Enjoy Life when 40

Just things in which I have my passion ranging from retiring early, enjoying life and nice things.

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To laser your eyes with SMILE - an honest story

To laser or not to laser... your eyes, this was something that took me a time to think about. To be honest, almost 40 years that took me to make the final decision. I started wearing glasses since I was 8 in primary school and ever since I did not get used to see the world without any. 

Pain of glasses and contacts

I wore contacts during my student time, but the pain to every day put them in and out, your eyes getting tired quicker and working with computers put even more strain to the whole experience. So, I decided after 7 years to switch back to glasses again. 

But living your whole life with wearing glasses, it is a pain. Every day cleaning your glasses, the accidents I got with breaking the frame while playing with my kids or doing sports, and losing 3 pair of glasses in the sea and lake was not helping me feeling great with wearing these spectacles. 
Several  times I thought of doing a laser operation. Some friends told me about their great experience and recommended me to do so. Initially, it was a new thing where people went for to Switzerland, but it became a more mainstream operation where people would queue up and get fixed within 15 minutes. I was ready to sign up. 

But there was one problem. My eyesight was bad. I took the thinnest lenses to hide it, because I had -9 in both eyes. And the laser technology was good, but it could not fix my sight unfortunately. 

LASIK and SMILE

Till a new method became available. New? Yes, new, and to explain that, let me explain how is the old way of laser operating. There are several ways to laser operate  eyes. Traditionally they would use LASIK method. LASIK stands for "Laser-Assisted In Situ Keratomileusis", not very important, but basically they cut open a part of the top of the eyeball, flap it open and then with a laser they shape the inner cornea to form a new lense shape. They put the flap back in place and now you have a eye with a lense shaped cornea inside. 



Glasses
This is the most common used method to do laser operation, but it only recovers eyesight for people  with lower weakness, not -9. but now with the newer laser method, called SMILE ( Small Incision Lenticule Extraction) does help correcting people with weaker eyes. 

SMILE is an operation that with a laser they "burn" a corrective lens inside your cornea without opening the eyeball top. The burnt lens becomes hard and white and then this lens is removed with a small incision from the side. So no flaps nor opening up larger part of the superficie of the eye.

It has a number of advantages, the eye surface stays more in tact, which people were complaining about the LASIK operation. The flaps could dislodge even years after  the operation. And also nerves could be impacted as part of the top cornea is cut. 

SMILE operation does not touch the surface that much and therefore less risky from that point of view. And it better for people with weaker eyesight. 

Both operations are quick, and recovery is matter of one day typically. 

What was my experience and what do I see as pros and cons? I tell you with my honest opinion and without and marketing or thinking about the spent money.


How much does it Cost

This type of operation is not yet covered by most medical insurances. They do cover LASIK, but SMILE is too new for them to include it in their coverage. Also they consider this more a cosmetic type of surgery, so therefore they are slow to pick it up. 

The SMILE operation could cost up to 2500 USD per eye in Europe and US from what I saw as list prices. In Argentina where I l live they do it for 1500 USD for 2 eyes, with the same machines and care as in other parts of the world. 


Do you need glasses to read?

The doctor told me that after a laser eye operation, you would need reading glasses - oooh no! But he also mentioned quickly that that can be fixed by operating one eye with full sight (0) and the other one a bit weaker (-2 I believe), so you can still read without glasses with that eye, but you would not see that far. Combining both eyes would provide you full recovery, for both seeing objects far away as well as reading small print on medicine boxes.  I opted for this option. 

Being operating with SMILE

So i chose for getting operated with SMILE. The Argentinean doctor mentioned that I could also get a lense inserted in my eye, but the success stories of laser operations convinced me to do the latter. 

The operation is really quick. Before you get some medicines to put in your eyes. On the day, I came to the clinique in the morning, waiting 10 minutes, got a protection sheet over me and over my hair, and then went in the operation room. There I saw a large machine and was asked to lie down. They put some liquids in my eye and opened it with a metal holder and asked me to stay calm. Then the machine put a rubber holder on my eye, and a small light centered on my eye and with a buzzing of one minute, the eye was "lasered". The lasered part was hard and white, and with a small incision with a knife, they took that part out. And ready. 

