3rd Lasik Review

 

Yesterday was my 3rd eye review. Again, I have to go for some tests, but this time much faster. There were an eye pressure tests and also the eyesight chart test. During the checking of the eye pressure, the woman kept asking me to open my eyes wider. It was not like I have big eyes. It is already the widest! Doctor went through the test results with me and said that everything is all right, though my vision is still not stable yet. Sometimes 20-20vision, sometimes 25-25 vision. He said that this will take at least 3months to stabilize. I told him about the blurry around the edges problem and he said it is normal. Well, shall take his word for now and see how it goes after 3months.

2nd Lasik Review

 

This is the 2^nd day of my review and my parents were worried about me, they ask my aunt to stay one more night so as to accompany me to the clinic for my 2^nd review check up at 9.15am. Man, I feel love surrounding me warmly. The doctor put in contact lens which is to add as a bandage for the corneal flap and today the review is to check the eyes as well as remove the contact lens. My eyesight is still blurry and there is no “eureka” I have perfect eyesight feeling at all. My eyesight is like after wearing contact lens for long and there are protein build up which causes the blurry looks. Doctor told me that is common for patients to experience this, but by the 3^rd day, it will be fine. I hope this will be the case.

Ah yi treated me again this time it is Delifrance breakfast. She went to walk after our breakfast and I head over to Nokia Care Center at Wheelock place. My phone is giving me problems, when I call or when people call me, they can hear me loud and clear yet I can’t hear a single peeps from them. It’s only when I turned the loudspeaker then can I hear them. I was one of the few waiting for it to open. They open at 11, took a number and shortly it was my turn. They told me it will take 4hours to reformat, change damaged parts so I had to hang out around Orchard wasting more money in my half blind state. I tried hunting for the books that Mr. Ng wants, but to no avail at all. Both Kinokuniya and Borders don’t carry them and they say it’s no longer in print. I bought one pair of shoes, one t-shirt during the waiting time. Luckily most shops are still closed, allowing me to save money. Haha

I’m quite pissed off with the Nokia Care Center people as they solved my existing problem and created another new problem. I only discovered it at home. Damn pissed off! Now when people send me new messages, there is no indication of it, no icon, no vibration , no tone to let me know at all, and I have to keep opening my mailbox to check. @$@#. I might have to go down to their care center again. Fug it!

 

Price of Sight

 

Price of sight

Description	Qty		Net Total Fee(S$)
Motex Micropore W Disp ½”	1		0.00
Novartis Lid Care Ster Wipes	10.00 Sac		0.00
Refresh Plus 30 X 0.4ml	1 box		0.00
Tobradex Suspension 5ml (anti-biotic eye drops)	1 bottle		0.00
Imovane 7.5MG (sleeping pills)	3 tablets		8.40
Treatment Visx Standard MK			2,780
Discount (Evaluation)			-100.00
		Sub-total	2,688.40
		Add GST 7%	188.19
		Rounding Adjustment	-0.04
		Total Amount Payable	2876.55
		CARD-Payment Received	2876.55
		Outstanding Balance	S$0.00
Refresh Plus 30 X 0.4ml	5 boxes		90.00
Discount			15.00
		Sub-Total	75.00
		Add GST 7.0%	5.25
		Total Amount Payable	80.25
		Payment Received	80.25
		Outstanding Balance	S$0.00
			80.25
			2876.55
		Total Costs Owning	SGD$2956.80
		Monthly Instalments for 12months	S$246.40

Pre-Lasik Evaluation and Surgery Process

 

Pre-Lasik Evaluation & Surgery Process (information from the Lasik Surgery Clinic)

1-      Registration

2-      Optometry

 

 

1.       Eye Power Test

2.       Eye Pressure Test

3.       Corneal Thickness Test

4.       Manual Eye Power Test

5.       Dilation Eye Drops Instilled (Dilating eye-drops are used to dilate pupils so as to facilitate the doctor to do a thorough examination of the eyes. It allows the doctor to identify and diagnoses the problems that may go undetected. Some might experience glare and discomfort. My near vision was affected temporarily. The nurse will apply reversion eye-drops after all the evaluation.)

