Monday

Lasik Surgery vs. ICL

It has been exactly one year since I had my eye surgery completed. It was a long road that took some strange turns - so now that I'm completely through my recovery I'd like to share my story.

When I was in 2nd Grade I started having terrible headaches in class. My teacher thought I was just being lazy, the school nurse though it was stress-related, and my mother was the only one who thought my eyes might be bad. Sure enough - a visit to the family optometrist proved I needed glasses. It seemed odd to my whole family because everyone had made it to the age of 15 before they needed any vision assistance (including my older brothers, who were age 20 & 22 at the time). I got my first pair of glasses at age 8, and it was just me and the retarded kid wearing them all through elementary school. Yeah - I was way popular.

At age 14 I began actively competing in scholarship pageants and programs, and my mother decided it was time for me to convert to contacts. We had moved across the state by then, so we found a new doctor who wasn't afraid to tell us like it was. I had extreme astigmatism... and my vision was worse than my brothers and my parents. To me, I just had progressively gotten a little worse every year and didn't think my eyes were THAT bad. The doctor explained that he could get me into contacts that would improve my vision - but I would never be able to see 20/20 with them.

I wore my new eyes for competition, and on special occasions, but was in my glasses the rest of the time. It was too hard to read without glasses - and I'd been wearing them so long that I felt almost naked without them.

So that's the way it was until I moved to Arizona. I began to research laser eye surgery when I was 21 because my eyes had gotten so bad that contacts weren't a good alternative even for "special occasions", and the "birth-control lenses" in my glasses weren't helping my dating life. I went so far as to put a deposit down for my surgery when the cattle clinic I went to popped up in the news for 3 cases of blindness in one year. In response, there were public service campaigns all over Phoenix for laser eye clinics - trying to restore positive opinions about Lasik and related surgeries. To me it didn't matter, I got my deposit back and was too afraid to think about it again for a long time.

Last March I visited my eye doctor for my annual exam - and spoke to him at length about contact technology. I had a pair of contacts that I would use once or twice a year, but wanted to get into something more comfortable for long-term use. He took a deep breath and said to me, "The best vision I can give you in contacts would barely make you legal to drive... I would even recommend driving glasses to go with your contacts. It may be a better idea to see what alternatives are out there for eye surgery in your case." Yes - my eye doctor referred my business away since my eyes were so crappy.

An example of my vision without glasses - I could see colors and basic shapes only.

I started researching again... and found a world renowned eye surgeon who specialized in cataract procedures, and was the person who thousands of Lasik surgeons trained under to get their certifications. He had been in business for almost 30 years, and had an impressive list of celebrity clients and references (70% of the medical professionals in my city who had laser eye surgery had gone to him). After talking it over with my husband, I made an appointment.

The first order of business was to analyze my eyes and see if I was even a candidate for Lasik. My eyes were dilated, pupils measured, corneas scanned, and then I was put into an examination room to wait. A young doctor came in about 15 minutes later and sat down with a grim expression. "Your astigmatism is the worst I've seen in years. I'm not sure what kind of procedure you qualify for... so I'm referring you up to our lead surgeon." He left.

I sat and waited another 10 minutes - and then the doctor I had read so much about walked in. He was a distinguished older man with a calm demeanor that instantly put me at ease. "Let's talk about your alternatives. There may not be enough material in your eye to allow us to make a Lasik correction. We could attempt it, but if the tissues are thinned out too much to try to correct for your extreme astigmatism the correction may not last beyond a couple of months. Also - Lasik is permanent and whatever the outcome you will have to live with the result. At your age, the next suggestion I want you to consider is an ICL - Implantable Contact Lens. It is similar to the procedure used in cataract patients where we would place a hard floating lens behind your cornea. It would give you 20/20 correction without a doubt - and if you have any more changes in sight we would simply change out the ICL later in your life." I was sent home with a pile of paperwork to read through and more questions than ever.

I read every last piece of paper my doctor had sent me home with. I researched countless articles online. Here's the summary of what it came down to in my decision:

- Lasik and similar procedures have been practiced for nearly 35 years.
- ICLs have been used in cataract patients for decades, but only used in patients with healthy eyes for the last 12 years.

- Lasik is permanent.
- ICL is reversible.

- Lasik does not guarantee 20/20 vision in my case.
- ICL guarantees 20/20 vision in my case.

- Lasik has a long recovery period (up to 1 year).
- ICL recovery is almost instant.

- Lasik will not further effect your eyes once the recovery period is over.
- ICL causes cataracts in many healthy eye patients within 10 years.

- Lasik (at a clinic that doesn't herd people through like cattle) should run in the $3,000 ballpark.
- ICL is only performed at professional eye clinics and runs in the $4,500 ballpark.

Price was not a big deal - I had started saving up for eye surgery the first time it was mentioned by my eye doctor. With our tax return last year, there was more than enough money to cover either procedure and still pay for vacation. I had to consider my age first and foremost to determine what would be my best option. I was torn...

