Jules - Laser Eye Surgery
I have been wearing glasses for 12 years and contacts for the last 2 to help correct my mild - moderate myopia. I first seriously thought about Laser Eye Surgery 6 months ago as I was really fed up with my quality of vision and the inconvenience of having to rely on external aids. I know quite a few people who have had corrective eye surgery in Perth with great results, although the cost of $6000 was never really in my budget.
This was all about to change as my husband and I were planning a trip to Thailand and with the help of Restored Beauty Getaways I booked a consultation with the eye specialist at the Bangkok Pattaya Hospital (BPH) Laser Eye Centre to see if I was a candidate. I was still a bit nervous about the whole idea of going overseas for surgery, especially being my eyes, so I decided to book an appointment at the Lions Eye Institute in Perth to compare the types of testing performed.
Before my evaluation in Thailand I had to stop wearing contact lenses approx 7 - 14 days prior. My consult at the Laser Eye Centre involved having eye drops and various tests to analyse my prescription, corneal topography and all the other important information that was required to determine whether I was a suitable candidate for laser eye surgery. At the end of all the testing with the lovely Thai nurses, I finally met my surgeon Dr Somchai with whom I immediately felt at ease with his professional manner and quirky mannerisms (he is very passionate about his job and helping people achieve the best possible results for their eyes). I was then given the good news that I was a successful candidate for laser eye surgery and he went on to explain my options...
The LASIK procedure involves a suction ring to be used to keep your eye pressurised and immobilised so that an incision can be made to create a corneal flap, which is lifted up allowing the laser to sculpt inside the cornea to improve vision.
Rather than making cuts into the cornea, Photo Refractive Keratectomy (PRK) uses an excimer laser to sculpt an area of approx 5-10% thickness of the cornea for mild to moderate myopia and up to 30% for extreme myopia. The benefit to this procedure is that the integrity and strength of the corneal dome are retained and can be tailored to unique vision correction needs. The laser is set at a wave length which can remove a microscopic corneal cell layer without damaging any adjoining cells, allowing the practitioner to make extremely accurate and specific modifications to the cornea with little trauma to the eye.
When it comes to advantages and disadvantages of each procedure, LASIK patients have less discomfort and obtain good vision more quickly. Alternatively, PRK patients show a more gradual improvement over a few days to months, but many surgeons worldwide prefer PRK for patients with large pupils or thin corneas as this is less invasive and has lesser risk of infection.
After receiving all this detailed information from Dr Somchai, I was somewhat relieved that he recommended custom PRK for my procedure as I had seen an example of a LASIK procedure and the lifting up of the corneal flap really made me feel ill and turned off by the surgery. I left BPH hospital not knowing the exact date I would book in for my surgery but a lot more confident with the surgeon, hospital and service provided by Restored Beauty Getaways in helping achieve this first step.
Upon my return to Perth I never had a chance to have an eye examination at the Lions Eye Institute - I was contacted for my appointment whilst I was away in Thailand and when I tried to reschedule, my phone calls were never returned (from what I gathered it was very difficult to get an appointment with the increased popularity of Laser Eye Surgery). Luckily after my previous experience in Thailand and the news that I was a candidate, I was confident enough to book my surgery appointment (April 21st 2007) and holiday travel with the help of Restored Beauty Getaways.
Those months leading up to my trip included excitement and at times doubts whether I made the right decision. I told many of my family, friends and work colleagues about my intentions and often got mixed responses. Many people were positive and confident with my choice, although others were worried with the stigma attached to going to Thailand for any surgery. I think the most unsettling thing for me was conversations with a work colleague who had LASIK in Perth. Unbeknown to him, comments that he made about PRK and LASIK recovery times made me a bit nervous about which procedure I should choose. Ultimately I wanted the best for my eyes as suggested by Dr Somchai, but selfishly I also wanted to have a holiday too. I feel silly when I look back on it as it was my eyes and recovery I should have been focusing on and not how much sight seeing and shopping I would do when I was away.
