INCLUDE_DATAINCLUDE_DATA

Archive for the Category »Eye Surgery «

Sep
18
Thoughts while writing the refractive surgery book
Ami Chopine

I am stumbling on how to write what should be a simple part of my book, describing refractive errors. Why? Because I keep on wondering what and how much I should explain. Like, should I get into convex and concave lenses, and describe how the angle of light is changed? I keep asking myself, what audience am I writing for? How much is overkill and how much is not enough? How much do they want to know, and how much do they need to know in order to make a fully informed decision? Where does the line between geek and healthily informed lie?

I know my audience will at least be the kind that would consult a book before making a decision. But that doesn’t always guarantee a lot in the way of ability to understand.

On one of the LASIK horror story sites, a 28 yr old doctor who is a practicing family physician wrote about how bad of an outcome he had, with a slight overcorrection of +0.5 D. The way he wrote his entire story made me cringe. There was clearly a lack of understanding the difference between anectodal vs statistical evidence. He seemed panicky and not very well informed about the very procedure he was to have done on himself, except to not have his eyes done bilaterally. I have never had LASIK and knew far more than he did. (Is that where geek factor comes in?)

Anyway, I really wouldn’t want this guy as my physician.

But his story is not so unusual. People have outcomes they are pretty satisfied with, and then stumble onto these sites and suddenly they are upset and frightened, and convinced their doctor was evil and misled them. I wrote about researching those sites a few months ago, and recently got an interesting comment on that article about how those sites caused a satisfied patient’s anxiety, when she didn’t have any before.

As I read the one tonight, I was very disturbed by the heavy legal leaning it had. This one clearly seemed to me to be a recruiting site for litigation lawyers to fish for people to sue doctors. It certainly is to their advantage that previously satisfied refractive surgery patients become scared that they’ll go blind or live in debilitating pain for the rest of their lives.

Who really is seeking to make the big bucks in this business?

Category: Eye Surgery, Writing  Leave a Comment
Apr
05
The Incredible Body and Amazing Eye Surgery
Ami Chopine

I have the video of the surgery done on my eye. It is absolutely incredible. The workings of the human body, from the grossest anatomy down to the molecular lace that makes up the cell, inspires a deep sense of awe. This delicate machine can heal itself. Our brains can comprehend our body enough that when it can’t repair itself, we know how to help it. We’ve invented thousands of devices and procedures to do just that, and to improve where nature has erred. Nature, science, and technology are wonderous.

The size of the needle used to suture my eye looks like it is about the size of a capital C in normal size printing (12 pts, usually). Wow. This isn’t just cool technology, it’s fantastic dexterity on the part of the surgeon.

I do have a thousand questions now, though.

One thing I’m not questioning is the doctor’s wisdom in putting me totally out for the procedure. I’m not a very anxious person. I would like to think that I have good self control as well. Still, having sat through several suture removals from my eye that were not very painful, I can say that no matter how good the pain control was, I would still have been very uncomfortable for the length of time it took to work on my eye.

Anyway, today I am seeing well enough that I’m comfortable driving a car, both day and night. I can read, as well. How great is that? I’ll answer that question. It is glorious.

Category: Eye Surgery, Writers and Bloggers  Leave a Comment
Mar
29
Verisyse 2 weeks
Ami Chopine

When I was a little girl, I used to take my glasses off on the way to my grandparent’s house and stare out the window of our car. I’d put them on again and take them off again, and then put them on. The yellow lights of the city glittered at the base of the mountains, revealed to me in more ways than the normal human being could see. I often fiddled with my glasses, tilting the lenses in every direction to see how things changed. The refraction was enough that I had a slight prism effect towards the rims and could see blue or red isolate itself out from the vision of creation I saw.

It was years since I played around like that, until now. I look outside with one eye, then the other eye. I try it with and without a contact in my right eye. It is kind of fun. I’m amazed all over again.

Yesterday my BCVA (best corrected visual acuity) was 20/25. It had been 20/60 the previous Wednesday. The surgery induced astigmatism has improved considerably. After learning that, I had two more sutures removed from my eye.

What is interesting about this suture removal is that the shape of blurred out lights in darkness changes with each procedure. At the very first, it was just the normal big blur I’m used to, perhaps smaller, like when I was 16 years old. The first suture removal sculpted the blur into a tear drop shape. With this latest removal, the tear drop shape has elongated on the top, narrowed somewhat, and to the right has another very slight ray. Everything to the bottom seems almost clear. In the daytime, I can read road signs from about 25 feet away in the car. Moving closer to them produces an odd dance of double images that finally resolve into one slightly blurred image.

It is a blessing that I have had such poor eyesight. It is a blessing that it is getting fixed.

Next Tuesday I get the last two sutures removed. I’m very excited.

Category: Eye Surgery, Uncategorized  2 Comments
Mar
23
Some thoughts on “LASIK horror stories”
Ami Chopine

Meanwhile, in my boredom and obsession, I’ve stumbled back (I found them when researching LASIK years ago) upon some of the LASIK horror story sites and community boards. It is frustrating all around. There is no question that many people have suffered poor outcomes from LASIK. Many of these problems are because they were not good candidates in the first place, and were told that everything would be fine. Other adverse outcomes were simply bad luck.

I am not sure that many of these communities are very helpful.  I fear that the emphasis on how bad it is has a negative effect on the perception of pain and discomfort, on the perception of their vision, and on the patient’s ability to cope with the poor outcome. Those communities that encourage a culture of victimization and suffering do no service to those who come to them for help and support.