I decided to talk to my optometrist for some extra guidance - because I had trusted him for so long with my eyes. I valued his opinion and wanted his professional evaluation. He told me, "ICL is a risky procedure because not enough is known about it for long-term. If you were older, in your 50's or 60's, and the ICL procedure was recommended as an alternative to Lasik, I would recommend it because your years of good vision are limited - and ICL would give you the best vision at that age. Since you are younger - I have to say that Lasik should be your front-running choice. Even though you may not get 100% correction with the procedure, glasses or contacts would get you there after the procedure, and there are no foreign objects to work around."

I decided I didn't want to face the chance that I could have cataracts in my 30's. Lasik had been around for so long, and the doctor I had chosen knew what he was doing when it came to eyes... so I went back to him with my decision. "I think you're making a great choice. Just know that I can't guarantee 20/20 because of your particular situation - but I will do my best."

My Lasik procedure was over with in 10 minutes. I sat up from the table and could see across the room without any help - it was the first time for me to see like that in 20 years. While it was like seeing through watered-down milk, I could still see things people take for granted (hands on the wall clock, the outlines of trees in the distance, people faces across a room). I took it easy on my eyeballs for a few weeks - following all of the recommended care while adding a week to everything (wearing goggles at night, using eye drops, not wearing makeup). With each monthly follow-up I was seeing better and better - 20/60, 20/50, 20/40... my eyes were always a little off of each other, but close in correction.

At 3 months I had my last healing follow-up. My right eye was 20/40. My left eye was 20/15. There was concern that my right eye might not catch up and I would need to wear a contact in that one. My doctor decided to wait for a little more healing to see if the correction could be made with an adjustment surgery. At 6 months I went in to see if it would be another surgery in the right eye or wearing a contact on my right eye from there on... and to everyone's surprise I was at 20/20 in my right eye. NOTHING NEEDED!!!

The money I spent to have the procedure done (even with the potential to still need some correction) was the best money I've ever spent. I see the world differently than ever have and it's incredible! I cried eight months after surgery when I was looking at the night sky and could see the stars... STARS!!! I had only been able to see a fuzzy moon even with glasses for over a decade.

What 20/20 vision has done for my outlook on life!

For fun I went in to have my eyes checked again - and at one year both of my eyes are at 20/20.

14 Comments:

Anonymous Anonymous said...

Thank you for your story. I had Lasik done in January and still haven't tested at 20/20. My prescription was very high...however first the doctors said "3 mo's and you'll see 20/20", then it's "4-6 mo's" now it's "6-8 mo's"...I was beggining to wonder if I was being strung along. So it sounds like I just need to relax and let time go by. I look forward to good eyesight.

8:33 AM  
Blogger Conqueress said...

My regular optometrist forwarded an information packet to me that was compiled by a research firm. It was about 35 pages of intensive medical reading... with only a 1/2 page on the long-term effects of ICL (also called "permanent contacts" in the packet). The statistic was for patients who received the procedure as an alternative to LASIK with no history of cataracts. The high percentage jump at the 10-year mark was believed to be caused by the constant motion of the ICL behind the iris.

12:29 PM  
Blogger clifford said...

Hiya- I live in Phoenix, AZ and am interested in going to the same doctor you went to for your lasik surgery. Can you share with us which doctor you went to?

Thanks!

blindly yours,

c.

1:00 PM  
Anonymous Paul said...

Hi, can you tell me the stats on your original astigmatism right before surgery. I know someone with a severe astigmatism with a 9 in one eye and 9.5 in the other, 20/10000 i think (i dont wear glasses so im not very knowledgable sorry). She is trying to find out if lasik is even an option for her and your story sounds very similar, severe astigmatism, glasses at 7, progressively worse and worse vision, getting to the point where contacts arent working.

Yeah as the previous post mentioned, the name of the doctor would be apprecieated also

thanks

10:24 AM  
Blogger Lizette said...

Thank you so very much for your blog. I was given both the ICL and Lasik options by my doctor. I've been wrestling with the decision for over a week now. You have provided answers to most of my questions. I can now call my doctor and ask questions specific to my case. Now I have a couple of questions for you....1. What has been your experience regarding "dry eye." 2. How would you describe your night vision (particularly when driving) prior to Lasik and after Lasik. I look forward to your response. Thanks again, Lizette

5:44 PM  
Blogger Conqueress - Egoist Views of the World said...

I live in Colorado, and have personally had no problems with "dry eye". It seems to be more of a case-by-case basis. One of my good friends has had chronic "dry eye" since her Lasik procedure... but even so she says it is the best decision she has ever made.

The best advice I was given was to prevent "dry eye" was to follow the doctors post-procedure instructions to the letter:
1. Don't use your eyes the evening following the surgery... i.e. keep them closed and listen to music, keep it dark in your home, and have someone else bring you food (and feed you if they're nice).
2. Keep your eyes protected by putting your "eye cups" over them with tape every night for a week (I did 2 weeks because I rubbed my eyes A LOT in my sleep).
3. Use your preservative-free eye drops regularly for as long as your doctor recommends (3x a day for a month for me).
4. Get some good sunglasses (not necessarily expensive)... ones that provide 100% UV protection and give good eye coverage. I didn't go for fashion, and bought several pairs so I'm never without my shades... a pair in the car, in my purse, in my jacket, in my gym bag, etc. I got all of mine from Target.

