Sunday 12 June 2016

Under The Knife - Laser Eye Surgery - part 3

Catch up with 

I signed and initialled the various documents in the Patient Pack before turning up to the Optical Express branch on Shaftesbury Avenue a few minutes before my 1445 appointment. I had my father with me - the paperwork I'd signed had insisted I brought someone with me to 'help me get home' along with a pair of dark sunglasses as my eyes would apparently be sensitive/painful after the surgery and I would be very drowsy. He had generously volunteered to be my chaperone. 

After handing my documents to a nurse for verification, I found a comfortable seat and waited to be called up. As I was doing so, a man walked out of the clinical area wearing dark sunglasses. He was unaccompanied and stopped to exchange a few very cheerful and upbeat pleasantries with the nurse and then sprightly exited the building - still alone. I watched with confusion and after he'd gone, I asked the nurse if he'd had the surgery. She confirmed he had. I felt very reassured - this man had just been through it and come out on the other side in what was clearly a very buoyant mood and seemingly none the worse for wear. I wondered if my father had noticed, but I decided not to raise the issue as I felt a bit silly for having wasted his time and quietly continued to leaf through my documents.


Another man came out wearing dark sunglasses, this time with his parents, but again in a chirpy mood. I felt even sillier.

My name was called up about half an hour after my arrival. Only patients are allowed in the operating room so I walked in alone to find a very friendly and talkative nurse who asked me to leave my jacket on the side and lie down on the cushioned surgery table underneath a very large and bulky machine which I imagine is the laser. I leave everything on the side: phone, wallet, coins, keys - I want absolutely nothing on me that may upset a machine that's about to get up close and personal with my eyes!

The nurse is chatting away while explaining what he's doing - asking how I got there, sterilising the eye area, asking about my work, putting in some anaesthetic eye drops to numb the eye surface, talking about how good the surgeon is. If he was trying to help me relax he did a good job. Some time passes and he announces that the surgeon is here now and we'll commence. I wonder if the drops have done their work.

The surgeon gets straight into it. 

He warns he's applying suction - "hold very still - you'll feel pressure on your eye - don't blink until it goes dark and you can't see anything. Just relax."

I've read the procedure detail and know to expect all this but it's different when it's happening! "Just relax" while some machine pushes down on my eye and my vision goes dark?!?! Each eye is prepared in about fifteen seconds but so far it's definitely easier said than done.

The bulky machine swings to move directly over my right eye and I'm told to keep looking at the little flashing orange light directly in my line of vision. The next bit is the creation of the corneal flap. This is the actual surgical, slicing part of the procedure where the cornea is cut and folded back from the iris so the laser has the access it needs. This is where the surgeon earns his money and is a very delicate process.

He begins by saying something like "Ok Yusuf, I need you you to keep your eyes still and not to squeeze your eyes in this next part while I make the corneal flap. OK? No squeezing."

This part wasn't described in the notes. I murmur agreement but I'm thinking WTF? How do I even squeeze my eyes? I don't want to sound an idiot though so I resolve to just keep eyes very still and and stay very calm. He continues: "It'll be 15 seconds again for each eye then it'll be done. Just relax and keep looking at the light. You might see instruments moving over your eye - don't worry about them - just focus on the light."

And he begins. I do see an instrument moving over my eye. It's pointy but I keep my attention on the flashing orange light which has become a little bit of a friend. I hear "Yusuf don't squeeze". Dammit man, I don't know what you're talking about! I'm not squeezing! I resort to deep breathing exercises to help relax and distract me from what's happening. 

The instruments keep moving and suddenly the orange flashing light turns in an instant from sharp to an orange blur - similar to looking at a streetlamp in a thick fog. But it's still flashing and I keep looking at it. I calculate that the sudden blurriness means he must've folded back the corneal flap. "Don't squeeze, OK?". There's a bit more alarm in his voice now. And then he moves away. It was a very long 15 seconds but the eye is prepared. 

He moves to the other eye. It's the same procedure and having been through it once I'm feeling confident. We go along and it's the same thing except this time there's more alarm in his "Don't squeeze!" instructions. I learned later that I was actually squeezing quite a lot and almost spoiled things on the second eye. If I had done my last bit of squeezing a split second earlier we'd have had to do the flap all over again. I also learned that the squeezing he kept talking about was similar to when you squint at something! I can't help but feel it would've been useful to know before the surgery!

Now we've come to the laser - this part is all computer controlled. I'm still looking at the foggy flashing orange light when the surgeon warns I'll hear noises and possibly smell some burning. "Perfectly routine and nothing to worry about, just keep your body and your eye very still and it'll be another 15 seconds per eye." Easy for you to say - you're not about to smell your own burning eyes. But this is it. This is what I'm here for. I hold very, very, very still and exhale deeply. It begins.

It was over very quickly - one eye then the other in thirty seconds. I did hear the noises I was warned about but I'd heard them from the waiting area during the prior surgeries so wasn't alarmed. Thankfully, I also didn't smell any burning. All that was left was to replace the corneal flap which took a second for each eye and returned my vision to me, then to move the bulky machine away and finally to sit up. 

I looked around the room - the effect was instant and amazing. Having been staring intently at a foggy orange light for the last 5-10 minutes, everything I looked at was sharply defined and in clear focus. The surgeon led me to an examination room and checked close-up that everything was ok and as it should be and I was OK. No problems from my side, none from his side so we shook hands and I went for a post-op briefing with another nurse.
Eye protector

I was given a little bag with three different eyedrop bottles and an eye protector. She explained take the eye drops four times daily for a week and use the eye protector when I went to sleep also for a week. Absolutely no rubbing the eyes for a couple of days no matter how much you might want to, no water on the eyes for 24 hours, don't take the Underground for a few days (too dusty), come back for a check up tomorrow morning and various other instructions which were also detailed in the Patient Pack. Once that was done I was free to go. 

Eye drops
I felt really, really good. There was none of the pain or sensitivity that I'd been warned about in the reading material. I put on my sunglasses anyway, went to my father and about an hour after we'd arrived, we left the building and departed into the bright afternoon sunlight to catch a bus home. I took every opportunity to look at things in the distance and marvel at how astoundingly sharp and defined my vision now was and sat on the bus feeling, all in all, very good about myself and what I had just gone through.

It was about fifteen minutes after we'd left that the anaesthetic started to wear off and it became clear why they insist on having someone with you to help you home. 

TO BE CONTINUED.