Hurrah: much clearer vision today after they took the right contact lens out! In fact, early tests show better than 20/20 vision!

Here are the details.

Ater a day of work yesterday, not much change: much clearer vision in my left eye, pretty consistently blurry vision in my right. If I needed to see something on the screen or on the whiteboard clearly, I'd just use my left eye. I told my coworkers that I was just adjusting to my post-LASIK vision, not giving them the evil eye. They joked that I'd make a good pirate. Arrrrr.

Being in a familiar environment where I needed to see medium-distance objects (like projector images and whiteboard scrawling) in detail, I could tell my left eye was much better. I could see whiteboards from across the room.

I was hopeful that the right eye blurriness was mostly due to the lens being in there, though I did have moments of doubt: why would a clear lens cause so much blurriness?

Happily, my paranoia was unwarranted. Dr. Lee took off the lens today using a pair of what he called jeweler's forceps -- though I'm sure they're of the medical variety, as they came shrink wrapped in the plastic you see other surgical gear wrapped in. He took a close look under the bright lights and declared the eye much better than the day after the surgery.

And I felt it too: as soon as the lens came off, I could see more clearly, so, um, clearly, the lens itself was causing some blurriness. :-) Dr. Lee said that was expected.

He didn't do a detailed one-eye-at-a-time check, but he did show me the parade of successively shrinking rows of letters, and based on that cursory check, I'm seeing slightly bette than 20/20. We'll see what the exact measurements are when I go for my follow-up next week. Assuming the right eye continues on its rapid healing, I'll be able to start doing my followups with Darren in Foster City again. Hurrah.

On the drive up to the clinic, I could tell that my left eye was seeing much more clearly compared to before the procedure. My right eye was still more blurry.

Once at the clinic, they popped off both contact lens "band-aids" following a few obligatory eye drops (numbing, I think).Dr. Lee confirmed that my right eye was still pretty irritated following the procedure, and after a brief consultation with Dr. Faktorovich, popped the contact lens back in and told me to come back in a day.

Throughout the day, the left eye steadily improved while my right eye stayed about the same. I wasn't sure if it was because I had the lens in or it was just taking a longer time to heal. Probably both.

Well, I went in for my follow up procedure on Tuesday. Compared to my first treatment in January, this follow up was much quicker and less uncomfortable -- though it did involve the same number (I actually lost count) of prepatory eye drops: numbing drops, antibiotic drops, anti-inflammatory drops, pupil-dilating drops, anti-allergy drops, and even more. As I said, I lost count.

The big difference this time was that they didn't need to use the Intralase machine to create a corneal flap because I already had one (well, technically two -- one for each eye). I must say it's slightly unnerving that 11 months after my first procedure, the flap is still "loose" enough to repeat the surgery. Normal, but unnerving all the same.

I arrived at around 9:30 am for my appointment and was out the door by 11 am.

• The first hour involved prep work: sterilizing the area around my eyes, getting the aforementioned eye drops, and taking a Valium.
  
• I don't remember getting one last time.
• I'm not sure it had much of a difference for me me given that I'm generally a low-anxiety, high faith kind of personality.
  
• The system makes a pretty loud turbine-like whine when it's "warming up" -- not sure whether I found that reassuring or disconcerting. :-)
• This time, they didn't make a map of my eye using the wavefront device. All they needed was the standard eye chart and the gizmo optometrists use to check your prescription.
  
• The actual procedure took probably 5 minutes, most of which was consumed by the doctor getting you into position, mounting some kind of contraption to keep your eye steady, and lifting your corneal flap. Of course, she had to do this twice.
  
• The excimer laser that reshapes the cornea was on for less than 1 minute for each eye.
• The laser system (manufactured by Alcon) actually talks, mostly I think for the benefit of the patient. You can imagine the chatter as a last-minute failsafe. Among other things, it announces:
  
• Your name
  
• A series of numbers which I'm guessing correspond to the correction it's about to do
• It has a lock on whatever part of the eye it recognizes ("acquired")
  
• How much time left in the procedure ("17 seconds remaining").
• The system has a single blinking red light that you're supposed to focus on throughout the procedure.
  
• It was wild watching the light (1) move and (2) go in and out of focus as Dr. Faktorovich lifted up the corenal flap.
• I'm guessing the light helps you keep your eye steady, though the doctor also uses some gizmo to keep your eye from moving around -- and has your head in a headlock during the time the laser is actually firing.
  
• The blinking red light is surrounded by 6-8 very bright (halogen?) bulbs which presumably help the doctor see what's going on. Despite the fact that you're flat on your back during the procedure, it makes you feel a little like you're onstage. The afterimages I saw because of the light's intensity varied in color: purple, orange, red, black. Fascinating.
  
• After the reshaping laser had finished its business, Dr. Faktorovich carefully applied two contact lens-like objects onto my eyeballs.
  
• She didn't do this the first time.
• Because this is the second time they're lifting the flap, it apparently causes the eye some irritation.
  
• The lenses help the eye heal.
• "Kind of like little Band-Aids for your eyes," they explained.
  

After the procedure, the attendants walked me into a dark room to rest, eyes closed, for a few minutes. They gave me a set of post-operation instructions and a few more eye drops (of course).

Recovery time -- that is, the time to non-blurry, mostly in focus vision was much speedier this time. It's only been three days, and I'm just about seeing normally with the exception of a few lapses in focus.