I decided to do some more research on the internet about Dr Somchai and the laser machine that was going to be used for my eyes. Information on Dr Somchai was impressive and in my research about the machine I looked at which laser eye machine was being used at the Lions Eye Institute (Bausch & Lomb Technolas 217z100) and compared it to that at BPH (Carl Zeiss MEL-80). I discovered in DR Somchai’s website, 6 reasons for the choice of the BPH excimer laser as opposed to others on the market. In this information two particular points that interested me were: "Cone for controlled atmosphere: The laser is the only laser that controls the space between the eye and the laser (the beam path). This is a Carl Zeiss Meditec unique patented technology, and enables more accurate results that are less influenced by extraneous environmental factors. This laser has shown better results, with the same surgeon, than the Bausch and Lomb 217.
Closed Loop Energy Monitoring: The MEL70 is one of very few lasers available that feeds back to the energy control unit during treatment (active monitoring). The feedback sensor controls for any fluctuations in energy that occur during the procedure, keeping constant the energy delivered to the eye within 1-2%. In contrast, for example, the Bausch and Lomb 217 does not have active energy monitoring, and actually switches off in the middle of a treatment if energy fluctuations exceed 30% (passive monitoring) http://www.doctorsomchai.com
I guess that this information finally gave me the reassurance I needed to know that I was making the right decision about going to BPH for surgery. I decided I was going to leave which type of laser surgery I would choose to when I saw Dr Somchai again.
Preparation for my final examination prior to surgery
The day before my surgery I went in for my final examination (to check if my prescription had changed from my last eye testing) and discussion with Dr Somchai to ask any more questions.
Would I experience pain? - No pain would be experienced during surgery at all but as I was quite anxious I would be given a sleeping tablet and two paracetamol prior to surgery to relax me.
What was involved in my post-operative recovery? - Immediately after surgery my corneas would be covered with a clear protective contact lens (kept on the eye until day 5) and then my eyes would be covered with an eye shield for 24 hours. I would be given a sleeping tablet and paracetamol tablets for pain relief. The following day after surgery I would come back into the Laser Eye Centre and the shields would be removed, my eyes cleaned and checked for inflammation. On this day I would be given some cleaning solution to be used morning and night, antiseptic and artificial tear eye drops which had to be used 4 times a day and another set of eye shields and tape which were to be put on before bed each night and removed when I woke in the morning.
I was informed I would feel discomfort a few days after surgery (an irritation, gritty like sand in my eye) although this would go away after a few days. My vision would also fluctuate over the next week; some days would be good although other days may be slightly blurry but to be patient as recovery would only get better and better from 2 weeks up to 2 months post surgery. There would also be another follow up examination on Day 5 after surgery to see how things were going and a final check over on Day 7 before I was to depart Thailand. I would not be allowed to wet my face / eyes for 7 days (still able to shower), only wipe with a face towel around my eyes. After 7 days I could wash my face like normal.
I was also told that over the following week post surgery to make sure that no water entered my eyes (kept free from infection) and to avoid dust and smoke. As for exercise, nothing vigorous over the next week which would cause sweating and drip into my eyes and that I was not able to go swimming for 1 month post surgery. Also, no eye make-up should be worn for 1 month post surgery.
After being given all that information I felt very prepared for what was ahead of me, although I had to ask one final niggling question;
Why Custom PRK instead of LASIK, as most Laser Centres in Perth performed LASIK, and I wandered why my procedure was going to be different? - Dr Somchai answered confidently that for Laser corrective eye surgery many practitioners world wide were now heading toward the latest laser technique Custom PRK as it was tailored more specifically to individual corrective needs, less intrusive and less caution required in regard to future trauma as there hasn’t been any alteration to corneal strength (as cuts are not made), although the post operative recovery would be longer. I was pretty happy with that explanation and left the hospital excited that I was about to take the plunge in getting my full vision back with the surgery I was to have the following day!
Shower as normal, although no cream, lotion, make up or perfume on the day of surgery. I arrived at the Laser Eye Centre at 9am and was instructed that the first thing I needed to do was have the standard pre surgery blood test. I hate needles and having blood taken (I often feel faint after), but the nurse was very lovely and helped me get through my light headedness. I went back to the waiting room, until I was called up for my surgery. I said a nervous good bye to my husband and walked into the pre-operative area.