6.       Video About Lasik Treatments (The video creep me out slightly as I always thought there will be a zap of light and voila problem solved. It is not, to my horror)

7.       Repeated Eye Power Test

8.       Repeated Manual Eye Power Test

 

3-      Medical Concierge

 

1.       Counseling Session

2.       Payment for Evaluation Or Surgery

 

4-      Doctor’s Room

Consultation by Senior Eye Surgeon (

5-      Medical Concierge (Reception)

Confirmation Treatment Plan/ Surgery Date/ Others

All this evaluation process was not that long. I went there about 10am and the whole procedure was done by 12pm. There are snacks and drinks available there too. My eyes were good enough for the standard Visx MX procedure.

The actual Surgery

On the day of LASIK surgery, an operative assistant will clean the area around each eye.  Different types of medication may be administered.  A mild sedative like diazepam may be used to help with relaxation while eye drops may be applied to prevent infection and to numb the cornea thereby minimizing discomfort during the operation.  A speculum is then placed between the eyelids to discourage blinking. 

The actual surgery is a two-step process.  The first step involves the cutting of a very thin, circular layer of corneal tissue to create a flap that opens to reveal the corneal stroma.  With advancements in technology, this can now be done using a femtosecond laser that creates a series of small bubbles in the cornea.  Because of the numbing effect of the eye drops, there will not be discomfort although a slight pressure may be felt around the eye. 

It may not be easy to maintain the eye in a single position throughout but as long as the eye position is stable and movement is minimized, the tracking system employed by advanced laser technology is able to follow the movements of the eye.   

The second step of the process involves the use of an excimer laser, or from recent advancements, a solid-state laser to remodel the stroma and correct the underlying refractive condition.  The laser is programmed with calculations arising from measurements taken during consultation.  Nevertheless, the eye surgeon remains in full control of the procedure and will monitor the position of the laser as it contacts the cornea.  Utilizing the tracking system that monitors the movement of the eye, the surgeon is able to ensure that the laser remodeling is precise. 

When the flap is lifted prior to the laser remodeling, there may be a feeling of disorientation as a result of vision becoming very blurry.  Only white light will be observable around the light of the laser.  This is to be expected and should not be a cause for concern. 

The entire two-step process takes approximately 5-10 minutes per eye.  Once completed, the flap is repositioned and healing can begin.  Additional eye drops may be applied.  The use of an eye shield may be useful in preventing eye rubbing and protecting against physical hazards until healing is complete.  Because the laser is applied to the corneal stroma beneath the flap, inflammation associated with wound response is not extensive.  These results in a rapid visual recovery with little discomfort or pain.    

My doctor is Dr Jon Goh’s profile

PROFESSIONAL SERVICES

·         General Ophthalmology

·         Special Interests :

o    LASIK and Refractive Surgery

o    Microincision Cataract and Implant Surgery

CURRICULUM VITAE

·         Senior Ophthalmic Consultant Surgeon, The Lasik Surgery Clinic

·         Medical Director & Director of LASIK and Refractive Surgery, Singapore Vision Centre

·         Fellow of the Royal College of Surgeons(Edinburgh)

·         Fellow of the Royal College of Ophthalmologists(London)

·         Fellow of the Academy of Medicine, Singapore

·         Diploma Certification in Refractive Surgery (European Society of Cataract and Refractive Surgery)

·         Global Certification in Refractive Surgery (International Society of Refractive Surgery)

·         International Faculty Registry, American Academy of Ophthalmology

·         Member, International Society of Refractive Surgery(ISRS/AAO)

·         Clinical Teacher, National University of Singapore

AWARDS

·         Singapore Excellence Service Award (EXSA) 2005 – Star Award

·         Singapore Excellence Service Award (EXSA) 2004 – Gold Award

 

