My Experience of Laser Eye Surgery (“Smile” procedure)
Ever since my teens I have had glasses or worn contact lenses. My prescription has never been that bad, but sufficiently so to need one or other to be able to go about my day to day life, and drive. It must have been about 15 years ago now that a friend of mine had laser eye surgery and raved about his results. I was intrigued, but too nervous to really consider it myself. I do however remember discussing it with my father (a doctor), who advised I wait for the techniques to further advance and for it to become more and more routine. So I parked the idea and over the years I have known more and more friends who have had it done. Then earlier this year my best friend did it and after a very frank conversation with her, I decided now was the time.
It felt like more of a mission living here in France than it would have been in the UK to decide where to have it done. Everything is in French and I was anxious not to choose an Ophthalmic Surgeon just because he also spoke English. In the UK I would have gone to who my best friend used, or I would have gone to the world renowned Prof. Dan Reinstein at the London Vision Clinic, who is a pioneer in corneal surgery. But I am currently living in Paris, so I sought recommendations here; from friends, online... the more I asked the more difficult the decision became. However, I finally made my choice, had a few appointments and decided to proceed.
The Pre-operative Process.
I went for one appointment where my vision was thoroughly checked, and I mean thoroughly. The Ophthalmologist felt that my prescription was slightly over corrected, and so prescribed a different one on a trial basis. When I returned after this, it was tweaked again for a further short trial until we were both happy.
I also had another appointment where drops were put in my eyes to dilate my pupils for further examination. I have to say, and I wasn’t fully prepared for those drops to be quite unpleasant and sting (worse than any part of the surgery). I was prepared not to be able to drive home afterwards though (because they made my vision really blurry, until part way through the next morning) and my husband acted as my chauffer.
I then had an appointment at the Clinic in Paris to have photographs and measurements taken of my eyes, to assess the corneal thickness to see which surgery I was suitable for. This is my understanding of the two procedures we were looking at: “Smile” - a less intrusive surgery and with a quicker recovery time (and so my preferred option), and “Lasik”, with a slightly longer more painful recovery time where a larger “flap” is lasered and lifted up before being replaced again. From what was described to me the newer “Smile” procedure has less potential problems and side effects, and fortunately my cornea’s were deemed to be thick enough. I was consented, provided with lots of paperwork (in French!!) and a long prescription containing many eye drops for pre and post op…and surgery was scheduled.
There was a bit of a delay for me between these appointments and the surgery, purely due to personal logistics in organising myself and the kids. Ultimately, we fixed a date in November 2016 and all that was left was for me to slowly get more and more anxious! Yes, I had a couple of bad dreams in the lead up. Yes, I googled eye surgery once or twice, but very very quickly stopped reading any forums because it became apparent that the vast majority of people only post if they have had bad experiences. No, I didn’t watch a You Tube video of the surgery, I couldn’t bring myself to and I’m glad I didn’t...sometimes too much knowledge can be a bad thing!! I was nervous about it all going wrong and not being able to see my children again as both eyes are done at the same time. I asked my best friend if she had worried about this, and rather sensibly her thinking had been that the chances of both going wrong, or getting an infection in both eyes seemed rather small, and so it had not really been on her worry radar (my friend Charlotte is most wise).
I managed to collect and translate all of my prescription, my Ophthalmologist phoned me the day before to check I understood and was happy with everything. For a few days before the surgery I had to wash the outside of my eyelids. On the morning, I had a couple of drops to put in including an antibiotic, and an hour before I had been prescribed a sedative tablet to take.
So on 17th November 2016, off my friend and I went into Paris (thanks again Sonja, you superstar). I was very nervous, the sedative helped a bit! I had rather hoped that my friend could come into the surgery with me, she is a dental nurse by training and would have known how to expertly keep me calm. Alas she had to stay outside. My Surgeon checked my eyes that morning again shortly after I arrived, made another tiny tweek to the operation plans and then I went back to the waiting room… tick tock!
