Lasik Eye Surgery

Discussion in 'Medical Topics' started by mhockey21, Oct 28, 2010.

  1. mhockey21

    mhockey21 Pre-Flight

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    In December I'm going to have Lasik Eye Surgery, I'm just wondering what I have to do in the way of informing the FAA about what I'm doing so they can remove the corrective lenses statement from the back of my license. I'm really excited about this, anyone have it done?
     
  2. infotango

    infotango Line Up and Wait

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    I had PRK done a month or so ago. For pilots or other active people, I'd strongly recommend getting the PRK procedure done over LASIK, since there is no cut in your eye. Read about the differences. You really want to do your research with this procedure.

    My vision is now 20/20 and 20/15, up from 20/400. I got the procedure done because I want to join a division of the military that requires nearly perfect uncorrected vision. The procedure itself was painless, however the recovery was awful. The pain was intense, and you don't know the outcome of the procedure until about a week later. According to the doctor, my recovery was very rapid compared to the average population, which is what I would expect, since I'm in pretty excellent shape. LASIK apparently has a much easier recovery although you have a cut in your eyeball for the rest of your life. The Navy has decided that this is not acceptable, and I did too.

    For most people I'm not sure if I would recommend the procedure. If contacts work for you, why wouldn't you stick with them? That being said, I really love waking up and being able to see, not having to deal with glasses and contacts, having better than perfect vision, and the fact that I'm now eligible for a whole lot more things than I was before. If you don't have that last bit, or care, it may not be worth the risk of complications. Nothing is guaranteed, and in the end they are your eyes. The one other thing I will add, is GO TO THE BEST DOCTOR around. Ask other eye doctors and surgeons who they send their problems to, and go to that doctor. If you can't afford the best, don't get the procedure done at all. Your vision is not the place for 2 for 1 eyeball deals, or shady mall store doctors.
     
  3. Lance F

    Lance F En-Route PoA Supporter

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    Rob, congrats on the successful procedure!
     
  4. Doggtyred

    Doggtyred En-Route

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    I think some clarification is in order here regarding PRK versus Lasik.

    Both involve the use of a laser to reshape the "stroma".. the material just beneath the cornea.

    LASIK involves the use of a keratome, the sharp scalpel that makes a flap out of the cornea, which is folded back, to allow the laser to shape the stroma, then the flap is folded back. It heals quickly and after a short period of time its back to original integrity. The visual improvement is noticed fairly quickly, and as healing occurs, and many of the short term side effects disappear (halos, starring, etc)

    PRK involves the REMOVAL of the portion of the cornea that LASIK would otherwise cut as a flap. The laser then reshapes the stroma in the same manner as in LASIK. Because the cornea has been removed, you have to grow this layer back. This takes a bit longer. When I was screened for my LASIK 10 years ago, the doc explained that using PRK would involve the use of a "bandage contact lens" post procedure.

    If during LASIK, the corneal flap is unable to be replaced properly or it gets "botched".. then its discarded, and the healing will progress in a similar fashion to PRK.

    Both procedures involve the removal of the cornea from over the top of the stroma within the "zone of correction". LASIK involves replacing it. PRK involves growing it back.

    Both are perfectly acceptable to the FAA. All this stuff about "active" lifestyles and whatnot.. consider this. DIRECT blunt trauma to the globe and cornea of the eye is bad... whether its virgin or postoperative. If you are concerned about eye trauma in an activity, what type of surgery you had is irrelevant. Wear protection.


    As for me, I had Lasik around 1999-2000. A few weeks post procedure, once the surgeon was satisfied I was without side effects, he gave me a letter that stated my current stable visual acuity, that I was free of adverse side effects and complications, and that I no longer required corrective lenses. I submitted a copy of the letter immediately to the FAA, and resumed flying as PIC at that point.

    At my next medical, I submitted a copy of the letter to the AME. Noted it on my form as previously reported. The AME was unfamiliar, so held my medical overnight and made a phone call. Handed it to me the next day without issue.
     
    Last edited: Oct 29, 2010
  5. BillTIZ

    BillTIZ Final Approach

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    AME should require a completed FAA Form 8500-7, Eye Exam Report from the Eye Doc to accompany the standard medical form stating your new corrected vision, Near, Far and Intermediate (if you are of that age).

    All reported visions should be within required tolerances (20/20 - 20/40 etc) and also must state that you have no glare or halo effects from the surgery. It also needs to be at least a month since the surgery.
     
  6. timwinters

    timwinters Ejection Handle Pulled PoA Supporter

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    Nice write up Dave.

    There is a new version of lasik out though that uses a laser to cut the flap instead of a keratome. That's what I had done a little over a year ago. I went from 20/800 to 20/40.

     
  7. infotango

    infotango Line Up and Wait

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    rob!
    I was under the impression that the procedure you are describing is LASEK not LASIK. From what I understand LASEK can be reverted to PRK, but LASIK cannot, since the cut is much deeper.

    And thanks Lance!
     
  8. Doggtyred

    Doggtyred En-Route

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    loss of the corneal flap is loss of the corneal flap, whether intentional or by accident. Either way it grows back within a days to weeks.

    both procedures involve revision of the subcorneal tissue (stroma).

    Sure there are fine differences..

    My main point I choose to make is.. people try to claim that PRK is superior to LASIK due to the risk of untoward complications when the eye is directly traumatized.