I could see things coming into focus in my left eye, even by late afternoon after the procedure. I could tell the left eye (which didn't have much of a correction to do) was seeing much more clearly than the right eye.

More later...

Compared to my first procedure on January 5, recovery is much faster. I remember having hazy vision and dramatic halos for a few weeks after the first procedure.

This time, I still have hazy vision, especially in my right eye (which underwent a slightly larger correction than my left). But the halos are less dramatic. Also, I could actually see better at the hours went on. By late in the afternoon, I had moments of pretty clear vision in my left eye and could definitely notice that it was sharper than before the procedure.

Lunch following the procedure was interesting, because I ate it with my eyes closed. Fedora was kind enough to put everything right in front of me, and I managed to eat my fried rice and vegetables without peeking. The staff told me I could open my eyes for brief moments with no danger, but I figured I'd play the dutiful patient. Smells and tastes are definitely different when you can't see your food: there's more of an element of surprise because you're not sure what's in your spoon with each bite.

Funny moment: after lunch, I wandered into our pantry looking for a snack. I knew we had an open bag of potato chips, so I grabbed what I thought was the bag, removed the bag clip, and dug in. Turned out I got some cheese puffs that I didn't know we had.

After lunch, I slept until about 4 pm and started in on the every-two-hour regimen of drops: antibiotic, anti-inflammatory, and lubricating.

When I first woke up, my vision was definitely hazy. I was so out of it I didn't remember that I was still wearing both the eye shields and the sunglasses they slapped on me on the way out of the clinic. Vision much improved after the sunglasses and eye shields came off. :-)

It’s been about 6 months since my last update. I’ve been visiting the office monthly so they can check to see if my vision is stable enough for the follow-up procedure. Well, after 6 visits, they’ve finally declared me ready, and I’m all scheduled to go the second week in November. Hopefully this means I’m 4-6 weeks away from 20/20 vision!

I continue to read and use the computer just fine. I’m probably 20/30 in my left eye and 20/40 in my right eye. Interestingly, the left eye just kept on improving over the last 6 months, with both the nearsightedness and the astigmatism steadily improving. The right eye seems about the same. When I want to focus in on far away details, I close my right eye.

Aside from not being 20/20, my chief complaint is still seeing halos around bright lights. As I reported earlier, it’s the worst at night around bright point light sources like street lights, night lights, even the LED from my clock radio. They mostly like startbursts these days. I’m hoping the follow up procedure will reduce this. Both the clinic and Darren say that astigmatism can explain at least part of the phenomena.

Brad has expressed some interest in getting the surgery. But a lot of people are still on the sidelines. Overall, I’m happy with the results to date, and I’ll have more to report in a month or so. I guess there is still the worry about the downsides. I wonder how many personal injury lawsuits have been filed by overanxious lawyers for failed LASIK surgery patients? (And I wonder how sensitive Google AdSense is to words in text? Will I have to saw "personal injury lawyer" more than once to trigger a relevant ad?)

Doh, I had just finished my description of what happened at my 3 month follow-up with Pacific Vision Institute when Blogspot crashed, throwing off 500 errors. It looks like it's back up now.

Anyway, my son Colin came with me for my 3-month followup appointment on Friday. It was absolutely pouring, so he loved it.

The checkup itself was very brief -- probably about 10 minutes. A new doctor's assistant ran me through the normal eye chart exam. My right eye is still noticeably worse than my left eye at resolving detail. I guess I'm still seeing around 20/35 or 20/40 depending on the eye. I don't notice the difference between my eyes much in normal activity.

Dr. Faktorovich dropped by to take a quick look. First, she clucked at what a "big correction" I had. She repeated some of the eye chart exams and took a look at the eyeballs through one of those scopes with a bright, thin beam of light.

She concluded that I would benefit from a follow up procedure sometime over the next 3 months. The second procedure, she said, is much easier than the first -- less pressure on the eyeballs, and much faster recovery time. That's good news.

I mentioned something Darren had said to me, which is that it's harder to correct for astigmatism compared to near-sightedness. She said that most of astigmatism is gone, and yes, it would be easy to correct for the mild near-sightedness. If accurate (and I'm not sure how it could have been given the brief exam), that would be a change from last month.

They'll check me monthly until my vision stabilizes, then it's back to the zapper. I'm going to try and have the checkups done with Darren so I don't have to drive all the way up to the city this time. On a bad day (like last Friday), it can take 45-50 minutes.

I got answers from Darren (my optometrist) as well as the Dr. Lee at the PVI about the strange blurring effect I described earlier. Dr. Lee said that he experienced the same thing as well, interestingly. He speculated that it might have to do with my eye muscles pulling on the eye and changing the focus.

And here's what Darren said:

Hi Frank,

I spoke to Dr. F yesterday and also spoke to another
refractive surgeon the night before. They both had a
very similar answer, basically, "I don't know what
that could be, I've never heard of that happening."
Dr. F reassured me that this is not reason for
concern.

-D

The blurring doesn't really impair my everyday vision -- it's not like I go around with one eye closed witn my neck a-swivelin' very often. So I'm not going to worry about it.

Things haven't changed very much since my last update: still basically seeing like a slightly near-sighted person, which I expect will get resolved with my follow-up procedure 2 months or so from now.

I still keep on reaching for my glasses because my body is so used to adjusting my lenses. Very amusing.