

Ask HN: Have you had laser eye surgery? What was your experience? - lasik

Hi,<p>I am a long term HN member writing under an anonymous account as this is a somewhat personal issue for me.<p>I have been short-sighted (myopia of about -5.00 in both eyes) all my life, and generally wear both contact lenses and glasses. I find contact lenses really irritate my eyes when programming (dry eyes due to less blinking when on computer) and am fed up of issues with glasses (steaming, cleaning, etc) and recently have been considering laser eye surgery.<p>I live in the UK, and have booked consultations at the 3 main providers here - UltraLase, Optimax, Optical Express. I'll write my assessment of them each later once I go for my consultation with the last provider at the end of the month, but so far have concluded that one has to really research the area to avoid much of the nonsense that they tell patients especially with regard to equipment and surgeons used and why e.g. Ultralase charge £4700 for lasik+intralse+wavefront and say they use new Bausch &#38; Lomb lasers that has higher resolution (dpi) and better surgeons (but ironically most of them are ex-Optimax surgeons) but Optimax charge £2395 for a similar lasik+intralase+wavefront procedure but say they use Nidek lasers as gives better results (even though it is older generation device) and they are cheaper as they already bought their machines and premises and have less ongoing overheads.<p>Anyway, I was wondering if any other HN members have had laser eye surgey (or thought about it and why you did not do it), what prodcedure you took (e.g. Lasek, Lasik, with Wavefront and/or Intralase), what your experience was like, what equipment was used (e.g. Visx, Nidek, Alegretto), and whether you researched this and what your thoughts are about various equipment-factors in the final result, and most importantly your surgeon and final result.<p>Thank you!
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bigsassy
I had Lasik surgery 6-7 years ago, and I had a bad experience with it.

I went to a highly recommended surgeon in my area. I had the procedure done
using a machine that didn't have eye tracking, so I had to look straight ahead
and not move my eyes during the procedure. I must have done something wrong
because my eyesight had some...issues.

All the visual anomalies they'll warn you about in your consultation (halos
and starbursts), I had in spades. They were so bad I had trouble functioning
in dark settings. So walking around at night was difficult, watching movies
was awful, and so forth.

My vision DID kick ass though otherwise.

My surgeon had me coming in regular to monitor my progress, and when things
weren't getting better scheduled a touch-up (all included in the initial
cost). After the touch-up, all the problems were resolved, and 6-7 years later
my vision is still pretty damn good. I don't need glasses, but my vision took
a tiny dip a year after the surgery and maintained the quality ever since.

So with all that said, would I recommend Lasik? Absolutely. First, the
technology has come a long way since then. Two, my brother had the surgery the
same time I did from the same surgeon, and his turned out fine the first time.
Third, having perfect vision is something I'm still thankful for all this time
later.

tl;dr - I had Lasik surgery twice. First time gave me problems seeing at
night, a subsequent touch-up fixed the problems. I still recommend the
surgery, but when they say problems can happen, BELIEVE IT.

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codex
I have not yet had laser eye surgery, but I've done a lot of research. You're
fortunate to be in the UK, home of one of the best laser eye surgeons in the
world, Dan Reinstein. He's known as a surgeon that fixes other surgeon's
screwups, but his own first-time results are quite stellar; see the bottom of
this page: [http://www.londonvisionclinic.com/what-makes-us-
different/re...](http://www.londonvisionclinic.com/what-makes-us-
different/results-stats). Almost _zero_ surgeons publish their statistics.
Rainstein does because his statistics are the best. He works closely with
Zeiss, the world's premier optics company, in their development of new
refractive surgery products. They are truly doing some amazing things with
wavefront technology these days; some patients come out with a best-corrected
Snellen score of 20/12! Unfortunately, his clinic is probably also the most
expensive in the world. Expect to pay seven thousand pounds, but I, for one,
would not trust my eyes to anyone else.

Keep in mind that while serious complications are rare, there are some
downsides to refractive surgery. LASIK, for example, frequently results in a
loss of "contrast sensitivity"--a metric which isn't captured in the typical
"20/20" Snellen score. Vision can be sharp but dynamic range can be lost.
Furthermore, the flap interface creates a distortion in the eye's optics
which, while normally hidden in during the day, becomes apparent when the iris
is forced to widen at night (especially affected are those with blue eyes,
which "leak" more light). Nerves are cut in the procedure, too. Also ask about
other forms of error, such as cyclotorsional registration and nomograms.

The field is evolving so quickly that I have chosen to wait. Femtosecond
lenticule extraction (FLEX) is on the horizon, but I'm most excited about
intrastromal corneal reshaping
([http://www.lasiksurgerynews.com/news/intrastromal-corneal-
la...](http://www.lasiksurgerynews.com/news/intrastromal-corneal-laser-
surgery.shtml)). The intrastromal proeedures promise to change the interior of
the cornea via laser triangulation. No flaps or cuts of any kind are made.
Incredible stuff.

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tworats
Had it done 4-5 years ago. Quick and painless, made me wonder why I hadn't
done it earlier.

My main concern was developing myopia again after the surgery. Sure enough my
eyesight today is poorer than it was immediately after the surgery and I
expect it'll continue to get worse over time.