When it was my turn I went into a dimly lit room which had some deck chair type seats in with blankets and little tables, possibly there was music playing softly - it was all rather reminiscent of a relaxing spa room...but not! I was given surgical scrubs to wear and a delightful hairnet and asked to sit and wait. There was a girl in one chair curled up under a blanket, completely still saying nothing. At one point she tentatively emerged with eyes like a mole, fumbled for the cup of tea she had been brought, took a sip and disappeared under her blanket again. Another girl was led out of an adjacent room, having just had her surgery, sat in another lounge chair, ordered a cup of tea and too covered herself with a blanket. This was all a little disconcerting!
Then in I went with the nurse. She was friendly and kind and spoke a little bit of English, but was far from fluent. We got by. I lay on a bed and she placed anaesthetic drops into each of my eyes. I could feel a scratchy feeling in one eye a little after so I mentioned this to her (my imagination was on overdrive as to whether this meant it hadn’t properly numbed pre laser) and she popped another drop in. Then my Ophthalmologist arrived, and we began.
They reassuringly talked me through the whole process. My right eye was "clamped" open first (i'm sure this is the wrong word, but it adequately conveys what happened). This being done was the most unpleasant part of the whole procedure, and that was only brief really, once it was in place it was ok. I had to keep very still whilst the laser came right down onto my eye, I had to look at a dot and keep my eye still, I think the laser touched my cornea and there was a suction contact made. I could feel none of this, only sort of see it. Then they said the lasering was to start and he counted to I think it was 20 or 30 whilst I had to keep very still. I had been reassured though that I could not mess it up as the laser tracked my eye and accounts for any movement.
I felt nothing. Not a thing. Honestly. I’d heard tales of people being able to smell burning, but I could not.
As the lasering took place my vision disappeared. It wasn’t pitch black, but rather completely foggy so I could see nothing from that eye. Then the laser was raised up, the clamp removed, placed on my left eye, and the same process repeated and I could see nothing at all. I remember thinking, and saying, "so this is what it would be like to be totally blind". Sobering, but in that moment I was being constantly reassured and never actually thought that it could be a reality - maybe that was the sedative helping!
The bed was swung around by 180 degrees and my right eye re clamped and my left eye covered over. What happened next I can only describe by what I felt. It felt like something on the surface of my eye was lifted, some scraping was taking place and then something was smoothed back down onto my eye ball with what felt like a little soft brush. This was repeated on my left eye. It was the single most bizzare thing that has ever happened to me. I could feel it, but it didn’t hurt at all. I have since watched a video on You Tube of the procedure… and what I thought was happening was pretty accurate. I think this was a good order to have watched that particular video - after the event. It is utterly fascinating.
I stayed at the clinic for a little while to rest under a blanket! But as my friend was there we just chatted. I was told to go home and have a big sleep and then I would be fine by the morning. The Ophthalmologist said I should be able to drive the following day to an appointment with him late morning to see how everything was. To be honest the anaesthetic must have started to wear off on the drive home and it felt really quite unpleasant. Not unbearable, but deeply unpleasant. My father’s medical advice resounded in my ears, that eye pain is like any other pain and paracetamol will help it - I duly obliged. It did. I went home, fumbled around to eat some lunch placed before me by my husband who was then working from home…and then went to bed. Not before commencing my regime of 6 (later increasing to 8 plus an ointment, before decreasing to my current 3) different eye drops 4-6 times a day.
