drained & didn`t have any problems falling asleep.

DAY ONE (Post-op Appt): I was excited to hear that the flap was seated perfectly back on the eye and already had 90-95% adherence at the fracture point. By the next day my eyes were still irritated from the clamps used to keep my eyelids open but clarity was quickly returning.....WITHOUT GLASSES!! My optician advised that the range of vision was between 20/10 to 20/40 and my Rx. was 20/20 in the LT eye and 20/30 in the RT eye - simply brilliant!

Thinking back to the surgery, I can`t imagine that I was temporarily rendered blind & now I have almost perfect vision which will continue to improve with careful oversight & care. I was told that there are few restrictions for diving and since I have my first trip down the the Florida Keys, Dec. 9-16, I will cautiously try my first contact-free, shallow-water dives in pristine conditions. HOPEFULLY YOU`VE READ THIS AND HAVE ADDITIONAL QUESTIONS AND ADVICE. I truly hope this inspires more open dialogue on this topic with I`m happy to hear from anyone at both ends of the spectrum. Happy Diving!

~~~~~~~~~~~~~~~~~~~~~~~~~ UPDATE ~~~~~~~~~~~~~~~~~~~~~~~~~~~~

For anyone interested, here are some updates since my last post:

"1-WEEK CONSULT" [11.30.07]: Shortly after the Intralase LASIK I had another scheduled check-up with my primary optician. The patches of blood, which had been created by the suction device placed over both eyes during surgery, were still pronounced and looked irritated (to me). My updated eye exam results yielded a consistent 20/20 in my LT eye and now 20/20 -1 diopter (a hair less than perfect) in my RT eye. When the doc took a closer look he determined an increased white blood cell count under each corneal flap, indicating low grade infection. As it turns out, my efforts to avoid unclean/dry environments weren`t met with good results. The doc told me this can happen following any surgery and by this time I had run the course of my anti-inflammatory & antibiotic drops so the advice was to continue the antibiotic drops. I was told that further progression of the immune response might cause a condition referred to as Sands of the Sahara - when enough white blood cells migrate beneath this area which progressively begins to occlude vision... needless to say this caused a mild sense of trepidation, LOL!!

This news truly put a damper on things. I decided to schedule an[


Toni-Ann - 5/08/2009 10:04 AM
I had LASIK in January 2008 and can’t imagine having to wear contacts while diving...
anemone - 12/01/2007 12:18 PM
One more comment: cost. Yes, expensive, it depends on how bad your sight is. Insurance coverage,no, unless your insurance has a special optical plan. They eval your eyes and let you know how much, the worse your eyesight, the more expensive to correct. I would not use anyone offering Lasik cheap, come on, it`s your sight. You get what you pay for.
anemone - 11/29/2007 10:10 PM
I had Lasik done 2 years ago and considered it well worth the expense. Down time 2 weeks, I have since dove to 130ft many times, no problem. Great not having to dive with contacts and worried I would flood and lose `em.
DiveRex - 11/26/2007 8:26 PM
I had LASIK back in 2000 and have been over 100` deep many times since. I have also done 5 dives a day for a few days in a row, and short of being physically exhausted by the end of the week, my eyes were in great shape. Dont get crazy for a few months, but the long term shouldn`t be an issue. And it was the best money I have ever spent on myself.
Greg - 11/26/2007 8:55 AM
I had lasik nearly 4 years ago and my eyes are still perfect. 20/15 vision. No glares at night or any of the other problems some people complain about but put up with. I couldn`t imagine being a diver without good vision. I suppose I`d have to buy those prescription lenses. Good blog!
cpjmazz - 11/25/2007 8:33 PM
Between both MD`s I was given a lead time of 2 weeks.
My optician recommended that I limit my diving to "shallow water" dives.
Since this is non-specific, I would like to hear from anyone w/ more insight on restrictions b/c I wouldn`t want to overdue/undue anything at this point.
NWKatShark - 11/25/2007 8:15 PM
What did they say your diving "restrictions" will be? Larry
NJ_Wreck_Diver - 11/25/2007 7:33 PM
Any pain involved at all during the procedure? I have been thinking about getting this done JUST because I have a difficult time seeing while diving. I don`t have an RX mask, and really don`t want one. Also what was the total cost involved? Thanks for such a great blog entry!!!!