Night vision was interesting... it took me a few months to be comfortable with night driving. I had the "starburst" effect in my night vision where every light had an extra orb of fuzz eminating from it making it double in size. I wouldn't recommend going to the movies for awhile (rent DVDs for a few months - where you can control the light balance in a room). My night vision didn't return to normal for almost a year. I wouldn't say I just adapted to the "starbursts", but I believe they went away (which was something others with Lasik couldn't really answer for me). I actually look for the effect now when I'm driving at night and it's just not there anymore.

Hope this helps - and let me know if you have any other questions!

9:03 PM  
Blogger jaywalker said...

Hi,

I am so glad that it worked out for you. I backed out of a scheduled lasik surgery a couple of years back because of similar concerns and realising that the surgeon I was going to operated on an "assembly line".

My wife and I are evaluating the various surgeons in the valley. Which surgeon did you use? Would you mind sharing your cost and if you were able to negotiate the price down.

How has your experience been since you posted this blog.

Look forward to hearing back from you.

5:57 PM  
Blogger Conqueress said...

I went to a surgeon in Colorado... The "assembly line" experience I had was also in Phoenix - which is why I gave up on getting the surgery until I moved.

I recommend visiting:
www.aao.org (Search on the right for your city/state, and "Refractive Surgery") These doctors are part of the same organization as my surgeon, who operate to exacting standards. This will help filter through the "cattle shops". DON'T DO A GOOGLE SEARCH. You will find literally HUNDREDS of surgeons who paid a high price to pop up on the list. There are only 14 surgeons in the Phoenix area listed on www.aao.org.

Back in 2007, the cost was $3,300 for both eyes. My husband had his Lasik surgery in 2010, same surgeon as me, same price.

As of January 2011, my vision is still 20/15 L - 20/20 R. My husband had a speedier recovery than I did... achieving 20/20 in both eyes within 3 months.

9:54 PM  
Anonymous laser vision correction dallas said...

I agree with Night vision was interesting... it took me a few months to be comfortable with night driving. I had the "starburst" effect in my night vision where every light had an extra orb of fuzz eminating from it making it double in size. I wouldn't recommend going to the movies for awhile (rent DVDs for a few months - where you can control the light balance in a room). My night vision didn't return to normal for almost a year

10:11 AM  
Anonymous Amy said...

Thanks for the info. I was just evaluated for Lasik and the doctor recommended ICL instead of Lasik. He said with my nearsightedness, combined with cornea thickness, he wouldn't be able to get full correction...I would still probably have to wear glasses or contacts of -3.0 prescription or so. Great to hear you got to 20/20 (no need for glasses). What was your prescription before Lasik?

I'm trying to decide if I should go with less-invasive/less-chance-of-cataracts/longer-proven Lasik and still have to wear contacts...OR go with ICL which to me seems to have more longer-term risks (cataracts and don't like the "invasive" part as they do have to put you under). The doctor said that in the past 5 years, he can only remember about 5 people in my situation that moved forward with Lasik. Of those 5, 1 was unhappy with not getting full correction. He was recommending ICL. However, since I came in with a mindset of doing Lasik, we didn't talk much about ICL yet AND he never mentioned the chance of cataracts within 10 years (thanks for the tip!).

Your thoughts? ICL vs. Lasik vs. doing neither and living with my -10.0/-9.0 eyeglasses (contacts)?

Thanks!!

9:37 AM  
Blogger Conqueress said...

You know, I wrote this article in 2008... 1 year after my surgery. As of today I am looking back on the last 4 years and I wouldn't change the choice I made. Knowing there was a chance I could be in contacts after the Lasik, for me it was less of a risk than ICL. Nearsightedness and cornea thickness were also my surgeon's reason for recommending the ICL, but thanks to my Optometrist I chose Lasik because I was in my 20s when having the procedure done... too many unknowns for the long-term with ICL.

Of course, over time the studies have changed, technology has changed, and the handouts I received from my doctor in 2007 are no longer available.

I cannot make the decision for you, only say that the choice I made was right for me. Good luck with whatever you choose!

9:03 PM  
Anonymous Anonymous said...

I am scheduled to have lasik surgery in a little over a week. I am nervous about it, but your story is very similar to mine! Except they say that my eye is thick and a lot of room to do some carving! However, I'm 10 years older than you so I have to decide if I want monovision or not. The doctor seems like that would be a good idea, but I'm still uncertain.
Thanks for posting your story. It made me feel better.
miraclesdohappen at yahoo dot com

2:32 PM  
Anonymous Tara said...

Thank you so much for writing about this - I've wanted to get lasik for sooo long!

11:42 AM  
Blogger Nichole Mercado said...

Congratulations on a successful surgery! I had the same experience before, although it wasn't as drastic as yours seem to be. I had my lasik surgery done by Arizona Retinal Specialists, under the supervision of Dr Gholam Peyman and Dr. Mandy Conway. I'm so happy for you!

2:32 AM  

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