Epi-Lasik – An Eye-witness Report

After years of thinking about it I finally went through: I did a Lasik operation and got rid of my glasses. I read through so many forums and sites before for bits of information here and there. I felt quite prepared because of that but I think it is really worth to write one comprehensive blog about the whole experience for anybody interested in the procedure and also the small nuances before and afterwards.

TLDR: what an experience, great results, some side-effects, steady recovery

EyeOperation

Preparation

Fun fact: 10 years ago I had already planned this operation, as a student back then. To save money, that was in Bratislava (me being based in Germany). One week before the operation I chickened out and I think it was for the better. Not to say anything against that institute there. But one has to be realistic: the operation itself is only one part. There can be complications, which might mean you have to go there again, you need a qualified check of the results some weeks afterwards etc. For me it was: Saving money when it comes to my eyes – not a good idea.

Fast forward 10 years, in March this year I went to the info days at two centers here in Heidelberg (Germany) where I live. The university and a big private clinic. They both made a good impression although the private one seemed a bit more professional and to have more experience. Pricing nearly the same, around 3.500€. I then went ahead in the private clinic and did a pre-check with the doctors (for 90€). It turned out my cornea is very thin and not all methods would be available. That brings me actually to a very important topic. One has to decide for a type of operation. The ones I considered were:

  • Lasik where a rather deep cut is made (a so-called flap) and then folded to the side and afterwards back
  • PRK where the upper layer of the eye is kind of etched away with alcohol and then rebuilds gradually
  • Lasek where only a shallow cut is made causing the laser to operate at a different height
  • ReLEx smile where the cut is actually made by a laser and extracted through a small incision

One can usually do these operations until -6 to even -8. I started out with -3.0 and -3.25 so all these were possible. Something one has to be very clear about though: with all these methods there can be side-effects after the operation. Some might even not go away. This is a risk one has to take. Typically most people have some of these side-effects but they quickly fade. Common ones are (images taken from the linked site) star bursts, glares/halosghosting and reading issues especially when looking at monitors. The thing is though: the probabilities for side-effects vary depending on the method.

halos post LASIKghostedmoon reading2

From what I learned, there is no “best” method (I read there is no case of somebody turning blind so that is already quite positive). My definite guidance would be though: always accept pain in favor of less side-effects. That did for me rule out Lasik (which seems to be the most common one). The flap it produces can cause issues that the other methods simply don’t have. This is also the reason it is not allowed for jet fighters or police personnel. ReLEx smile seems very interesting but my eye-specialist did not recommend it in my specific case (and it actually is 3 times more expensive). PRK is what I would call hard-core and outdated. It’s successor is Epi-Lasik. It promises quite some pain the first day and you need one week of vacation (I actually took two) before going back to work. But that is the one I ultimately went for.

Now it was time to make the appointment for the operation. Spoiler: this is not how you want your call agents to work 😉 The lady at the reception told me they only operate once a month or even every two months. Surprised about this I asked why that is the case and she said that many people now simply go to the less expensive private clinic. That posed a big issue to me: I wanted a doctor with lots of experience, not somebody who did this only every now and then. Especially for the high price.

I hung up and did my research. I had not heard about the third alternative in Heidelberg so far but sure enough there was one. What was really interesting: the doctor (Dr. Till Anschütz) allegedly did over 22.000 operations already and the reviews were great. I did more research and decided to do a pre-check there as well. It is a very small and cozy clinic, one doctor, around 4 staff, checks done inside the bigger waiting room. A bit optimized for throughput but everybody just super friendly and altogether a great atmosphere. It felt right to me and that was important.

Now the fun fact: the price was much cheaper. 2000€. And now the really weird coincidence: In this week they had a special going on (they later told me they do it around twice a year) to get a coupon on Groupon (seemed really odd to me but it worked, we joked at home that maybe I can even use our Sanifair highway coupons to pay). With this coupon I only payed 1300€. Wow. Since money was not the prime reason for me I was actually worried but still decided to go through after some days of deliberation.