    In my humble opinion the difference is akin a truck running over a tricycle at 60 mph versus 62 mph. Blunt trauma to the eye is more of a mediating factor of damage than what sort of corneal correction was performed sometime in the distant past.
     
  9. jstro

    jstro Pre-takeoff checklist

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    I'm having custom lasik done in January. According to the doc most patients are back at work the next day and don't have any pain issues aside from some itchy/watery eyes for a few days.

    Here's a good link describe the different procedures (custom LASIK, LASIK, LASEK, PRK, etc)

    http://www.tlcvision.com/lasik-laser-vision-expectations/custom-lasik/
     
  10. elmetal

    elmetal Pre-takeoff checklist

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    how much does a procedure like LASIK/LASEK/PKR/custom LASIK/etc/etc cost from beginning to end here in the US?

    I mean including a dr visit to determine what procedure would be best, what's possible, etc

    any sort of ballparks?

    I am curious because I know a lot of capable drs in Brazil that can do the same for me and I want to see what would be cheaper: a mini vacation with surgery to Brazil or just staying here and doing it here.
     
  11. Doggtyred

    Doggtyred En-Route

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    You can get it on the cheap for under $1000 an eye if you shop around.

    So if you go to Brazil, and you have a complication a few days after you come home.. then what? Who is doing your follow up care?
     
  12. elmetal

    elmetal Pre-takeoff checklist

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    I find a doctor here to do it.

    Any doctor would charge for a follow up visit anyway I'm sure.
     
  13. elmetal

    elmetal Pre-takeoff checklist

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    1000 bucks an eye is really not bad. hmmm... I wish I had that money
     
  14. timwinters

    timwinters Ejection Handle Pulled PoA Supporter

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    When I had my Lasik done there were many follow up appointments. 1day, 1wk, 1mo, 3mo, 6mo, 1yr.

    that's a lot of mini-vacations to Brazil!

    Mine was $3500 all inclusive. That was for the newest custom measurements & procedures. You can get it done for about 1/2 that if you're willing to accept the older technology.
     
  15. Doggtyred

    Doggtyred En-Route

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    I'm gonna share something with you I've learned from working in hospitals for many many years....

    Surgeons are really really hesitant to take over someone elses screw-up. When there is a bad outcome in progress, a lot of folks will NOT take it on, because when the lawsuits get filed, it's not so much who is to blame but who's got the deepest pockets... I see it a LOT with plastics and general surgeons.

    It may not be the same among Opthamologists, but just telling you how it is.

    Just do it here.. plan on spending 1-2k per eye, find someone reputable. Go get screened by several, which is usually a free visit. Have them explain to you how/why if you are a good candidate for correction. They should be mentioning how big your pupil is in the dark/fully dilated versus the zone of correction. They should be mentioning the slope of your cornea and whether the area to be corrected is big enough to undergo proper correction. You can finance the procedure if you want, usually through someplace like GE Money Bank..

    If you DO go across the border, you would be VERY well advised to make sure he's trained in western medicine, preferably in the US. You'd also would be well advised to make sure you have a follow up doc firmly lined up before you go over to get it done. Lined up as in he knows that you are going to get the procedure elsewhere and want to pay him for follow up after you get back.

    Older vs newer technology tends to deal with FDA approved zone of correction size (older is less, newer is more), as well as the "eye tracking" ability, so that if your eye moves during the correction burns, the laser tracks it and moves to follow.
     
  16. pilot_dude

    pilot_dude En-Route

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    Mine was $900/eye all inclusive. That was 3 years ago and they still perform annual exams for the initial expendature.
     
  17. kgruber

    kgruber En-Route

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  18. elmetal

    elmetal Pre-takeoff checklist

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    I'll have to take a look and see what the doctors here say.

    I guess I should have cleared it up in my post, but I am Brazilian and I visit Brazil often to see family so I figured maybe on one of those trips I could sneak in the surgery, but I never realized there was more than just one visit after the surgery. I always thought it was: pre surgery, surgery, then just a single post surgery, ok everything looks good ok see ya

    1000 an eye is really not unreasonable. I thought it was 2500+ an eye here in the US, which is why Brazil seemed like a good idea. Now I'll likely stay here
     
  19. colohan

    colohan Pre-takeoff checklist

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    Prices vary based on the doctor. I went to one of the better known (and more expensive) doctors in my area ($2500/eye?), and after taking some measurements he clearly explained that I was not a Lasik candidate, and I was a slightly riskier-than-average-but-doable PRK candidate.

    The two numbers that were relevant to me were the size of my pupil in the dark (it was larger than average), and the thickness of my cornea (thinner than they'd like for lasik).

    Given that data, I chose to skip the whole thing. I'm convinced that if I went to a less conservative doctor they may have said "ahh, a bit close to the boundary, but let's go for it!"

    When it comes to my vision, I prefer the conservative and experienced guy any day of the week.

    Chris
     
  20. jstro

    jstro Pre-takeoff checklist

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    I got quoted about $2000 per eye for the custom lasik, which includes all pre-op and post-op care.
     
  21. bbchien

    bbchien Touchdown! Greaser!

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    The gold standard for me is the city's busiest LASIK practitioner. My 35 y.o. just promoted Horizon Captain came back to the office to tell me, "Dr. Si__er has GLASSES on his face.....!"

    "Hey no kidding!!!".