The Procedure

Ok I promised the full gory details, so here they are.
I arrived at the surgery at 11:30 and after signing the consent forms and paying the fee(!) I was taken through to the preop/recovery area where I was kitted out in a paper gown (on top of the clothes I was wearing), paper shoe covers and matching paper hat (luckily BIP hadn’t thought to bring a camera along unlike one other poor pre-op patient whose partner was gleefully snapping away!). The first part of the procedure was to take an oral sedative – this tasted particularly unpleasant and had to be held under the tongue for one minute –yeuch. A mint was kindly supplied after to take away the taste. Then the first lot of eye drops went in, first antibiotic and then anaesthetic, a bit stingy but not too bad. Next was a wipe around the eyes with liquid iodine –oooh lovely yellow panda eyes (you can imagine how happy the amateur photographer was with this) and then iodine drops in the eye – they really did sting, so were swiftly followed with more anaesthetic drops. Then a wait of about 10 minutes for everything to start to take effect. I was warned that the laser would emit a gas which smelt like burning flesh but not to be alarmed as it was just the laser operating and nothing to do with the eyes, apparently it’s a cold laser so there is no actual burning of the eye. This was interesting as lots of the stuff I’ve read says that the smell is the smell of burning eye and pretty offputting so I wasn’t sure if they’d just made up the story about the gas to stress people out less or if it was really true!! The sedative is a mild one and is aimed to relax you rather than put you to sleep. Finally one more set of anaesthetic eye drops and it was into the operating theatre.
This was a bit freaky. Basically there is a thing to lie on – it looks a bit like the slab you lie on for an MRI scan, there is a dip where your head goes and what looks like two small stalk mounted cameras each side of your head. They put something under my knees and then everything was underway. Dr Cox explains what he is doing at each step which is a good thing but does make you think about it a bit too much. He started with the left eye. First he measured my corneal thickness again, looks like something white and plastic is being pushed into the eye for this, but of course you can't feel it, then taped back my eyelashes and put a plastic speculum around my eye to hold back my eyelids, as this is screwed open it’s a little uncomfortable but ok. The other eye was covered with a patch to protect it while the first eye is worked on. Next is the thing that holds open your eye and has the suction, this is is the worst part of the whole procedure. Once it is on your eye and the suction applied you have the discomfort and gradually your vision goes and everything is black, then you hear a whining noise as a flap is cut from the front of your eye. It takes about 15 seconds, then the suction is turned off and vision comes back, albeit a bit blurry. Then Dr Cox peeled the flap back which makes vision even more blurry. You have to focus on a red light above you (the laser equipment looks a bit like standard optomotrist equipment and slides over your head during the procedure). It’s quite hard to focus on the red light as it’s all very blurry by now but at this point the eye tracker is used to lock the laser on your eye (so that if you don’t stare rigidily at one point it doesn’t matter). Then comes the actual lasering, in my case this was 57 seconds (they tell you exactly how long it will be) and would be delivered in 7 short bursts. The gassy smell is unpleasant (regardless of whether it’s burning eye smell or not!) and I could certainly feel my heart pounding away – again the sedative must help keep people still and not too stressed. Then it was all over for that eye. The flap was put back down over my eye and sponged into place, then the various bits and pieces removed and a patch put over it. Then straight onto eye two where the procedure was repeated. After the second eye was completed and taped over the cover was taken off my left eye and Dr Cox examined it and then I was taken back to post-op recovery and told to keep my eyes shut for the next 10 mins. I was actually feeling pretty sleepy by now so it wasn’t too hard to just relax and keep my eyes closed. After about 10 minutes Dr Cox came by and examined each eye to make sure the flap was adhering correctly (both eyes were fine). Then there was another set of eye drops and then the clear plastic eye patches were applied and taped over. And that was it, time to go home with some panadol and sleeping tablets and instructions to go home and take both and sleep for the afternoon, which is exactly what I did.
I slept for about 4 hours and woke up feeling gritty eyed, and with the plastic patches covered in condensation from where my eyes had been watering. I spent the evening relaxing on the sofa watching tv, my vision was ok although it was hard to tell really due to the foggy eye patches!!
I took the other two sleeping tablets before going to bed and had a reasonable nights sleep. The next morning it was back to the clinic for a check up. It was like a convention of the fly-people, a swag of people with big plastic eye patches all gathering together! First the eye patches were removed – yay! Then off to the waiting area where we all sat with silly grins on our faces sharing our excitement. The visit consisted of a look at the eyes to check the flaps again (still both ok) and then a look at the eye chart. He started with an easy screen which I could read all three lines of without any problem, then went to the next smaller screen to see if I could read anything on that, again I could read everything although the bottom line was not that clear. This was actually a good result as they usually aim for being able to read the first screen post-op and anything else is a bonus.
So that pretty much was it apart from getting the various eye drops that have to be used for the next week. These are two lots of antibiotics, one steroid and artificial tears, all to be applied 4 times a day.