Operation

The big day was finally there. I took the early 9am slot so that I don’t have to wait all day. After checking my eyes again and seeing a short movie about the procedure and meeting the doctor once more I got 4 times eye drops to numb my eyes. The first time they burnt like hell but that soon stopped and the other three times I felt nothing.

Then I got led into the operation room. There is a long bed onto which I got and then it got rotated under the laser. It helps so much if the assistant is talking to you and making jokes while preparing the eyes. I got tons of eye drops in to have them clean and fluid. The bad part about this position: you have to look into the laser. While the small green light is no issue, around the laser are like 40 super bright LEDs. It’s like looking into the sun at first and I struggled but after a while I managed.

When the doctor arrived she put a clamp into one eye so that I could not blink anymore. This was the part I feared most upfront. I could not imagine what it’s like to not be able to blink. So what is it like? It turned out you can still blink, you just don’t close your eye. That is not even weird at all. Also no pain, just a bit uncomfortable when putting it in initially. So if you fear that as well: there’s no reason.

Now comes the amazing part: since you are fully conscious you can actually watch the operation as it’s done. Like sitting under a glass table looking up. First he put some ringlike device onto my eye and then cut the upper part away. No pain but scary I have to admit. Suddenly you don’t see the LEDs anymore but only stripes and while patterns. After a while suddenly you see them again, I assume when the cut part was moved away. Quite a relief.

Now you hear him say “the laser will start now”. The green light suddenly turns into a big red circle and starts to melt away your cornea. It lasted 23 seconds and was over faster than I could think.  It smells a bit burnt afterwards. When done the clamp is removed and a protective lens is put into the eye. Then it repeats for the next eye. Clamp, eye drops, cut, laser, lens. 25 seconds this time since the anatomy was different.

There is not much that can go wrong there. The laser will stop automatically if you move your eyes too far to the sides. For the sake of science and this blog (ok, accidentally) I actually did that and indeed the laser stopped. Seems to work 😉 Once the procedure was over I realized how much I had sweat and was happy everything went smoothly. I could (still) see, but all a tiny bit blurry. The moment is super-cool though when you don’t put your glasses on anymore though but instead into your bag. Big smile on my face.

Technically you can manage to go (not drive yourself!) home alone afterwards. The sight is ok, a bit blurry but no pain. You have around 1-2 hours until that starts. It is really handy though to have someone around in case it kicks in earlier and especially when it starts, since trust me, you can’t do anything yourself. I couldn’t.

Pain

After the operation all was beautiful. The assistant had told me that some people even don’t experience pain. I was delighted and so hungry that we went to a fast food place. After we finished I felt a small pinch in my left eye. Soon after again, but in my right one. I suspected I was not one of those with no pain. How right I was. We were barely home when it hit me. If I would have to describe it visually, imagine a roller coaster after its initial ascend. There is this plateau and you are a bit unsure what will come next. And then you fall. Steeply. And with full force.

I think I have never had pain like that (besides when my appendix needed to be removed) before in my life. It’s like somebody put a fork into your eyes. And there is no way to get it out. It’s just constant pain. All the time. And constant tears. I think I used up one or even two rolls of toilet paper just to dry those. Multiple times I felt like there is an object in my eyes. Do not rub your eyes. Do not move the protective lens. Under any circumstances. I wore contact lenses before and I could have sworn the foreign object feeling in my eyes was from the lens. I can tell you now: no it is not. Even after taking it out the feeling is still there. So don’t play with it.

And while this all is bad already, you suddenly become super light sensitive. To illustrate that: you probably know electric tooth brushes. They have a small green LED showing that they are fully charged. Looking at this was not possible. We had to cover these LEDs and I had to constantly close my eyes. THIS sensitive. You will not believe it when you did not experience it. The apartment was basically pitch black. That was the only way to “survive”.

I got quite some medication (which I was told to buy shortly before the operation):

Ibuprofen is against the pain but I felt they don’t help at all. Maybe the eye pain cannot be taken away. I got emergency eye drops which were the same as the ones used in the clinic in case the pain was too strong. Bummer. Of course it was too strong but they had a drawback: they would prolong and potentially alter the healing process. Since I couldn’t open my eyes anyway due to the light sensitivity I could not put them in anyway and decided to simply suffer through these first hours. As I said before: I rather accept more pain in exchange for less side-effects.

