IM SPENDING SO MUCH TIME AT MY WORKPLACE NOW. Dude, never thought I could walk into Minor so much over the summer. Just finished my visual testing for the research study this week (I can’t believe how difficult some visual tests are for me. Small 3D dots from 3 meters away and contrast testing are IMPOSSIBLE) and starting next week, I’m gonna be playing 3D video games 10 hrs/week :). I have a choice between a lot of okay-looking PS3 games….I’ll look through them next week.
Anyway, today was another epic shadowing day! Lots of LASIK surgeries and a PRK that I wasn’t able to finish watching because I had to run off to my visual testing :(
LASIK is a pretty awesome and pretty basic procedure. Not as invasive as a cataract surgery, but literally just as quick (15 minutes or so).
Here’s the surgery as I remember it:
- Patient talks to surgeon. Patient gets nerves out of the way by asking any last minute question, pops in a 5mg valium (I think?! I forgot. Dang memory.), closes eyes to let sedation run through body.
- Patient gets onto the LASIK surgery table. Pads cover the unoperated eye and ears, and patient has hairnet, booties and covers. Wait a few minutes to let sedation fully settle. Patient is not under LASIK machine yet.
- LASIK machine preps and calibrates by firing random lasers. Closest thing I can compare to the sound/color is like the gas stove sparks that happen right before the flames come on. In fact, it’s pretty much exactly like that. Purple color, spark sounds approximately 8 sparks per second ish. Pretty quick stuff.
- Doctor starts operation by sliding patient under the laser. The patient is told to stare up at the red light the entire time, so that pupil matches up with laser. Doctor preps by inserting numbing drops, followed by two clear tapes that pull up and down eyelids, followed by a speculum that holds the eyelids even farther apart and open for the remaining part of the operation.
- Doctor uses this vacuum thing which sucks the eyeball INTO THE SOCKET. This is kind of scary to see, but the doc kinda pushes down on the eyeball with a metal circular thing and then a vacuum is (somehow, though I haven’t quite figured out the physics of this yet) employed to fix the eyeball down so that it doesn’t move much. For the first patient I saw today, she panicked and said it hurt the entire time it happened. After the surgery, the doc said that pain and pressure usually result from anxiety during the operation.
- Doc puts ink marks on eye to mark edge of cornea, followed by a metal circular tool that has a hinge on it with which a microkeratome (mini slicing blade) can be attached onto it. Once doc makes sure that metal circular tool is aligned with the cornea, he swings microkeratome which slices a perfect circular thin film of cornea which he lifts up (though a portion isn’t sliced which serves as a hinge). This is called the “flap.”
- Patient is ready for the actual LASIK portion! But before that, he needs to check the interocular pressure. Doc reminds patient to stare at red light, and tests out the pressure of the eye. I think the ball park number was somewhere around 400 (WHAT UNITS. Gah! I don’t remember them).
- Doc looks through the microscope and starts laser surgery. Tells them to hold steady and to continue staring at the red light. A sponge q-tip is employed to keep eye in place as well as wipe away any blood from the initial keratome incision.
- FIRE AWAY!!Basically, the purple flashes start at like 8 flashes per second, and the operation is usually 30 seconds-1 minute for each eye. The worse your eye was (LASIK usually has a range of treating -12 to +5 eyes), the more laser fires needed and the longer the surgery was. It’s a spectacular sight to see, as the machine is SO precise and (funny enough) wisps of fumes go into the suction tube on the side of the microscope. I had always heard from a family friend that being in the room of a LASIK procedure smelled like roasted chicken. But, I guess since the fumes went into a tube that traveled to the depths of intergalactic space, I guess I wasn’t able to smell it. Besides, I had a mask on so it prevented it anyway.
- Once the flashes finish, all the doc has to do is put a bunch of drops of stuff in and carefully place the flap back onto the space on the eye. He goes onto other eye if needs to be operated on, otherwise patient goes into post-op room where he/she sees doc a few minutes after surgery.
- Doc checks up on them and uses a microscope to make sure that flaps are in precise place. If there seems to be a crease of some sort, doc gets a sponge q-tip with ophthalmic solution and smooths it out. Doc then gives patient goggles (hehe on one of the typed up procedures on the wall, it said “give patient googles”, which someone had crossed out and wrote goggles” hahahahaha. I thought it was hilarious). Tells patient to keep eyes closed as often as possible for the next 5 hours, and goggles day and night for next 5 days. Try not to rub the eye for ANYTHING.
PRKs are actually really simliar to LASIKs, but more invasive in that he tears the entire epithelium away and then does the LASIK surgery, then covers it with a large contact thing to help the eye heal. Designed for people with flatter or thin corneas, but longer recovery time.
Check up 1 day after just to make sure there aren’t any post-op immediate irritations, check up on day 4 to make sure that inflammations from any infections pop up (usually pop up on day 3-4), and several times afterward to check up.
Anyway, I ran off after the PRK to do my research eye study thing and then went to the lecture that my doc was teaching at Minor on complications of LASIK (how perfect! Right after I saw the LASIK surgeries too :D) for the 4th years. Got to sit next to some of the 4th years I got to know from last year and ask what their plans were for post-grad :D pretty cool! ^^
I also got to help out with the surgery by handling random vials to the doc and assistants that were helping him out today. Always feel so cool when either I put scrubs on or told to put gloves on so I can help out with something :P haha.
If anybody wants to watch a PRK or LASIK surgery, it’s actually REALLY easy. There’s a huge flat screen with the surgery in HD directed at the windows to allow family members observe from the hallway. Though you don’t have a doctor next to you explaining everything, you can literally stand there at the window like a nobody and just stare at the screen for several surgeries. I’m pretty sure no one at Minor would mind. Just let me know and I’ll let you know when the next surgeries are happening.