Note to those with naturally perfect vision: we half-blind folks certainly
do appreciate good vision a whole lot more than y'all.  Starting at the
age of 12, my days began with vision fuzzier than an Al Gore
mathematical analysis.  That is, until I had my eyes zapped by the
friendly doctors at Laser Vision Centers in St. Louis.  Why'd I do it?  
It's sort of like asking a guy in a wheelchair if he'd spend $3,000 and
an hour of his time in exchange for walking again.  Poor vision is a
handicap, and LASIK is an easy fix.  So I called the Laser Vision
office, got educated, and ended up with perfect vision for the first time
in 18 years.

Poor Vision + Dirt Bikes = Expensive
One afternoon in 1995, while stranded on a muddy hillside with a
dozen other racers, I received my first lesson in what corrected vision
can do for you in the woods.  I took off my fogged-up goggles, began
dragging my bike back down the hill, and got hit with mud spray from
a guy charging up the hill.  A piece of mud shot into my eye and that
was the last I saw of a $75 contact lens.  After that, switching to
disposables for races kept the replacement costs down, but I was
never completely satisfied with the clarity of soft lenses.  And when I
was riding, the contacts dried out my eyes and I had to remember to
blink frequently. So the dirt-bike-related issues were part of the
equation that led me to LASIK.

LASIK Education
In the 1990's, a guy I knew had the old-style RK procedure, where
they actually cut your eyeballs with small knives. To me, that would
rank right up there with having my bowels surgically removed.
Actually, it worked out good for him.  With RK, the idea was to make
some cuts that would weaken the cornea so it flattened out and
improved distance vision.  Problem was, it permanently weakened the
eyes to the point that eye protection was highly recommended for
contact sports.  We've come a long way since then, and LASIK is now
the most common corrective surgery for myopia.  The concept is fairly
simple: reshape the cornea back to the way it was in your pre-
corrective days.  It's done with a laser that sculpts the cornea.

LASIK prices have generally come down from 3-5 years ago when the
procedure was fairly new.  I've heard of prices as low as $500 per eye
and as high as $2,500 per eye.  Laser Vision's cost was $1,500/eye.  
For the cost-conscious, look for referral discounts or choose a less
popular day for surgery (early in the week) and you might get the cost
reduced a little.  For me, it wasn't the cost as much as is was my
comfort with the doctor performing the surgery and the equipment
that was used.  Here are some of the key questions to ask:

  • How many procedures has the doctor performed? (I'd be
    comfortable with 1,000 or more)
  • What are the doctor's qualifications and background? Does the
    cost of surgery include post-op visits? (it should)
  • What percentage of patients have to come back for additional
    corrective procedures? (i.e. problems with the procedure that
    required another session under the laser)
  • What kind of equipment is used, how new is it, and what is the
    maximum pupil size that the laser can handle? (if the laser
    resembles the rifle-mounted scope you saw in last month's Guns
    & Ammo, move on to the next doctor)

Even if you've asked all the questions and were satisfied with the
responses, be cautious if the doctor downplays the risks and/or
encourages you to proceed even though you have above-average risk
of side effects.  Most doctors are very upfront in explaining the risks
and will usually recommend other options if you're not a good
candidate, but a small minority are all about volume.

The Procedure
On my first visit to Laser Vision, I watched a cool video of someone
getting his eyes worked on.  The procedure doesn't last long - maybe
5 minutes per eye.  Dr. Steve Wexler and his crew have done about
10,000 of these and they don't waste any time.  I had them set up my
pre-op exam for two days before the actual surgery and I was
instructed to take out my gas permeable contact lenses 3 weeks
ahead of the exam.  Hello, glasses.  The pre-op exam is where they
take measurements of the eye and make sure that you're a good
candidate.  Most people qualify just fine, but if your corneas are too
thin, you probably won't want to have LASIK.  Pupil diameter is also
taken into consideration, as those with wider pupils have higher risk of
side effects like "halo" and "starburst" (most noticeable at night, when
you look at a light fixture and see a glow around the light).

The pre-op exam was cool because they dilated my eyes and I looked
like I'd just got back from a 24-hour rave.  This lasted well into the
following day, and when I mentioned the rave comparison to my
banking co-workers, they didn't know what they hell I was talking
about (they just thought I was stoned).  Overall, my pre-op exam was
good, except that one pupil was just a little large.  The laser is
designed for a maximum pupil diameter of something like 6.5mm, and
I was 7.0mm in one eye.  However, they assured me that this was a
relatively minor difference that shouldn't cause any undue risk of side
effects.  So I went ahead with the scheduled surgery two days later.

