The eyes have it

Today is the second anniversary of my refractive surgery.

I'd been considering laser surgery for some time, being a long-term wearer of contact lenses. I eventually summoned up the courage. I looked at several websites and had numerous conversations with Dubai clinics offering the service before selecting Gulf Eye Centre . Following a detailed eye examination, Dr Grim (eek!) suggested that I might consider Intacs as an alternative to laser surgery, and this is what I eventually did.

Intacs are for practical purposes surgically fitted contact lenses. The primary advantages of Intacs over Lasik are that the centre of the cornea (where most high-resolution eyesight is concentrated) remains untouched by the surgery, and the surgical procedure is reversible. I am assured that if my prescription changes or I get fed up of carrying bits of plastic in my eyes, the inserts can be pulled out by having a surgeon grab one end with a very small hook and gently pull...

I shall not go into details of the surgical procedure here. Perfectly normal people can become physically upset when confronted by graphic descriptions involving sharp objects and eyeballs. Local anaesthetic too, so I remember every part of the procedure. The surgery is relatively painless, for a given value of relative. There is definitely some discomfort. The pain comes over the following three or so days, after the topical local anaesthetic has worn off. All light feels like red-hot pokers and waking up in the morning feels like someone has spent all night polishing your eyes with wire wool.

But it does get better, and the improvement in vision is immediate. Gulf Eye Centre includes after-care in the surgery costs. This comprises weekly, monthly and quarterly inspections for up to a year. I now have better than 20-20 in one eye, approaching 20-16 in the other, and my astigmatism has vanished completely. I was initially faintly disappointed. Having got used to 20 16 in both eyes when corrected with glasses my new eyesight wasn't quite as good.

For clarification, having 20-16 means that you can see from 20 feet away what a hypothetical normal person needs to be 16 feet away to see. Birds of prey apparently have something like 200-20 vision, which is bad news for small rodents.


Two years on...

The good bits

I haven't had to wear any form of prescription lens for two years now, and I have no use for all the potions and other contact lens paraphernalia. There is no need to haul a shoe-box of eye stuff every time I go abroad or even camping.

No more 'grit under the contact lens' syndrome.

No more headaches caused by ill-fitting spectacles.

The sunglasses of choice, instead of being limited by the prescription.

I can see when I first wake up, and everything is in focus in the shower, swimming pool, water flume park and while scuba diving.

The bad bits

In low light, when my pupils open wide, I get haloes around points of light. This is only an issue when looking at the exit signs in the cinema and looking at my digital watch at three in the morning. The haloes were initially quite disturbing, but have mostly disappeared. Apparently the brain learns to switch them off.

One of the effects of the surgery is to upset tear formation. Dr Grim prescribed lubricating gel which was definitely necessary for the first couple of months.

Tiny salt crystals form around the inserts in the minuscule amount of fluid between the cornea and the plastic itself. This makes the insert a little more visible than officially advertised, but you still need to be less than a foot away to see them.

The inserts can't normally be felt, but an accidental poke in the eye is excruciating. I imagine a deliberate one would be too.

I had to buy a new diving mask: one with plain glass.

Advice?

If you're going to get it done, do both eyes together and live with the pain. If you only do one eye, you'll be very reluctant to go back later for a second session.

Ensure the optical practice includes after-care. Do not be tempted to go abroad for a 'fit and forget' procedure.

Intacs can't help long-sightedness, big myopia or large astigmatism.

My total bill came to US$1230 for both eyes. It is theoretially a one-off lifetime payment. If this seems expensive, consider how many pairs of prescription spectacles that buys, how many packets of contact lenses, how many pints of saline solution, wetting agents, hydrogen peroxide, and so on. I can't put a number on the added value of convenience.

If I'd been able to afford it and Intacs had been available, I would have had the procedure done ten or more years ago.