In a lot of ways, this kind of behavior resembles that of alternative medicine practitioners.  The difference is that rather than promoting an intangible “wellness of being”, those websites and communities devoted to poor LASIK outcomes promote unwellness of being, often using the same tactics: anecdotal evidence having more power than studies or statistical evidence, the demonizing of medical and scientific authority, out of context quoting, partial truths, and appeals to emotion. Some of the more outlandish claims from this group are that 100% of LASIK patients have poor outcomes and that the corneal flap never heals, and that refractive surgeons do this surgery to become rich despite knowing how it ruins lives.

For the most part, participants are simply sufferers looking for community support. They might gain this, but too often it is at the cost of losing rational grounding in what has happened to them and how they can best deal with it. Rather than it being the refractive surgeons who have taken advantage of them, as they are told over and over, it is the ringleaders of the “LASIK horror story” community who take advantage, either emotionally or financially.

I noted one site that did not allow even viewing their discussion boards without a paid subscription, except for the original post op experiences that patients wrote. These serve as teasers, enticing not only patients but the curious to pay the fee in order to find out what happened next. Many of them were posted before the bulletin board became subscription only by patients seeking support and advice.

It is possible that we might find a handful of lawyers involved in this community as well. Litigation and public accusation without telling the whole story is a common theme.

What is there to find in this mess? Same old story: when using the internet to find out something, take what you find with a grain of salt and apply common sense liberally. This particular pseudoscience episode convinces me even more that we need a formal course on logical and critical thinking in our public schools with lots of supplementary support within other courses.

Category: Culture, Eye Surgery, Writers and Bloggers  18 Comments
Mar
22
Verisyse day 6
Ami Chopine

I got one suture out yesterday. My vision in that eye has improved a decent amount with the removal. I will probably get two out on Tuesday.

Everything is going very well.  

“No vigorous activity” is driving me nuts! Vigorous activity of several varieties is how I cope with everyday stresses and moods. I’m okay without it for now, especially since the idea of having good vision is an exciting and happy thing. Still, I’m usually pretty active, so all the energy I’m not expending is leaking out of my fingers and toes.

Category: Eye Surgery  Leave a Comment
Mar
18
Verisyse Experience: pre-op & days 1-3
Ami Chopine

“When I was a kid, this was science fiction,” I said, sitting in a darkened room, staring at an orange dot while the computer measured various parts of my cornea and iris.

“It’s pretty awesome stuff,” replied the assistant.

I felt comfortable here, and not just because the staff and doctor are nice. It is because they turn away patients regularly for the various refractive surgeries they do here. I am very reassured that they are so conservative with treatment. 

The next two days passed in a blur of everyday occurrences sparked by the undercurrent of anticipation. Anticipation wasn’t the only emotion though. The closer I came to it, the more I realized that I am implanting a piece of technology into one of the most delicate parts of my body. It will never be the same. The longest anyone has ever had these lenses in is 15 years, and I have a family history of living 90+ years. How will this grow old with me? I am putting a great deal of trust in science. This is not a hard leap for me, but still…

I really cannot say much about the procedure itself, since I was put under general anesthesia, standard protocol here. From what I gather, this is not common with Verisyse implantation, though it is certainly not unheard of. Surgeons preferring this seem to appreciate the superior anxiety and pain control. It is a longer and more complicated procedure than the Visian ICL.

A video was made of the procedure which I may post, if anyone expresses an interest in it.

I do remember a dream in which my husband was teaching me how to cut an onion very carefully. It was very important that I do it just right because other people depended on it.

There was a patch on my left eye when I woke up and it felt quite scratchy. The doctor and his resident soon came around and wheeled me into a room to check out the eye. Everything looked good, so I was allowed to get dressed and go home. The next morning my husband drove me back to the office where I was checked again. My vision had improved considerably, but because of the tight sutures, there was a lot of astigmatism. This was an expected outcome. It will improve over the next two weeks, with big improvements every time a suture is removed.

My eyesight has improved over the last two days. The doctor checked my eye again this morning. Things are progressing nicely. I was somewhat disappointed to find out that he would prefer to do the next eye in four weeks rather than the two I had scheduled. Vigorous activity and exercise is not allowed right now. I am not sure how long this will be the case. I doubt I will be back in shape in time to run a 5K in May, let alone a 10K.  However, in the long term it is better to remain patient and cautious in order to achieve the best results.

I put 3 eye drops in 4 times a day and another two eye drops in 2 times a day. One of the eye drops will be discontinued after a last dose today.

Category: Eye Surgery  One Comment
Mar
12
Can’t wait to be a cyborg
Ami Chopine

Resistance was futile from the day my first grade teacher insisted I must wear my glasses. I was an active kid, and I broke a lot of glasses, but we couldn’t always replace them. So I often wore taped up glasses. By sixth grade they were really thick, too. Thicker than now, since carbon lenses were not yet available. When I was 14, I got contacts for the first time. They told me it would take a while to get used to them. I wore them four hours the first day, and then never put on glasses again. At least not until they told me I was wearing my contacts too long and would have to wear glasses some of the day.

It isn’t that I hate glasses. It is that I hate what my glasses are. I see a cute set of frames, and then I imagine what my lenses would be in them.

What is my prescription now? -12.5(L) and -12.75(R) diopters. Slight astigmatism.

Other characteristics of my eyes include being very healthy, having lots of endothelial cells, plenty of room in the anterior chamber, having a thin cornea and a small iris.

No, no lasik for me. I get something much cooler. I’m going for the Verisyse. There is a computer generated video of the procedure here. The other option is the Visian ICL. It is slightly less expensive, is a faster procedure that is a bit easier to recover from, and cannot be seen since it is behind the iris. However, since my iris is a bit small, fitting one back there would cause it to bulge out just a little. Not horrible, but not ideal. In this case, the Verisyse is literally, a better fit for me.

Tomorrow is my pre-op and Thursday I get the implant in my left eye, the non-dominant one.

Category: Eye Surgery  3 Comments