Thursday 24 April 2014

My Epi-Lasik Experience

I recently went for a eye-correction surgery and there have been lots of people asking me how it went, how was the procedure like, was it painful, etc.

I thought I might as well share my experience here, where everyone can read it. Do note though, that this is merely my personal experience with the procedure. Do not take this as direct reference.

So the surgery that I went for was epi-Lasik, which is actually an enhanced (and safer) version of Lasik.

Differences between Lasik and Epi-Lasik
The standard Lasik procedure includes cutting a flap in the cornea. After the lasering is done, the flap is covered back and left to heal on its own. Risks of this procedure include trapped dust under the flap and uneven flap recovery. Furthermore, there will be permanent scarring which means that even if your eyesight becomes worse in the future, a second surgery cannot be done and it is not advisable to wear contact lenses.

Epi-Lasik, on the other hand, is a flap-free procedure. Epi-Lasik can be a better option for patients with thin corneas, where Lasik may not be suitable for them. It is slightly more costly than the traditional Lasik, but it poses less risk (Note: I said LESS risk, but still not entirely risk free). Instead, Epi-Lasik involves the removal of only the superficial layer of epithelium, which heals itself in a few days. If myopia returns, a second surgery is possible, depending on the eye conditions at that time.

Research and cost
After some research, I chose Clearvision Eye Clinic, as it was highly recommended and I had friends who went there for their surgery before. Their doctor was Dr Tony Ho, who is an experienced and certified eye surgeon.

Location of the clinic is conveniently located just in front of Mount Elizabeth Hospital (Orchard).

Their Epi-Lasik package was $3388 for two eyes, which includes a full evaluation, the actual surgery, full set of initial medication, and post-op reviews for the 1st month.

Pre-Lasik Evaluation
Because the clinic only opens during office hours and half day on Saturday, I had some difficulty scheduling an appointment for the initial evaluation. The only time slot I had was Saturday morning, which I arrived at 9.30am, feeling so damn sleepy.

They let me fill in a form for registration, and after taking down my details, I was told to wait. After like 30 mins, I was led to a room for a vision test. And then led me to wait outside again. And then another room for another test. And then another. I lost track.

Finally when all the tests were done, I was led to yet another room where a guy sat me down and showed me the initial test results. My cornea was slightly thinner than average, but still possible for the surgery. He played an informative video which describes the process and what to expect. He also explained the procedure, and told me I would be given medication and a pair of sunglasses to wear after the surgery. (He told me the sunglasses would "look cool". I naively believed him.) He also gave me some leaflets on eye-care instructions, and allowed me to ask as many questions as I wanted. I was told that on the day of surgery, I was not allowed to wear any make-up or perfume.

After that, I was told to walk over to Mount Elizabeth Hospital (Level 3) to go directly to the doctor's office. It was like super crowded and I had wait even more for more tests. GAHHHHH...

After I was done, I scheduled another date for the actual surgery (which can be scheduled any time, as soon as the following day, up to 6 months later). My surgery was scheduled to be in two weeks time. I paid the initial cost of the evaluation, which cost $85.60 (deductible from the actual surgery cost of $3388).

The entire evaluation process (plus waiting time) took about slightly over 2 hours.

Day of Surgery - Day 1 (Friday)
My surgery was scheduled to be on a Friday at 4.30pm (I took a half day leave from work). After work, I went to the restroom to remove my make-up and freshen up, had lunch, and went for a brief window shopping at Ion while waiting for time to pass.

I arrived at the clinic at 4pm. I was given a few forms to fill in, and to sign some consent forms which basically states that I have read and understood the risks and that I will not hold the clinic liable should any complications arise. After reading the entire thing throughly (more waiting time), a lady went through the forms with me again verbally and then I was given the full set of medication: 4 different types of eye drops (which include antibiotics, steroids, and whatnot), vitamin C tablets, sterile eye wipes, and sleeping pills (just in case). I was also given a pair of sunglasses (which were hideous!! The guy lied!!!!)

ugly shades!