I was settled on a comfy chair and then given approximately 5 lots of eye drops over a period of what felt like 5 - 10 mins. I was finally led away into the operating area where I gowned up for surgery and was given my relaxant pills. From here I walked into the next room where Dr Somchai, his nursing team and the Laser machine were waiting for me. I was instructed to lay down, a large pillow placed under my legs for comfort, two stress balls given to me to squeeze and covered with a sheet for warmth. My body and head were then positioned so that I was in perfect alignment for the laser machine and then my face fully covered, except for my right eye.
Another few eye drops were inserted in my eye, my eye taped apart and an apparatus inserted which was used to keep my eye open during the procedure. The Laser machine was then moved into place and I could see a green flashing light. I was then told to keep as still as possible whilst looking at the green light, hold my breathe for 10 seconds (to decrease any chance of movement) and then the Laser began (looked like flashing red spots of light). Once the Laser was finished, my eyes were attended to with some kind of instrument, more drops added, a soft contact lens placed on my cornea and then the whole process repeated on my left eye.
Once this was over my eyes were covered with clear eye shields, I was taken out of the operating area, de-gowned and then wheeled out in a wheel chair to my husband. My first thoughts after the whole experience were that I had survived the operation and that I could see through the little wholes of my eye shields. We caught a taxi back to the hotel and I spent the day resting my eyes and sleeping.
Day 1: I woke up with a bit scratchy eyes, took some more paracetamol and headed back to BPH for my 9am appointment. The nurses removed my eye shields, cleaned my ayes and gave me another eye examination. Looking at the chart I felt as though my vision was slightly better than before, but still blurry. Dr Somchai then checked my eyes for inflammation and said that all looked very good. Day 2: My eyes were still a bit scratchy and sore, although didn’t feel the need for any paracetamol. My vision was still a little hazy and I found it a bit hard to focus at times, but ok. Day 3: I woke for the first time with no pain at all and my distance vision was quite clear, although a little bit difficult to focus at reading level. Day 4: Still able to focus on distant objects well, every now and then a little bit hazy. Day 5: Headed back to the hospital for my follow-up appointment, where Dr Somchai removed the protective contact lens from each eye and told me that my eye recovery was on track. Once the lens was removed my eye felt quite naked, which took a little bit of time to get used to. My eyes felt a bit tender for the rest of that day, although visions still ok. Day 6: The tenderness was no longer there and my vision was quite good. Day 7: My final eye test (20/20 vision) and check up today with Dr Somchai who gave me the ok that all was good with my eyes and that from 2 weeks up to 2 months post-operative my eyes would get better and better each day.
It is now 2 weeks since I had my surgery and I am back at work and into normal life. My distance vision is great, I can’t believe that I can watch TV, am able to see street signs when I drive and have clearer vision in general without my glasses. My eyes do get a little bit tired when I am sitting in front of the computer too long and the screen can seem a bit hazy every now and then (I have to make sure I rest them every hour or so, by shutting my eyes for a few seconds and rotating them up, down, left and right), although I am still in my recovery period for the next two months so I am being patient.
All in all I had a fantastic experience with my Laser Eye Surgery; with the help of Restored Beauty Getaways who gave me all the information I required about my procedure, organised my surgery and liaisons with the Bangkok Pattya Hospital as well as helping out with travel and accommodation, along with the great experience at the hospital and all the helpful staff and my professional surgeon Dr Somchai and finally just enjoying having a holiday in Thailand whilst recovering from my Laser Eye Surgery. I would thoroughly recommend my experience to anyone thinking about getting Laser Eye Surgery. Find out if you are candidate for this type of Eye correction, do your research and remember to follow all the advice and recommendations Restored Beauty Getaways and the staff at Bangkok Pattya Hospital give you. Keep in mind that everyone recovers differently and to be patient, as each day may be different but the results are so worth it in the end!