I did my evaluation and the surgery on the same day. The whole surgery procedure only 15minutes for me but it was the waiting time that was a killer. I was asked to go into a white waiting room with white chairs, white curtains, then made to signed a consent form to absolve them from any liability. When the doctor is there, the nurses sterilize my eye area, and then asked me to wear those gauzy head covering, gown and shoes. I waited another like 20mins before I went in for the procedure. Total time spent waiting was around 45minutes. Argh, I wished I was outside with Mr Ng during the waiting time.  Luckily the nurses are all very attentive and are able to make everyone understand what they meant clearly. There is a moment of hesitation during the surgery. The doctor suddenly says oh dear, and don’t know start doing what to my eye. I was like oh my god, oh my god, what the fuck happened. Then after awhile he says yeah, everything went well. Phew~

 I am really grateful for my aunt (Hannah) who woke up bloody early with me to go for the evaluation, to help me make payment, where I will start paying her installments every month. My aunt treated me to River Valley nasi lemak rice which was bad and gave me bad tummy runs till the point of surgery. We went to Far East Shopping Center to get the top she wanted and after that part ways as she was going back to the office to work. After that, I was wondering around for nice clean toilet to camp inside. My tummy hurt that badly. Mr Ng came around at 3.30pm and we head of to Emerald Shopping center food court. As I was feeling that sick, we head back to Paragon, wander around for awhile, bought some antacid for my stomach and back to the clinic to wait. I’m really glad Mr. Ng offered to come and pick and send me home after surgery even though he needs to study for his upcoming exams.

 

Lasik

I’m considering doing Lasik( Laser Assisted In0Situ Keratomileusis) for my myopic problem. I’ve been reading it up on it and have heard good reviews from people who have done it. There are 3 types of lasik which I’m looking into.

 Laser Assisted In-Situ Keratomileusis (LASIK)

LASIK is a recent advancement and modification of PRK. It is effective for low to high myopiaof up to 1500 degrees and astigmatism of up to 600 degrees.LASIK is also effective for low to moderate hyperopia.A thin flap of corneal tissue is created with the use of a specialised instrument calledmicrokeratome. The corneal flap is folded to the side, and the excimer laser is applied toreshape the cornea underneath the flap. The corneal flap is then folded back to its originalposition where it adheres quickly within 2 to 3 minutes without the need for stitches. AfterLASIK, patient’s vision usually returns within a day, and there is less post-operative discomfortand less risk of scarring compared to PRK. Hence LASIK is currently the most populartechnique of laser vision correction. 

Customised Wavefront LASIK

Wavefront LASIK is a new way of doing LASIK as it customizes the exact laser pattern foreach individual’s eye. Every individual has minor optical imperfections in the eye which areunique to himself, just like his fingerprints. Using Wavefront technology, these minorimperfections can now be detected and analysed, and the information fed into the lasercomputer which in turn customises the exact laser pattern to treat not only myopia andastigmatism, but also these minor optical imperfections. This is an improvement over thestandard LASIK and may result in better success rates, sharper vision and less glare andhaloes at night. 

Epi-Blade free lasik

Intralase® is the latest technology for the blade-free creation of a corneal flap. The Intralase® laser actually replaces the handheld microkeratome blade and makes for a bladeless surgery.
Through a process known as photodisruption, infrared light is used to precisely cut corneal tissue. Because the laser beam is focused into a 2-3 micron area, the process of flap creation bypasses the outer layers of the cornea in reaching the inner layers. At the focal point, the Intralase® laser beam creates bubbles of carbon dioxide and water vapor that interconnect in an organized fashion to bring about the corneal flap.
A highly defined corneal flap is hence created taking into account various parameters that include diameter, depth, edge angle and morphology.

I’ve called up Lasik Surgery Clinic to check on the prices and the prices as per today (1April 2008) for Epi Blade Free lasik is SGD 4658, Lasik- SGD2780 and Wavefront- SGD3940. Tan tock seng is offering $1190 per eye according to the Straits Times Ad today. Considering the pros and cons and also most importantly the cost. But one can’t stint on the price of safety as eyes are the window to the soul.