After more waiting time, I was led to the cashier to make payment before the surgery.

After payment (more waiting time), I was given a blue surgery gown, a 'shower cap' thingy to wear on my head, and a pair of 'disposable slippers' to cover my feet. I also had to wear a surgical mask. One of my eye was covered with a plastic shield and the other eye was left exposed. I sat there and I waited... and waited... and waited... the doctor took like FOREVER to arrive. =(

THE ACTUAL SURGERY!!
By the time the doctor arrived, it was already like 6+pm (I thought my surgery was supposed to be at 4.30pm?!). He was really nice and friendly and made me feel at ease immediately. I was led into the surgery room and told to lie on the surgery bed. My head was clamped in place.

Here's a photo of me at the surgery bed, and the doctor and his assistant getting ready:

There I am, just lying waiting for the surgery to begin


The doctor then clamped one of my eye open and started the surgery. First, I felt this irritating (and slightly tingly and painful) feeling over my right eye and my vision became black. I think this is the part where the top layer is removed. After that, I could see again but my eye felt really raw and like kind of "exposed". The doctor told me to focus on the red blinking light above, and he started the laser (the laser was green). As the laser worked its magic, I started to smell a burnt smell and the white ceiling slowly turned black until all I could see was the red blinking light and nothing else. This part wasn't painful, to say the least. The laser lasted for about 15 seconds, and then the doctor immediately squirted a generous amount of liquid into my eye to cool it and wiped it clean (like, literally wiped the EYEBALL). Then, a contact lens was put over my eye (which is supposed to be left there for at least 5 days to protect my eyes while they recover, and will be removed by the doctor after my eye heals completely). The same process was repeated on my left eye.

The clinic was nice enough to take an after shot of me and the doc:

Successful surgery!

After surgery 
Immediately after the surgery, I was led to another room to rest. My eyes started to sting and I could not open them at all. I was told to close my eyes and rest, while the clinic assistant administered my first dose of antibiotics and steroid eye drops, in 10 min intervals.

The clinic was nice enough to help me call a cab. By the time the cab arrived, it was already 7pm and I was feeling SO TIRED. I was literally blind at that time, as I could not open my eyes at all. They were feeling severely irritated. Upon arriving home, I stumbled home and went straight to bed. Word of advice: Get someone to accompany you home after the surgery. Even taking a cab, riding alone was scary while being vision impaired.

Day 2 (Saturday)
I awoke the next morning and my vision was blur, which was expected in the initial recovery stage. I basically bummed around at home the whole day doing nothing, except keeping track of my eye drop time table. I kept napping every few hours, as my eyes got really really tired very easily. Basically the entire day was spent alternating between putting eye drops and napping. Prepare yourself for a few boring days ahead, as you will not feel comfortable enough to leave the house, nor being able to read, use the computer, or the TV. My eyes felt really dry.

Day 3 (Sunday)
I woke up feeling felt slightly better (even though my eyesight worsened even more, which was expected) so I decided to go out for brunch (of course, not forgetting my shades and my cap).

With the ugly shares and cap. I look like a celebrity, no?

Bad idea!!! Upon stepping out of the house, the sun felt extremely bright and even while wearing shades, I had to keep my head down to avoid the sun. One hour after being outdoors, I became tired and sleepy (due to tired eyes) and was already craving my warm comfy bed. After a short trip outdoors, I rushed back home and continued my routine of napping and eye dropping. My eyes were still dry, and I had to constantly remind myself not to rub my eyes or touch my eyes.

Day 4 (Monday - On Leave)
My eyesight seemed much better today, but still not good enough for reading. I got so bored I resorted to downloading audio books (why didn't I think of that earlier??) I felt slightly better so I went outdoors to get some fresh air, but as usual, I got tired after a few hours of being outdoors. Eyes still feeling dry, and still constantly feeling tired. I was beginning to worry that I wouldn't recover in time to go back to work.