The Day My Life Changed
On a Friday morning, my friend Resmi drove me to the office.  She
and her husband both had LASIK performed by Laser Vision Centers
and highly recommended Dr. Wexler's gang.  Patients are not
allowed to drive home afterwards, for a couple a reasons.  They
administer half a pill of valium to help you relax before the procedure.  
The half-valium isn't enough to have much noticeable effect, but
regardless, you are technically drugged up so driving is out.
Afterwards they tape on some cool-looking eye shields (would make
that Boner dude from U2 proud) to keep foreign objects out of your
eyes, which distorts vision.  Along with the drugs and distortions,
some people's vision can be a little fuzzy right after the procedure,
before the eyes have a chance to heal.  So everyone leaves the office
with a driver.

Friday is the most popular day to have LASIK because recovery can
take place over the weekend.  Most people are back at work the
following Monday.  I came in at 8:00 a.m. and was given my half-
Valium (the other half of the pill was supposed to be for when I got
home, but I didn't use it).  Even without the Valium I didn't really feel
tense or nervous, since several of my friends and co-workers have
had LASIK.  Hearing their stories gave me a pretty good idea of what
to expect.  I was also given some eye-numbing drops and a lovely
hair net to wear throughout the procedure.

At 8:30 a.m. I entered the "laser room" and lay down on a
comfortable, fully-reclining table.  One eye was taped shut, and with
the other eye I was instructed to focus on a flashing red light above
me.  The first step was taping back my eyelashes to keep them out of
the way.  Next, a device was put around the eye to keep the eyelids
wide open.  The pressure was a little uncomfortable, but I got used to
it.  Along with this was plenty of lubricating liquid to keep the eye
moist.  Another device was placed on top of the pupil/cornea area, the
purpose of which was to cut a thin "flap" to give the laser access to
the cornea (note: I'm telling this the way I understood it...the folks at
Laser Vision can explain it a whole lot better).   For a moment, I lost
vision and saw nothing but black "sky" and shooting red stars.  A
moment later my vision returned and I focused intently on the red
light while they fired the laser into my eye for about 20 seconds.  The
"flap" was put back into place, the instruments removed from the eye,
and they did the same thing to the other eye.

Afterwards, eye shields were taped to my face and I was sent home.  
On the way out, I deposited my glasses in a box full of eyewear from
some of the many people who left the office with fully corrected
vision.  As instructed, I tried to keep my eyes closed for the next 12
hours, which wasn't too hard.  I went to sleep for awhile, listened to
some music, and talked on the phone.  I had some burning for a
couple of hours after the numbing drops wore off, but nothing
unbearable.

The Follow-Up
The next morning I went back for my day-after exam and had 20/20
vision in the right eye and 20/25 in the left eye.  At the 3-day exam my
vision was perfect.  My previous vision was 20/400, which means I
could see at 20 feet what a person with normal vision could see at
400 feet (the prescription numbers were something like 3.50 and 4.00).

For one week after the procedure, I used two sets of eye drops four
times a day.  One was an antibiotic and the other was an anti-
inflammatory.  I also used non-preservative lubricating drops for when
my eyes became dry (which was pretty frequent) and some gel-type
lubricant at night. I was back at work the next week and felt pretty
good unless I spent too much time at the computer (had to curb the
at-work web surfing). There was some variation in the quality of vision
for the first couple weeks afterwards, but that was usually a result of
dry eyes.

The Conclusion
Six months later, I'm generally satisfied with my 20/20 vision. At night,
I do get the "starburst" effect when looking at lights, which is kind of
annoying when I drive.  Staring at computer screens for an extended
period makes my eyes more dry and tired than they used to be, and
I'm still fighting dryness at night.  But the benefits far outweigh the
minor inconveniences, especially when I'm outside in windy or dusty
conditions.  For dirt biking, I never have to worry about a dry contact
lens, or worse, losing a contact lens.  I consider LASIK to be one of
the best investments I've ever made.

Update 5/19/03
It's been about 16 months since LASIK and my eyes are great.
Depending on the days I had them tested, my eyes were never worse
than 20/25. The dryness that persisted for the first 6 months after the
procedure went away shortly thereafter . I was never so happy to
wake up in the morning with crud in my eyes. I still have some
"starburst" at night, but I'm used to it. The benefits far outweigh the
trade-offs.
Four-eyes No More
LASIK Education
January 2002