My Epi-LASIK (Blade LASIK) Experience: The Joy, The Pain and The Misconceptions

blade LASIK experience

             Pretty much my last photo with the prescription glasses on (and excuse the eyebrow)!

various eye drops for post LASIK surgery

So, after much contemplation, I decided to go for the LASIK treatment and fix my short-eyesight problem once for all. This is now my 2nd month post the operation, and I thought I would share my experience of having Epi-LASIK, which is the less common option (or you could say the less favorable child) in the LASIK world.  And just a friendly heads-up, it’s a VERY long post.

Before going to the details of the operation itself, let’s first address what are the differences between bladeless LASIK and Epi LASIK, shall we?

LASIK treatment is done at the middle layer of your cornea – cornea has multiple layers, just like your skin. We all know if you want to remove scars on the face (especially for deep scars), applying creams and lotions on the surface may help the appearance, but is not going to radically change anything, you need to penetrate the first layer to go to the deeper skin tissue. It’s the same when it comes to your eyes, laser treatment/correction needs to happen on the deeper layer of your cornea. And the main difference between bladeless and Epi LASIK is the method of how to get to the middle layer (I believe it’s called “stroma” in the medical term) of your cornea.  

With bladeless LASIK, a machine cuts a thin, hinged flap into the cornea, which will then be lifted for laser treatment at the middle layer. When the laser is done, the flap will be folded back with no stitch. With Epi LASIK, the top layer of your cornea will be gently exfoliated/scraped away, either by a machine or by the doctor with a blade, which is why it’s also called blade LASIK. When the middle layer is exposed, the same laser machine will be used for the treatment. And the top layer of cells will grow back in about a week time.

By the sound of it, no one in the right mind will go for Epi LASIK, right? I mean, who wants to have a blade come close to their eyes, let alone scrape away some cells from their cornea! Err… just typing it makes me feel uncomfortable. But there are people, like me, who are not suitable for bladeless LASIK, due to the thickness of the cornea, or the structure/curvature of the cornea. An ideal candidate for bladeless LASIK will be someone whose cornea is thick enough for their degree, and the curvature of their cornea is on the flat side – if I may compare the cornea to mountains (what?), you want your cornea to have lower altitude, so the cells are strongly bond together, and having a flap will not weaken its structure. Unfortunately, for my case, my cornea is very steep – I consider it the Mount Everest in the cornea world, so it’s safer for me to go with Epi LASIK.

Now, back to my experience. Based on the good reviews I have heard from a colleague who did her LASIK a few months back, I chose Eagle eye center to do mine. And different from other clinics, Eagle eye center offers 1-day option, which means you do everything, from the assessment, the consultation to the operation, in ONE SINGLE DAY. I was so anxious to fix my eyesight that I didn’t want to stretch things out too far, so naturally I went with 1-day option. In hindsight, I’m actually very happy I made that decision.

I stopped wearing contact lens 2 weeks before the “big day” – even though the doctor told me 7 days are enough, I liked to play safe. I went through the assessment smoothly, with pretty much everyone telling me bladeless is a no brainer for me, and I was thinking “of course, more than 95% of the people go for bladeless, I’m not a unicorn to go with the blade one!” And you know what? Turned out I was a unicorn! When the doctor handed me the final assessment, pointed out how my cornea curvature is off-chart high (i.e. my cornea is much weaker than most people’s), and he recommended me to go with Epi LASIK, I think my heart skipped a beat, because in my mind, Epi LASIK is no different from pure torture. For the next few minutes (OK, more like one hour), I considered dropping the idea of doing LASIK, and just wear glasses for the rest of my life. But after shooting tons of questions at the doctor, he convinced me it’s not as scary as I imagined, and it is actually safer than bladeless LASIK – because without flap, there is no risk of corean potentially changing shape during the recovery time, which is one of the main reasons some people had to go back to re-do LASIK a few years later, even though it requires much longer recovery time.

So I made my mind, let’s just go with it!

After the decision was made, the following process was actually quite easy and straightforward. On the same afternoon, I went into the surgery prep room about 15 mins prior the operation. The nurse applied several (I’m thinking 5-7?) types of eye drops on both of my eyes to relax and numb the eye muscle. So when I stepped into the operation room, everything looked hazy and blurry, I could still tell the directions, but could barely keep my eyes open without efforts.

I lay down on the operation machine, they put on the infamous eye clap on my right eye, which was not as uncomfortable as I thought by the way. It’s completely OK to blink your eyes as usual, as long as you don’t squeeze it with force – with the clap on, even if you blink eyes as normal, your eyeball doesn’t move (don’t believe me? try to stare at the mirror and blink your eyes, you will see!).

The doctor again told me that there is nothing to worry about for this is a very simple operation. I did have complete faith on him, as he has been doing cornea transplant for over 10 years, and I may or may not have asked him how did he practice cornea operating in his early days (I told you I asked a ton of questions!), so really, scrape away a thin layer of the cornea is truly a piece of cake for him. As weird as it sounds, that thought calmed me down and put me in a much more relaxed mood. He applied more eye drops, followed with icy water, which suppose to minimize any pain during and after the surgery, and then it’s time!

I was told to look at the green light projected from the machine, and the doctor proceed with the first step: exfoliating the top layer of cornea. It’s a pretty weird feeling, not going to lie, i vividly felt something was in contact with my eye and moving left and right. I’m pretty sure that’s the blade but I couldn’t really see anything clear, as my eye was very watery at this point and I was being a good patient and staring at the green light, uber focused.

