Lasik Part 1 – Pre-Op Evaluation

I’d been apprehensive for years but I figured it is time to have lasik done since the cost had come down recently and 15 years is a long time for the practice to mature. Besides, with my degree of myopia (850° both eyes) and astigmatism (225° left and right), my getting it done is good-value-for-money (compared to those with shortsightedness of 250° and astigmatism of 100°). But just like in insurance, sometimes even if we want to get it, we may not be eligible…

This blog entry will be part of a series to document my lasik experience and hopefully provide some useful information for anyone out there who may consider getting it done. This is Part 1 and there’ll definitely be a Part 2. But I may not have the privilege of sharing with you what goes on during the surgery and the recovery process. Pray for me that I will be able to go through it, to give my eyes a second life…

I arrived at the Paragon clinic for my evaluation at 11am and by the time it’s all over, it was 4.30pm. So for anyone planning to go for lasik, take a day’s leave for the evaluation despite the clinic’s advice that the process will take only 3 hours. To be eligible for lasik, you must be above 18-years-old, have healthy eyes, and thick corneas. You should stop wearing your contact lenses 3 days before the evaluation (for soft and toric lenses) and 14 days for hard lenses.

The evaluation process involved :

1) Checking degree of myopia and astigmatism with machine
2) Checking eye pressure (small jet of air shot into each eye)
3) Checking eye power by optometrist
4) Checking the thickness of your corneas with machine
5) 10 min video presentation about myopia, astigmatism and lasik correction
6) Counseling session with staff (briefing of the treatment procedure, recovery, complications, side effects, etc)
7) Dilation of pupils
8) Checking degree of myopia and astigmatism by optometrist after dilation
9) Checking eye power by optometrist after dilation
10) Consultation with the doctor
11) Booking surgery date and time
12) Payment (deposit is necessary)
13) Un-dilation of pupils

The lasik procedure involved 2 steps :

Step 1 : Slicing the protective flap of the cornea so that the laser can correct your corneas

Step 2 : Using the laser to correct your myopia and/or astigmatism

Even though there’re a lot of buzz going on about blade-free surgery, the truth is, the flap slicing is still necessary. It’s just that there’re 2 methods to slice the cornea flap :

Cornea Flap Method 1 : Microkeratome

Involves a suction ring holding the eye in place and then a machine slices a thin layer of the cornea flap. Think about ham-slicing machines.

Cornea Flap Method 2 : Intralase (Blade-Free)

Suction ring holds eye in place but laser does the cutting instead of a blade (so the term blade-free). It is more customized to the shape of your cornea, but also cost more than Microkeratome method. Intralase also take a longer time to cut (approx. 20 sec.) as compared to Microkeratome’s 7 sec. Due to the long time the suction ring needs to hold the eye in place for Intralase, incidence of injury to the eye white is higher. Injuries will present themselves as red specks of blood clots around the eye whites. These will heal in about 4 weeks though.

Just as there’re 2 methods to slice the cornea flap, there’re also 2 methods to get your lasik done.

Lasik Method 1 : VISX Custom

This is the grandfather of lasik. This procedure is the first method since lasik started about 15 years ago. It is recommended for people with low to moderate myopia and an astigmatic power of less than 150°. With high astigmatism, this method may not be able to correct 100% of it and leave behind some residual degrees (about 100°).

Lasik Method 2 : Wavefront

This method is slightly newer. It is prescribed and preferred for people with astigmatism above 150°. The difference from VISX Custom is that this method is more precise and can correct a wider range of focusing problems related to high astigmatism. There is also greater precision in predicting recovery with this method for people with high degrees. Of course you don’t expect to pay peanuts for this method.

If you are of moderate myopia and astigmatism, you’re pretty much free to choose any combination of Cornea Flap and Lasik method. Due to my high astigmatism, I have no choice but to go for Wavefront. Here’s the price package during my visit :

1) VISX Custom + Microkeratome — S$2,188
2) VISX Custom + Intralase — S$2,388
3) Wavefront + Microkeratome — S$2,888
4) Wavefront + Intralase — S$3,888

I chose option 3. All prices do not include 7% GST and there’s a S$45 charge for medication. So my total bill came up to be (S$2,888 + S$45) X 1.07 = S$3,138.31. A refundable and optional S$214 deposit is to be paid. They make it sound like it is a booking fee to reserve the surgery slot but is in fact, a charge for the pre-op evaluation. Previously, lasik clinics charged S$200 for the pre-op evaluation. But now, due to competition, they waived this charge. But this place I came to used the ‘reservation premium’ as an excuse to levy this ‘optional’ charge and it will be offset from your final lasik bill. Since I’m sincere about going for the surgery, I didn’t mind the ploy. If only my eligibility can be confirmed.

A Whole Lot Of Nerves

During the evaluation, it was discovered that the nerves at the end of my eyeballs were unusually thick (and I thought the doctor was talking about the other appendage elsewhere…), and this could mean 2 things – a natural physical anomaly unique to individuals (just like how some people have thicker arms or thicker legs), or the primer to glaucoma. *Gasp*!

Glaucoma is an eye condition that usually affects the elderly and largely heredity. It leads to blindness and there is no cure, but medication can be administered to delay the onset of visual impairment. Blindness is gradual with the tunneling of vision until total sight is lost. So, instead of happily making an appointment for my lasik surgery, I had to go for one more test – Visual Field Test. It costs an additional S$100.

I’m going for the Visual Field Test this Friday (11 Jul) morning at 9am. If I pass that test, I will have my lasik done on the same day at 2.30pm. What does the Visual Field Test entail? Will I be eligible for lasik…?

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10 Comments (+add yours?)

  1. xxpartyguyxx
    Jul 08, 2008 @ 01:30:08

    ooo, all the best! thanks for sharing. =)

    Reply

  2. xxpartyguyxx
    Jul 08, 2008 @ 01:30:08

    ooo, all the best! thanks for sharing. =)

    Reply

  3. icezworld
    Jul 08, 2008 @ 02:27:53

    All the best ok?
    I am glad I dun have to go through all these. *phew*

    Reply

    • celebratelah
      Jul 08, 2008 @ 06:56:03

      yeah… lucky you :o) and thanks for wishing me well… i’m praying very hard that all goes well… through my eyes, i’m beginning to cherish my body more… heh heh…

      Reply

    • celebratelah
      Jul 08, 2008 @ 06:56:03

      yeah… lucky you :o) and thanks for wishing me well… i’m praying very hard that all goes well… through my eyes, i’m beginning to cherish my body more… heh heh…

      Reply

  4. icezworld
    Jul 08, 2008 @ 02:27:53

    All the best ok?
    I am glad I dun have to go through all these. *phew*

    Reply

  5. heliosrealm
    Jul 08, 2008 @ 07:44:30

    hey darren have you check on various site about the danger
    http://www.lasikreality.com/lasikreality.htm
    Bear in mind that the way they market this procedure : its simpe, painless etc ( the same way like other cosmetic surgery)We only have this pair of eyes that will followed us this the day we died.
    Of course I just hope you will read and consider your choice carefully. The decision is yours and will follow you throughout your next life ,
    All the best =)

    Reply

  6. heliosrealm
    Jul 08, 2008 @ 07:44:30

    hey darren have you check on various site about the danger
    http://www.lasikreality.com/lasikreality.htm
    Bear in mind that the way they market this procedure : its simpe, painless etc ( the same way like other cosmetic surgery)We only have this pair of eyes that will followed us this the day we died.
    Of course I just hope you will read and consider your choice carefully. The decision is yours and will follow you throughout your next life ,
    All the best =)

    Reply

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