What I did use though were the sleeping pills. They are golden. They save you. Once you can sleep everything is good. Until you wake up. But I already realized: it’s much better already. The tears are gone. The pain much better. Light sensitivity was the same. But I could walk around with my eyes a tiny tiny bit open. So once you have 24 hours on your clock, you should be good. I knew that before and it turned out to be correct.

I had prepared 5 or 6 audio books for these days. Trust me, one is enough. At least I was not in the mood for these as I had so much other stuff going on. TV was kind of ok after 2-3 days so that was good to kill the time. The next evening I took the sleeping pills again and was happy to have made another day. The next day was again better and then came the first evening without sleeping pills. A disaster. Sleeping with my head to the side was really difficult since I constantly though I push onto the eye that is at the bottom. I woke up at 4 in the morning and could not sleep anymore. Also, the Hyloparin drops produce this sticky slime that still covers your eyes when you wake up, but they are actually hard in the morning. So you have to force your eyes open and remove that stuff somehow.

And then came day 4. Light sensitivity much better. Pain nearly gone. No foreign object feeling. Early in the morning when it was not so bright I looked out of the window the first time. I could read the small license plate of the vehicle at the far end of the street. You cannot imagine the smile on my face. It worked. It really had worked I thought to myself. All this pain is forgotten and irrelevant. It worked.

Having my scientific mind back, I started to test for side-effects. I had double-vision on my right eye, not on my left one though. I tested this by looking at a bright LED. With one eye it was perfectly round. With the other eye I saw to LEDs next to each other. That gave me the creeps. As it is a known side-effect that will vanish I kept calm though. Contrasts in general seem to be an issue. Street signs were really hard to read at first for me.

I also tried the PC again. Wow that is bright. And really really uncomfortable. I turned down the brightness of my screens to 18%. The first effect is: I had to be closer to the screen in order to read, otherwise the font is simply too thin. When there are big bright letters on dark ground I suddenly had ghosting effects. Again I got the creeps. Only on one eye. After around an hour I stopped there and postponed further tests to the next days.

Today

Two weeks have passed since writing this. I can use the PC again nearly normally and the distance where it feels comfortable constantly increases. I need to have enough light in the room though or after a while it becomes a bit exhausting and the eyes feel tired. I can also be further away from the screen already and still be able to read. Double-vision and ghosting have disappeared. I use eye drops one time in the morning and one time in the evening. No need really during the day which is strange as I read a lot of people need to do that. I don’t seem to have the dry-eyes side-effects. Sometimes I do have a bit of pain in my left eye, especially when waking up in the morning. It typically disappears after a while but it’s strange and I will have to watch it.

When outside I always wear sun-glasses which is recommended for the next weeks and even months. I drove several times already with my car and that is no issue. I played badminton and there I realized that after the match my eyes felt really dry. Maybe because of the sweat or so. I took two weeks of vacations, so they end today. If you can afford that, I’d really recommend it. I would have been able to go to work already on Monday but it would have been a pain (since I use the PC all the time). I have my check-up in 6 weeks. There my sight will be measured and if everything is fine I get my paper stating I can drive without glasses.

I really hope all will be fine. So far, it is an amazing experience and I don’t regret it at all. I think I was lucky with the side-effects. I would have expected more and I think you can probably expect one issue or the other to last longer but they typically go away themselves. I think it also helped to have the experienced doctor and an operation method that is more painful but more stable as well. Would I change anything in retrospect? Definitely yes. I would do it 5 years earlier already.

Update: After 8 weeks I now had my check-up with the doctor. We measured some eye stats and did an eye test. Result: left eye 1.25, right eye 0.9. Although I was initially a bit sad about the right eye it’s actually not an issue at all and I am super happy about having the official certificate as well now for my drivers license to not need glasses anymore. So still all is good and no side-effects so far.

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