This only lasted for a few seconds – it felt like 10 seconds, and then doctor told me we can now move to the laser treatment part. And boy, was that fast! The doctor moved the head of the machine slightly, told me to keep staring at the green light, and one second later, he said: “OK, we are done with right eye.” And put contact lens on my right eye – it was a special contact lens with higher content of oxygen, which is designed to be wearing for one week (24/7) to protect the cornea while the new cells are growing back at the top layer. My initial response was “What? That’s it?”  And yes, that’s it. It’s literally less than 30 seconds per eye for the whole treatment. I did smell a burning scent, but it was very light, so light that I didn’t even notice when operating on my right eye.

Just like that, it was done. I sat up, still with watery eyes, but can see the time on the clock hanging at the wall, didn’t feel anything particular, and certainly couldn’t tell if I’m seeing things any better than before. I walked out of the operation room, paid the bill, received eye drops and pain killers (yes, they prescribe that for Epi-LASIK patients), put on sunglasses, hopped on Uber and went straight back home around 5pm.

Nothing dramatic on the first night, I was wearing sunglasses the whole time as your eyes are very sensitive to lights post surgery. I applied prescribed eye drops every 3 hours as I was told, and used nature tear eye drops for God knows how many times to release the dryness. But luckily, no pain (yet). I cleaned my face with micellar cleansing water on a cotton pad – no splashing water to your face at least one week after surgery, and unlike many others, I actually don’t have to wear Goggles while sleep, because there was no flap, my cornea structure is intact and no risk of it moving or warping

The second day, still no pain but my eyes felt sore the whole day, feeling tired to lift up eyelid all the time. So after visiting the doctor for a quick check-up, I went home, closed curtains, turned off lights, turned on Netflix on Apple TV, closed my eyes – with sunglasses on – and listened to Friends for pretty much the entire day. On the way to visit doctor, I could already tell I can see things much clearer now, as I have no problem reading sign boards on the road anymore, but I was even more sensitive to lights comparing to the first night, so I was wearing sunglasses the whole time even when I was at home with all the lights off – even the lights from TV was too strong for me!

The third day was the day I started to feel the pain, especially when opening my eyes. But it wasn’t anything unbearable, it’s more like uncomfortable. So I literally slept the whole day, from Friday night straight to Sunday morning, except waking every a few hours to apply eye drops.

Woke up on Sunday morning, the discomfort has significantly wearing off and I was managed to book a bus on my own, go to supermarket (at night, with sunglasses on, of course!) and function as usual. But still very sensitive to lights, so my room was dark the whole day again.

On the sixth day, I started feeling much better, and went back to office. Functional normally, though not seeing things at 100% clarify, I certainly don’t need glasses to read anymore. I also went back to Eagle eye center for one-week post operation check up, and according to the doctor, cells are growing back and recovery well, but it was hazy at the center of my eyes. The contact lens were removed on this day. Oh and the good news is that I can start washing my face normally again, which was such a relief.

On the seventh day, probably because the contact lens were just removed, I had hard time seeing things clear up close (and only when it’s close), everything was double and hazy, so I had to zoom in my computer screen to 150% and turn on accessibility feature on iPhone for extra large texts. It was not fun! But not a big issue on daily life, and I started going back to gym and normal workout (no issue at aiming while boxing, if you are wondering). Did my second check-up, everything seemed fine, and the doctor prescribed two eye drops for me to use daily: one to improve the clarity and one to control the eye pressure.

The blurriness continued for another week, and not going to lie, I freaked out couple of times, and worried something went wrong during the operation and/or recovery. But I was reassured it’s completely normal, as the new cells are growing back and the eyes need time to adjust, just like the DSLR lens, it needs to re-focus every time when you move subjects or camera, or the lighting changes even the slightest. I went to work, gym as usual, and watched TV and used phone as normal. Though, weirdly enough, there are certain moments, such as the first 10-15 minutes when I open my eyes in the morning, or late at night just before I go to sleep, my vision suddenly becomes extra sharp, and I can see things (both far and close) the clearest they have ever been in my life. I was hoping that’s the vision I will end up getting when I’m fully recovered, which suppose to be three months after operation – yes it’s long (!), because after all the cells regenerated, the surface of your cornea need more time to be smooth and even again.

Things continue to get better from this point on. At the 1 month mark, I already started having clear vision most of the times throughout the day, but the blurriness still come and go often. I visited my doctor as scheduled check-up, changed eye drops this time- I wasn’t responding that well to the eye drops I was initially prescribed to, which apparently caused higher than usual eye pressure – another reason I was having blurry vision.

After changing the eye drop, I did feel much faster recovery. Now I’m at the 2nd month mark, 90% of the time I’m having clear vision, eyes are less drying comparing to the beginning as well. The joy of being able to see everything without glasses is simply amazing! So yes, it certainly hasn’t been an easy peasy process for me, but I still think it’s well worth it – a few months of discomfort for years and years of clear vision? Sounds like a good deal to me!

I’ll update again in another month time, we shall see how my eyes progress and if they reach the (almost) perfect vision.

<Update on Oct 30, 2016>: Almost 9 months have passed since I did my Lasik, so I thought I should do a quick (long overdue) update here. In short, I have absolutely no regrets, and have kicked myself in the butt for not doing it earlier, as it truly is life changing – no more worry about forgetting to bring glasses to a movie, no more awkward moments when someone is waving at you and you are lost, and yes, no more discomfort wearing a pair of glasses when your face is slippery from sweat. My vision was stabilized at about 3-month mark, which is much longer than bladeless Lasik, but the benefits of blade lasik is that I haven’t felt any server dryness after the initial recovering period, which is a huge plus.

So, if any of you is on the debate of getting eye Lasik, I would say: Go for it, you will not regret!