Day 4 (Tuesday - On Leave)
Today is my next appointment with the doctor! I went back to Mt Elizabeth hospital for my checkup and to remove my contact lenses. However, the doctor said my eyes were not recovering as quickly as expected, so he told me to visit him at his other clinic at Bedok 1 day later. The doctor told me to reduce the frequency of the eye drops to 3 times a day, instead of the initial drop every 3-4 hours. Which is a good sign, I guess.

Later that evening, still wearing my shades, I popped by my work office to clear some stuff. My colleagues happily welcomed me back and thanks to my awkward looking shades, some teasing ensued.

I had some difficulty checking emails, as I couldn't read very well yet.

Day 5 (Wednesday - back to work!)
Thankfully, my eyesight was much better when I arrived at the office that morning, though I was still wearing my shades the entire time. The hard part of adapting was having to wear ugly shades even while being indoors (my office has huge glass windows which is like the floor to ceiling kind, so it was really bright) and having to keep to my eye drop schedule. I would sometimes forget to use my eye drops, especially when I got really busy.

That evening, after work, I went over to the clinic at Bedok to remove my contact lenses. I felt liberated yet so exposed and slightly uncomfortable. The doctor then stopped two of my eye drops, and reduced to only one type of eye drop. He also gave me additional lubricants to be used as frequently as needed. I was scheduled to return for a follow up check up 1 week later.

Day 6 - Day 11 (1 week)
Work resumed as usual, and I learned to adapt to my dry eyes and blurriness. My vision initially got better, but then worsened again. It kind of happened overnight. One night it was good, and then the next morning when I awoke, my sight became blur. I called the clinic to ask if I should be concerned, but the guy said as long as I did not feel any pain or experience any discharge, it should be fine. The blurriness continued for a few days and I had much difficulty reading the computer screen. I had to squint. On most mornings when I wake up, my eyes are so dry that I have difficulty opening them.

I developed a new nickname, my colleagues started calling me a celebrity because I was wearing shades all the time at work (like a celebrity does, LOL)

Day 12 
I went back for a follow up at the clinic. The doctor checked my eyes and said my eyes were still healing slower than normal. I raised my concern of my eyesight getting more and more blur, but the doctor said its normal for my eyesight to fluctuate in the initial period. He took me off the eyedrops and prescribed me yet another kind, to be used 2 times a day. I was scheduled for yet another checkup 1 week later.

Day 13 - Day 18 
My eyesight was improving, and my eyes were starting to get less dry. Eventually I stopped wearing sunglasses at the office, unless it was to go out for lunch. I relied less and less on the lubricating drops, and my vision was improving.

Day 19
I went back to the clinic for a followup, as scheduled. Upon the eye check, the doctor said my healing was still slow, and advised me to increase the drop frequency from 2 times to 3 times a day. Instead of 1 week, I was scheduled for another follow up 2 weeks later. *yay my eye checkup frequency is finally reducing!!*

Day 20 (today!)
Well, here I am blogging away so you can probably tell I am well enough *yay*! =D

Even though I was advised to wear shades for at least 1-2 months after surgery, sometimes I will "forget" to wear shades outdoors, as my eyes are quite comfortable with the sun by now. However, sometimes I still get eye strain if i stare at the computer for too long.

Eyesight isn't perfect yet, but dry eyes are gone (even though I still use lubricating drops as frequently as I can, just in case). I am still on prescribed eye drops, while waiting for my next appointment two weeks later.

I guess it should probably be smooth-sailing from now on, so I guess here ends my journey of epi-lasik.

Overall, it was a good experience and I am so glad I did this, ending my slavery to glasses and contact lenses!!!

Pretty me without glasses!!!!!

**HIP HIP HOORAY!**

P.S.: I'm still being known as The Celebrity at work. Hee.