You do not feel any pain during this operation. They give you special liquid anesthesia in your eye and the only thing which makes me more uncomfortable is the thought of someone touching and cutting my eye. So, banning those thoughts,thinking of 40 years of wearing glasses, and squeezing the assistant´s hand as hard as possible calmed me down. 

After one eye is operated, they do the same to the other one. And then, ready, and you can walk away from the clinic with somebody to assist. The first hours it is a bit blurred, but the sight recovery within days quite amazingly. I could already see things sharply within the first day.


Post Operation

The days after you need to come back to do a control and pour liquids in your eyes to recover for one week. And that is it! 

First my eyes needed time to recover, especially when you read something, it takes more time to recover then to read far away. But I was amazed, I was able to read license plates 30 meters away and also read small print in manuals. 

I was really in the clouds! Took me time to get away with my glasses habits, every morning waking up, I was looking  for my glasses on the night stand, but then realized I did not need them anymore. I could try out sunglasses without asking for specially measured expensive glasses that destroyed the original style.


One year after

Still the best thing I have ever done. To get my eyes operated really helped my life and being able to do things easier than before. 

So, all 100% success? There are pros and cons as there are some things you need to consider that is not really explicitly told before. 


Mobile phones 

First, reading mobile phone is getting your eyes fixed. I mean, after reading mobile phone display, you need 3-5 minutes to recover you sight to see again sharply far away. It is consistent. Without a phone, I can see clearly far objects, but just 30 seconds reading a a phone message, lowers my clear sightness for a few minutes. Not a real problem, but just to know, especially if working with phones and small displays is your job. 


reading phone with laser operation
Mobile phones make your eyes defocus a bit to see far objects

I also noticed that the blue light in the new LED displays was hurting my eyes much more than before. I switched the blue light off and really helps your eye strain. Somehow your eyes got more sensitive to that than before. 

Working with computers and reading from larger tablet screens does not strain your eyes that much.


Watching screen projections 

Also, I noticed that looking at presentations with overhead projectors is more challenging to read. Still, on the street, my eyes are as sharp as an eagle, but reading a overhead projection, I have trouble even reading larger fonts. It is the same with reading at the eye doctor the letters from his display or watching television from larger distance. It has to do with the lighting as I could read sharply the same if it was on a cardboard. Again, it gives me the same feel that the iris does open up more than it should be with the lighting.


Watching display with laser operation
What is the text here?

Sunglasses and Driving in the dark 

Another thing mentioned little is what happens to laser operated eyes in the dark. When it is getting dark, my eyes seem to loose its sharpness for far objects. It could get bad that your vision becomes again hazy when it is really dark or wearing dark sunglasses.

Sunglasses and laser operation
More challenging seeing with sunglasses

If there are street lights, it is not that bad, but on dark streets outside the city, I have troubles seeing clearly. Recommendation I found is to turn on the dashboard light in the car. It has to do something with the iris of the eye opening up too much as I had the same before the operation when they gave me something to open the iris as wide as possible.



Sleeping

I noticed that if I sleep on one side with one eye on the pillow it does hurt a little bit after being operated. Even one year after, I can feel a slight uncomfort and affects my eye sight for a few minutes. I now accustomed myself to sleep with my eyes looking up to avoid this pain. 

More vulnerable 

A few months ago, I went to a nice boutique hotel. They had a great swimming pool and as a fervid swimmer, I decided to do some laps. Forgot my goggles and decided to keep my eyes closed under the water while doing butterfly. Wrong! 

I opened my eyes when I got above the water again, but the splashing water poured in my eye. Immediately I felt an irritation, like some dirt in my eye. During the day I rubbed my eye to get it out, but it got worse. 

Two ways later I got to the eye doctor as the irritation did not go away. I had an eye infection, but specifically where the eye was incised and still had a scar there. The eye surface stays like that (like a scar on your skin once operated) and is more vulnerable to infection. In this case it was a bacterial infection that could be fixed with antibiotics, but it was a warning to me to ALWAYS use goggles when swimming from now on. 


Overall

Overall, I am really happy i opted for laser operation. People told me I was too old (over 40) and my eyes were too weak. But at the end, the advantages of moving around without glasses weights up against the laser operation. 

There are some things to consider as I mentioned above. You have to be more careful with your eyes, which I only realize after the operation. You only have two for life. 

But I read still one year after license plates 30 meters away from me without any problem. And small prints on medical boxes are neither a problem. I am very pleased looking at the world now!



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