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Hmmm... I'm not sure who Helen's consultant is but what is being described here as LASEK is pretty much the same as Surface PRK. The apparent difference being in 'how' the epithelium is removed. The previous procedure involved anesthetizing the cornea and scraping the epithelium off. I guess this newer procedure is less injurious. I had this procedure (PRK/LASEK?) done in 1996 to both eyes simultaneously. I was a hurting puppy for 3 days - but WORTH it for the clarity of vision! Yes it is less invasive, but risk of infection is higher. This is why you wear the "band-aid" contact lenses for 4 days, to protect the eye while a new epithelium grows. That is also why I was using steroid eye drops for 3 months as a post surgical Rx. I imagine Helen is using something similar. My surgeon (also a diver, and also had the procedure done on himself) said I could dive about 6 weeks after surgery, taking care to keep up the eye drops and stay out of questionable waters (swamps, polluted, etc.) - I stay out of those anyway ;-) I did dive 6 weeks after surgery and was absolutely enchanted with diving all over again. This time I could see clearly, or wasn't risking the use of contact lenses under the mask. This substantially reduced stress and task load (fear of mask leaks, loosing mask, loosing lens, etc.). I can't recount how many times I have exclaimed how wonderful it is to be able to read the clock when I awaken in the morning. My vision was 20/600 (right) and 20/800 (left). In the US, at the time, Surface PRK was only available for those with 20/600 or better - else I had to go to Canada for the procedure. (This has changed now). Anyway, my surgeon and I decided to try an alternative, and if I was not happy, I could have the procedure redone at no cost. We under corrected my left eye - in the contact lens world this is called 'monovision'). Thus, at the age of 46, I could use my left eye for reading, and my right eye for distance vision. And I could eliminate reading glasses! Well, the procedure was successful - to a degree. The problem with monovision is depth perception in lowlight situations. I had difficulty judging distances (10-30 meters) while driving at night. I found it dangerous on the roads around Washington DC. So 10 months later I requested the left eye to be recorrected. By now (1997) the new Excimer Laser machine was out that also corrected for astigmatism, and the LASIK procedure was available in the US. The LASIK procedure is more invasive, but also yields FAR less susceptibility to infection - AND FAR less painful (actually no recovery pain that aspirin could not handle). This was successful too. Since 1997 I have enjoyed 20/20 vision in the right eye, and 20/15 vision in the left eye. Due to the residual astigmatism in the right eye (just one PRK procedure and no LASIK, remember), I sometimes revert to using reading glasses on very fine print (less than 8 point font), but usually do not require them for most reading. No changes or flucuations in my vision have occurred, no problems with diving, no eye problems at all. ==> Helen: I know the recovery. Glad to hear you're up and out. Congrats! Regards, Quinn > helen.johnstone wrote: > > LASEK is a.k.a. thin-flap LASIK. It's almost a half-way house > between PRK > and LASIK. My consultant said research is showing there are less > complications and regressions with PRK than with LASIK, and > PRK is more > understood as it's been performed for twice as long as LASIK. > PRK is far > less invasive, as there is no deep 'cut' as occurs in LASIK. > It's not so > dependant on the surgeons skills as is LASIK, as there's no > cutting. It's > far easier to treat any subsequent infection, and we felt was a better > option where diving was concerned. However, there is more > discomfort than > LASIK. > > Anyhow LASEK is where they use alcohol to remove a very thin > flap off the > front of the eye (epithelial layer - hinge at top), and then carry out > normal laser surgery. The flap is then replaced and a bandage > contact lens > placed on top for a few days. There is no cutting as in > LASIK, but only the > use of alcohol. The advantage is that there is less trauma to > the eye than > PRK (where they simply laser straight thru the surface > layer), there is > supposedly less discomfort, and the recovery is quicker. > LASEK was first > performed in Italy a couple of years ago. There are a couple > of consultants > in the States who are now using LASEK ... not sure who tho, > as well as the > teams in Italy, UK, Ireland and other places. Altho a new > procedure, it's > based on the very stable and well-known PRK. The results so > far have been > impressive, according to my guy, and he thinks that this will > become the > normal procedure soon. The amount of LASIK he's doing is > dropping quickly > and he's doing far more PRK / LASEK now. > > Surgery took 10 mins. A number of eye drops, and lie back on > comfortable > couch. The surgeon told me what was going to happen, and we > had a 'practise' > run. Stare at a green spot for 25 secs whilst the laser did > it's thing - > without actually using the laser ... just the countdown and > listen to the > noises. Seemed ok. Eye clamp went on ... couldn't feel any > pain, but was an > odd feeling. He put a spherical thing on the eye and squirted in the > alcohol. Left it for a few seconds, then very carefully > pulled the surface > layer flap away, using a hockey-stick-shaped tool. At this point, my > eyesight went blurred. You could see the 'flap' as it was > moved out of the > way ... bizarre feeling but completely painless. Once the > flap was away, > things cleared up and I could see (badly) again. Then was the > time for the > laser. Surgeon held my head very still, and ... zap zap zap. > He counted > slowly to '25' whilst the laser worked. At first, the green > spot was clear, > then it went blurred. Slight smell of burning hair. Again, completely > painless. Just odd. After 25 secs, the laser switched off, the eye was > cleaned and the flap was put back. The bandage contact lens > was put on and > that was that. He checked my eye thu the usual eye check > devices, seemed > everything went well. My eye was a tad red, but that was all. > By the time I > got to the car, I could feel it starting to hurt. So I took > some of the > painkillers, and they seemed to work. (Co-proximal). Once > home, I crashed > out in a dark room. Real pain kicked in a few hours later > .... outrageously > painful! Took prescribed sleeping pills, painkillers and > eventually slept. > Next day, felt sick, dizzy, felt I had been kicked in the > side of the head, > pain in the eye that the painkillers didn't seem to cope > with. My surgeon > had warned me about this. I think I suffered from side effects of the > painkillers, and that didn't help either. So, 2 days of outrageous > discomfort..... I went back for a check up Friday. The flap > had almost > re-connected. By this time, the pain had almost gone, and I > could see. :-) > My eye still was trying to imitate Niagra in the amount of > tears it was > generating tho. Unfortunately, the bandage contact lens came > off that day, > and then the pain came back, and the vision went blurred. > Saturday was > uncomfortable, but I wasn't taking the co-proximal as I > didn't like the side > effects. It felt as if there was something in the eye (gritty > feeling), and > the general headache was calming down. Today, Sunday, only a little > discomfort. I can open my eye. Vision is still blurred > though, as expected. > I still don't like bright lights so all the curtains are > still drawn. I've > got eye drops that I need to put in 4 x a day, and these will > continue for a > month. My next checkup is in 2 weeks time. > > I'm waiting to see how this eye turns out before thinking > about the other. > If everything works out, I'll have the other one done this > October, once the > diving season has finished in the UK. I've been advised no > diving for 6 > weeks ..... I've not organised anything for at least 12 weeks > just to make > sure.......and even then, it'll be shallow stuff. > -- Send mail for the `techdiver' mailing list to `techdiver@aquanaut.com'. Send subscribe/unsubscribe requests to `techdiver-request@aquanaut.com'.
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