Seeing is believing After years of foggy vision, one patient gets a new outlook on life from laser surgery. She describes what it was like.

September 20, 1998|By Jo Bremer | Jo Bremer,Sun Staff

With the surgical blade poised above my right eye, the last thing on my mind is moving. I'm not even breathing.

"Are you with me?" Dr. Anthony J. Kameen asks.

"Yes," I say.

I'm really not breathing: If I can just get through the next few minutes of this new kind of laser surgery, I have a good chance at being able to see clearly for the first time in my life, of going from 20/400 vision to 20/20.

For as long as I can remember, I've had poor vision. Photos of my childhood show black eyes and bruising - being a tomboy is difficult when you can't see.

I cheated on elementary-school eye tests, memorizing the answers of the students in front of me, but teachers eventually caught on. By sixth grade, I sported an extremely unattractive pair of spectacles to correct my nearsightedness and astigmatism.

After college, I tried wearing contact lenses, but they felt gummy and uncomfortable.

By the time radial keratotomy eye surgery came around more than a decade ago, I was ready to consider it. But the thought of someone making pizza-slice cuts in my cornea was unnerving.

Then just over a year ago, I started hearing ads for a new kind of laser surgery, laser-assisted in situ keratomileusis.

I called an 800 number (800-441-2456) and learned about LASIK from the LCA Vision Center affiliate at Greater Baltimore Medical Center. Easier than radial keratotomy. Safer. Better results. Less pain. (I particularly liked that part.)

Instead of making numerous cuts to reshape a cornea to correct vision, the LASIK doctor makes one cut to create a flap of cells, folds that back, then corrects the vision by using a laser to remove vision-distorting bulges. The flap is replaced, making for quick healing.

LCA offered a free evaluation, but I chickened out.

This summer, I received an updated brochure that mentioned 12-months-same-as-cash financing - an attractive deal for surgery that costs about $5,000 and is not covered by insurance.

But the deciding factor didn't come in a brochure. It came on my night stand.

I was awakened by noise one morning. Groggily, I turned to the digital clock on my night stand.

1:05 p.m.

Ack! I was due at work - 30 minutes away - in 25 minutes. I started to call my boss, bending closer to the clock to calculate just how late I would be.

7:05 a.m.

I'd mistaken the 7 for a 1.

I still had five hours to sleep.

After I woke up again, I became convinced that I should at least see if LASIK was an option. I'd seen Kameen do the eyes of Ravens player Benny Thompson live on television, so I thought the operation couldn't be that difficult.

At GBMC, a consultant told me I was a good candidate for the surgery. But I had lots of questions about my expected results. What is the likelihood I would achieve 20/40 vision or better with only one surgery? (98.8 percent; average is 97.5 percent.) 20/20? (93.5 percent; average is 93 percent.) How many surgeries had Kameen done? (4,000.) Of those, how many eyes had serious complications? (Four, but all were later successfully re-treated with LASIK surgery.)

I agreed to further evaluation, basically a complete eye exam including a computer-mapping of my eye. As I stared into a target of lights, an ultrasonic evaluation of my cornea showed the doctor where my eye was misshapen. From the looks of the printout, I had the Rocky Mountains in one eye and the Andes in the other.

My surgery was set for Aug. 31.

Reaction from family and friends was decidedly unmixed:

"You're going to do WHAT?"

"Ewwwwwww."

"Why would you get your eyeballs sliced open?"

"What if they mess up?"

But there is no turning back. The morning of surgery, I sign a release and financing papers and then pop the 10 milligram Valium tablet given to me. I want the Valium to work quickly, because I need it. My hands clench the arms of my chair in the lobby. I make mindless small talk.

Soon, they are ready for me. I move to the next waiting area to be prepped. For my post-op recovery period, I am given a clutch bag of drops and nighttime eye shields - and very large, very ugly sunglasses. My hair is bundled into a surgical cap. I am given anesthetic drops to numb my eyes.

Minutes later, I walk into a dimly lighted room with a large machine in the center. I take my place at the table, where Kameen's assistant takes my glasses.

"I forgot I had them on," I say with a giggle. My eyes tear when I realize that, if this works, I'll never have to put them on again.

Then the surgery begins.

Kameen inserts a speculum in my eye to spread my eyelids apart so he can cut a flap thinner than a hair on the membrane covering my cornea. The paper-clip-sized speculum wires are uncomfortable, but not painful.

"In the next few seconds, you're going to feel pressure, followed by a dimming of your vision," he says. "Are you with me now?"

"Yes." Please, don't let it hurt. Please don't let me squirm. Please let me be brave.

I see a disk placed on my eye. This is the suction device that will hold my eye steady as Kameen cuts.

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