Those 10 minutes in the OR. What are they like??
By Andrew E Holzman, MD FACS on November 14, 2010
I am sure that what keeps most people from doing LASIK, even though they want it, is fear. Some people will say its too expensive, but in reality the real reason is that many people cannot fathom having anyone operate on their eyes. They are paralyzed with the fear of the unknown. They think something is going to go wrong and that they wont be able to see. These fears are NOT rational and have no basis in truth. LASIK is in fact the safest elective surgery you can have--- and if you are being treated by an experienced surgeon, with state of the art technology, you will not only do well, but your life will be changed for the better, forever. Can't tell you how many patients tell me after the surgery --"i wish i had this done sooner" or "why didn't I do this sooner".... almost everyone!
So, to replace fear with knowledge.... day of surgery-- we go over all the things yo u need to know, all your post op meds, all questions answered, and a final exam of the eyes by me. I then give the patient a pep talk of sorts--- i give them all the important things to think about, how to get into the "zone" they need to be in, and how to allow themselves to handle this easily. I also give them a xanax and a few alleve. This will take all the edge off and allow the body to relax. The procedure is simple and takes only 10 minutes. I ask that the patient look at it like a mental concentration test, just concentrate on keeping a low intensity with normal breathing, and to keep the facial muscles relaxed. concentrate on the eyebrow and forehead and soften those muscles. We hold the eye open (one at a time- the other is taped closed)-- the key is that the patient isn't fighting the small device which holds the lids open. this is easier than you think and even patients that cant get contacts in their own eyes are able to do this. if the face is relaxed, then the patient wont fight the small device (its NOT uncomfortable at all.
First, we lay you down on a comfortable chair/bed. We prop up your legs which feels good for your back, and give you a stress ball to hold (for women, we usually give a stuffed animal!) This sounds funny, but it really does help with a comfortable feeling. I keep the OR very casual and calm, and we have good music playing. It is very calming in there and we keep the environment light to keep the patient relaxed (and makes our day better too!). If someone has a special music request, no problem. We love all kinds of music.... I go over the steps again with the patient and make sure that they are focused on the task... then we start.
LASIK is two steps. Step 1 is creating the flap with a Laser called INTRALASE. There are no blades used at all. This is all laser LASIK. In this first step, the patient feels mild pressure on the eye, similar to me pushing my finger on the eye a little bit. If the patient is calm, cool and breathing, the pressure sensation is very minimal and you may not even feel it. At the same time, the vision will dim a bit. This whole step lasts 30 seconds. We then do this on the other eye. Once this is done, the patient is finished with the "tougher" part of the procedure. The next step, we use a VISX Customvue or the ALLEGRETTO WAVELIGHT laser to fix the vision. We hold the eye open again, (other is taped), and then you have a blinking light to look up at. I elevate the flap and the light gets fuzzy. You feel nothing. You then hear some sounds of the laser and you may notice an odor like a hairdryer as the laser sometimes gives that odor. This step lasts approx 20-30 seconds. Then I replace the flap, and the light gets clear again. I spend a few seconds then finishing my job of securing the flap and making sure everything looks perfect, and then you are DONE! Sit up, start blinking and start a new life!
I look at the eyes, and then you go right home. Get a 3 hour nap, and when you wake up, the vision is so much better, you won't believe it. You will need to start your eye drops and then visit us or your eye doctor the next day. Most people drive and work the next day without any glasses! The vision will get clearer and crisper over the next few days and weeks.
Its that easy! You really have nothing to fear at all. WE WILL NOT OPERATE ON ANYONE THAT ISN'T A GREAT CANDIDATE> WE TURN AWAY 15-20% of patients because we feel that they are not PERFECTLY suited for the surgery, so this way we eliminate most of the risk. We only operate on low risk patients and people who we know will do well. Come to our office and see if you are a candidate. You have nothing to worry about and a lifetime of vision waiting for you....