Apparently some people can see well straight away or by the following morning. This was not my experience. I enjoyed my afternoon nap (quite a treat when you are a mum at home with 2 toddlers!) but felt quite sorry for myself after and then listened to an audio book in the dark! The next day I was expecting to be able to drive the 15 ish minute trip down the road for my appointment and hadn’t arranged any childcare - the toddlers were to come with me, it was going to be a circus but I was expecting it to be all quick. I should have heeded more carefully the accounts from other friends who had a much slower recovery time than had been indicated to me. The following morning, my husband had to go to work, there was no way I could drive, I couldn’t see very well at all. I could manage, just, but for example certainly couldn’t see the television I put on to keep the children quiet and entertained. It was quite uncomfortable, I felt tired, irritable and got a headache and was putting so many eye drops in it felt like a full time occupation. I was quite light sensitive so was wearing dark sunglasses in the house. I kept expecting it to improve dramatically throughout the day so didn't call in help... but it didn't. We managed, but it was a really hard day. In hindsight, I should have got help and I should have spent the day in bed. My husband was able to finish work promptly and I went immediately to bed, and to sleep.
The following day was a Saturday and my vision was a little improved and things were feeling a bit more comfortable, so I had my review appointment, was prescribed some more extra-lubricating drops and an ointment, and then rested for the rest of the day. We went to a wonderful Thanksgiving meal (delicious Jill, you are an inspiration) with lots of friends and the kids that teatime - It was wonderful and I was fine for a couple of hours, I used all the lubricating drops I had taken with me, but my eyes were getting so dry and uncomfortable that we had to leave earlier than I really wanted to. I think this was the first time I have been out in public in my adult life without foundation on, and no eyemake up. I don’t wear a lot of make up, but I must be vain because this really bothered me. That said, a small sacrifice, and I was amongst friends. I rested again on Sunday. Each day my eyes were getting slowly slowly better in all respects.
I tried a small drive on Tuesday, to take my son to pre-school. It is a 3 minute drive up the road. It was possible. The advice by my ophthalmologist re driving was to try when I felt it was safe. I drove properly on Wednesday, so that was 6 days post op, and felt fine. I wore foundation for the first time on the Friday, 8 days post op. And that same evening, I drove at night, with no problem. And I wore eye make up for the first time just over 2 weeks after the operation. This was more to do with concern about needing to rub to take it off. These timescales were longer than the minimum recommended, but they were what I felt comfortable with.
I had another review appointment with my Ophthalmologist last week and have been assured all is within the realms of completely normal recovery and that it can take 2-4 weeks for vision to reach a final stage. Dryness is a normal side effect, and I have another 2 months of 3 different lubricating eye drops, 4 times a day. At 3 weeks post op (at the point of writing this) I can see almost normally, save slightly for when my eyes get dry and it is uncomfortable, then I need to put drops in. This is improving every day. I also have a super lubricating gel which I drop in last thing at night; it’s like giving each eye a pint of water to drink, lovely! In the morning, it takes me a little while longer than normal to open my eyes properly and then I need to go straight and put my first lot of drops in. Sitting here in front of the computer typing this is making my eyes feel a little dry, looking at screens reduces your blink rate and so doesn’t help (and I have been doing this a lot recently for launching Five Little Stars!), that said I am now due my lunch time drops! At night there are halo's around lights but these aren't bad, and I can drive with no problem. They should fade, but for now they are quite pretty.
I have tried to be completely honest with how this experience has been for me. Everyone is different of course as we all heal and recover differently. In conclusion I think it is brilliant and even now I am so so happy with the results. If like me you have been thinking about it for a long time but are nervous about the actual surgery, that honestly is the thing that need concern you the least, it was entirely painless and quick. I think my recovery has been a little on the protracted side, and certainly longer than the rosy swift picture pre-operatively painted by my Opthalmologist, but even so I would make the same decisions all over again.
It is fantastic to just get up in the morning and be able to see, go to one of my babies in the night without fumbling for my glasses, I will be able to do sports and not have to think about contact lens’ or glasses, forgetting contact lens’ when I go away for a weekend or on holiday is a thing of the past, as is that irritating scratchy feeling when a lens folds or something gets into your eye behind the lens. I will probably need reading glasses when I get older, both my parents have them, but this doesn’t bother me at all. As my sister said to me the other day, now I’m just like her...perfect!!!! (?!)