Here's how I found my surgeon: I asked the various doctors I interviewed who'd
done their eye surgery. Surprisingly many of them had used the same person -
he was generally regarded as the best by the other surgeons. Once I found that
out I was willing to pay more and go with the best.

Overall I had an excellent experience, my only regret is not doing it sooner.

~~~
epo
Eyesight deteriorates with age, regardless of surgery. They should explain
this. You'll probably find yourself wearing specs after 40 or so.

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epo
UK resident. A good few years ago I asked my optician about the wisdom or
otherwise of eye surgery for my (not too severe) myopia. She went through the
pros and cons but ended up by saying that she was not aware of ANY opthalmic
professional who had had it done to themselves. I believe this remains broadly
the situation today. At a recent eye test, the lady doing the testing echoed
this, saying that her prof - who lectured on eye surgery - wore glasses.

~~~
turtle4
Any idea why this is? Our opthamologist is the same way. Says it is seems
safe, and all her patients have had great results, but when we asked her if
she had it done, she said no, not for herself (she wears glasses). I just find
that a little odd.

We're in the U.S.

~~~
epo
(reply to turtle4) Regardless of what they say to us they know what the real
success rates and what the long term complications are.

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dennyferra
Had it done a year ago. I had really bad vision with astigmatism, don't
remember the exact numbers, but they told me my right eye would never be
20/20. I went with the Lasik / WaveFront / Intralase, figured these are my
eyes I might as well not take any chances (I'm in California, imagine an
earthquake during the procedure). Cost me about $4500. From research to
procedure it took me about a year to finally decide to do it.

Took about 15 minutes for the whole procedure and my results were awesome. A
few minor side effects: After the surgery on the way home my eyes began to
burn a bit, like when you get hot sauce in your eye, but not unbearable. Only
lasted for about 30 minutes then went away. Also for the first few months my
eyes would take a little while to adjust to night time. At first I would see
larger halos in the street lights. After a few minutes in the dark halos would
get smaller. After 4 to 6 months I didn't have any issues adjusting to night
time.

I'm very happy I had it done, it's really worth it. Oh and even though my
right eye will never get to 20/20 my vision is still excellent. Definitely
life changing.

~~~
netc
I'm planning to get it done next year. Can you please share the name of the
clinic? My email address is in my profile.

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curt
AWESOME... GET IT DONE...

It cost me just over $4,000, 6 years ago, got both eyes done at the same time,
took a total of 5 minutes and now I see better then 20/20. Before with glasses
I could only get to 20/30. You get to 20/20 the day after the surgery.

Just make sure you find a good doctor, ask his success rate. The two worries
are 1)cornea thickness 2) if you have diabetes it's under control and not a
problem. My doctor had done a couple thousand procedures, owned his own laser,
and only had failures when the patient wasn't honest about their diabetes.

Don't go cheap get the wave front/adaptive procedure where they take a
topography of the eye.

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bigohms
Got Lasik over 3 years ago, paid the middle level ($2700) out of my health
savings account (tax-free). Amazing experience, best money and return I ever
spent on myself (includes all toys). Do it and be wary of their tiered pricing
model: everyone at the office I went to got magically upgraded for no
additional fee--the surgeon was vested in just using the best tool 100% of the
time.

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fakelvis
My ex-girlfriends sister-in-law was a consultant at one of the three main
providers you've mentioned in your post. She wore glasses, and I once asked
her why she didn't get the surgery done herself.

Her response: The long-term effects have not been studied thoroughly (i.e.
large samples, etc.) and enough time hasn't passed yet for patterns to emerge
in terms of any long-term complications that can withstand rigorous scientific
analysis.

I said to myself: When she gets her eyesight corrected through laser eye
surgery, I will to. She still hasn't.

I remember a few years ago the National Health Service's National Institute
for Health and Clinical Excellence released some results showing that LASIK
wasn't really effective for treating severe short- or long-sightedness. I
can't find this study now, and things may have changed. This was at least 5+
years ago. Still, worth mentioning and possibly finding out more if you're
seriously considering this.

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blrgeek
6 yrs ago. -8 myopia to 20/20 now. No astigmatism. Rs. 25K two eyes in India,
that's 350GBP to you :).

Some 'glare' around bright lights at night. But otherwise, the best 25K I
spent :)

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coffeenut
Stupendeous. Absolutely life-changing.

My wife had it done about 5 years ago. She went in to do Lasik, but due to
thin corneal tissue had to go with PKR. She could barely recognize my face
from a few feet away. Now she has 20/20 vision. She has slight issues with
hazing sometimes at night, but overall the best money we've ever spent.

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racecar789
Had Lasik 6 years ago for $2500. Before the surgery I couldn't even see the
big "E" on the eye chart. After the first op I could see halfway down the
chart. Waited a year for the second "touch up" and now can see the very last
row. Recommended.

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nmaio
Here's Harj's blog post on it: <http://blog.harjtaggar.com/laser-eye-
surgery-1>

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revorad
An old but good discussion - <http://news.ycombinator.com/item?id=290216>

