Forget swing lessons, fast convertibles, and big houses in silicon valley. Geeks have found a new way they can spend money to become more cool: Lasik surgery. I had avoided lasik for awhile, because a friend of mine who worked for OrbTek said that I should avoid it. But when my housemate dawn got her eyes done over christmas, I decided to take a second look. At first, from the FDA statistics, it looked great. Then my parents invited me for dinner with a friend of theirs who'd had a terrible lasik experience. Her eyes no longer produce tears, so she can't do anything involving a lot of dust. She has bad night vision and poor color sensitivity - everything looks washed out. She pointed me at a website called Surgical Eyes, put up by people with similar horror stories.

Now, Lasik has become the most popular elective surgery in the US, with around a million people having it last year, so it is no surprise that there are some screwups. By all reports, the chance of a bad result is pretty low. The problem is that since vision is so crucially important to our lives, this is a low probability event with a highly negative weighting. The thing that struck me most when reading about bad experiences on the net was that almost all of them had one of two common threads: bad doctors or contraindications. Some people described lasik clinics where flunkies do all the testing and screening, and they only saw the doctor for the five minutes of the procedure. Others used phrases like "Lasik increased the number of floaters I had" (when floaters are a contraindication for the procedure).

Another thing I found interesting was that some of the negative results attributed to lasik are halos and starbursts at night (as in this picture). I found these phenomena quite familiar, as I've always had them, and in fact was quite surprised (having never seen through any eyes but my own) to realize that some people don't see halos and starbursts around lights at night! I can see how they would be a bit distracting, especially to someone who wasn't used to them, but I haven't found them debilitating in any way.

It turns out that my parents friend had abnormally dry eyes beforehand, but hadn't really realized it. Lasik, since it severs nerves, tends to reduce tearing, especially during healing. Her eyes had been dry while healing, which was probably a significant contributor to her poor results. My conclusion, after reading through the data, was that Lasik is a reasonably safe procedure for those with no contraindications. However, because Lasik is so profitable and usually works out well, doctors sometimes do a poor job of screening candidates, and people get the procedure who shouldn't. Also post-operative care for those with complications tends to be poor, since (as the site puts it), it is so much more profitable to find new patients than to treat old ones.

After all this research, I decided to go through with it, one eye at a time to reduce the risk. My left eye has a much higher prescription (-4.75 as opposed to -1.75), so I had it done first. While my vision improved dramatically, to better than my uncorrected right eye, it was still significantly worse than my corrected right eye. This is probably due to undercorrection - since there is some variance in the result of the laser (especially for high prescriptions), they tend to program the lasers to undershoot, since you can redo but you can't undo. It was interesting to compare the two eyes. I didn't notice any loss of contrast sensitivity. My halos seemed to be slightly worse, although that could just have been from the remaining myopia. Last week I had the right eye done, and I am thrilled with the results. My vision is perfectly sharp, and while the halos are also a little worse they aren't too bad. In a few months when my eyes are healed, I should be able to get the left eye touched up.

I must admit that part of what appealed to me about lasik was the aspect of self-reinvention, of choosing not to be limited by the weaknesses of ones birth. Its kinda the same reason I have a tattoo and a piercing, except functional instead of merely decorative. And while, as Amanda put it, I will soon become so used to clear vision that I will forget about the surgery, for now it is profoundly satisfying.

If you are looking for a good lasik doctor, there is a screening organization called the Council for Refractive Surgery Quality Assurance.

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