Eyeglass wearers try laser surgery Nearsighted welcome lens-free life

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It’s all about freedom, they say.

The Mainers who are paying more than $2,000 for laser surgery to correct nearsightedness believe the procedure frees them from a kind of bondage.

Those who have worn contact lenses or glasses and undergo the surgery welcome life without corrective lenses. After the surgery, they can wake up at 2:37 a.m. and read the digital clock to know that it is, in fact, 2:37 a.m. Or come home on a cold winter night and not need a defogger for their glasses. Or swim in a pool without fear of striking up a conversation with a floating beach ball, thinking it is a person.

Though the reasons may seem inconsequential, people with nearsightedness are glad to leave these limitations behind, now that they can.

A procedure known as Lasik, in which a laser is used to reshape the cornea to produce 20/40 sight or better, is now available in the Bangor area. One provider of the surgery has completed about 1,000 procedures in the past year or so.

Variations on the procedure have been available in the United States since the early 1990s, and even earlier in South America and Europe. As the technology improves, the procedure becomes more precise, with less margin for error than existed in the early days, when corneal tissue was removed and sutured back into place.

But even with the advances, those in the business of providing Lasik surgery make no bones about the risks.

Vision Care of Maine, the Bangor facility off Stillwater Avenue that boasts of having the latest in equipment, makes prospective patients watch a video on the procedure. The video notes that Lasik is not guaranteed to succeed; that some patients need further surgery to correct vision; that some patients have had their vision diminished by the procedure; and that long-term effects of Lasik are not known.

Vision Care also provides written information that suggests that people comfortable with glasses and contact lenses should think twice about pursuing the surgery.

According to the American Academy of Ophthalmology’s Web site, hundreds of thousands of people have had Lasik surgery, most successfully. It also notes that Lasik may not provide perfect vision and that the procedure is “too new to know if there are any long-term ill effects beyond five years after surgery.”

Despite the favorable odds, the procedure has its critics. A Web site called www.surgicaleyes.org acts as a clearinghouse for information for and about people whose Lasik surgeries have gone wrong. It contains horror stories from people who claim they continue to suffer from visual distortions such as seeing “starbursts” or halos around lights, blurring in parts of their field of vision, and even seeing double a year or more after the procedure.

But talk to those who have had the surgery and been able to toss their glasses and contacts into the trash, and the endorsements ring out.

Debbie O’Leary, 35, of Belfast began wearing glasses in seventh grade, then switched to contacts as a junior in high school.

O’Leary operates Bell the Cat, a cafe in Belfast. Working in artificially chilled air in the summer dried out her contacts, making them uncomfortable to wear.

“It got to the point where I couldn’t keep the things in my eyes,” she said.

When she switched back to glasses, she found that leaning over ovens and sinks made them slide down her nose.

In June, O’Leary had Lasik surgery at Eye Care Medical Group in Portland. She paid $2,900 for the procedure.

Hours after the surgery, she was able to go shopping and out to dinner. She stayed in an area hotel that night so she could return for the follow-up visit the next morning. At that day-after check-up, O’Leary was already seeing 20/40.

“It was a simple procedure,” O’Leary said. ‘The next day, I was working.”

A month later, she was seeing 20/15 – better than normal vision.

“I was pretty excited,” she said of the results. “I’ve told everybody to do it.”

There was no pain during the surgery, she said, though O’Leary experienced some side effects: She saw halos around lights at night in the first weeks. These symptoms usually disappear in a month or so.

Rob Laite, a police officer in Camden, went to Eye Care Medical Group in Portland for Lasik. Laite took advantage of an offer the business made to provide Lasik for free to the first 60 police officers in Maine who signed up. The business is offering the procedure at half-price to the next 250 police officers who ask.

“The big reason is for officer safety,” Laite, 43, said, explaining why he wanted Lasik. Since he suffers from severe astigmatism in one eye – the eye is more football-shaped than basketball-shaped – Laite was unable to wear contacts.

Wearing glasses while breaking up a barroom fight had proved to be a health hazard.

“Getting punched in the face with glasses is not real great,” he said. Entering a warm building from the cold and having his glasses fog up was also undesirable in responding to emergencies.

Laite had the surgery on Jan. 3, and earlier this month was still suffering some of the normal early recovery symptoms.

“It’s very light-sensitive,” he said, with bright lights creating starburst effects. He also was wearing a temporary contact lens over one eye.

But Laite said he is already excited about his new life, free of glasses.

“I’ve always wanted to wear cool sunglasses,” he said, jokingly. “Now I can. What a lifestyle change. I’d do it again in a second.”

Another Camden police officer, Tracy Weed, also had the corrective surgery.

When Mary June Smith’s Lasik was done, she sat up on the operating table, looked across the room and was able to read a clock – something that would have been impossible before.

“I just burst into tears,” she said, so happy was she about the results.

Smith, 51, of St. George, first learned of the surgery in the early 1990s on a visit to Spain, where she met a Korean woman who had just undergone the procedure.

“I was just astounded by this,” she said. Then, a friend’s daughter had Lasik surgery in Quebec City. “The day they came back, I called and made an appointment.”

Smith felt that in Canada, where the procedure had been available for years, the physicians were more experienced. And she said she paid just $1,000 in U.S. currency for both eyes.

The day after the surgery, last May, Smith was seeing 20/20. An added benefit for Smith was improved night vision, and less reliance on reading glasses.

At Vision Care of Maine in Bangor, patients are warned that Lasik is not yet approved by the U.S. Food and Drug Administration for correcting farsightedness – difficulty seeing things close at hand – but that some improvements may be achieved with Lasik.

On Feb. 2, Adam Corrigan, 30, of Thorndike agreed to let a reporter and photographer observe his Lasik at Vision Care of Maine. Corrigan is an employee of the Bangor Daily News.

A native of England, where the procedure has been available for years, Corrigan said he and his friends had long talked about having the surgery. Like many, he said, he was fed up with wearing contact lenses. He began wearing glasses at the age of 6, then switched to contacts at 15.

Most insurance companies do not cover the $2,400 fee, but Corrigan said that considering the cost of contact lenses over many years, he concluded that the expense was reasonable.

Dr. Mark Morin performed Corrigan’s surgery. He estimates he has done 700 procedures in the last year. Morin said Vision Care of Maine has the most advanced equipment north of New York City.

An orb scanner – the only one in Maine, Morin said – is used to measure the thickness of a patient’s cornea, alerting the surgeon to any thin spots.

As important as the equipment is, Morin stressed that the number and quality of his visits with patients before the surgery ensures success. Patients are carefully screened and their eyes evaluated more than once, so the right amount of tissue is removed.

Patients must be at least 20 years old, and even if they are of age, Morin said, before going forward with the surgery he makes sure their eyes are stabilized. That means the vision has deteriorated as much as it is likely to do so. Morin said 70 to 75 percent of Vision Care’s Lasik patients get 20/20 vision or better; 90-95 percent get 20/40 or better.

Corrigan begins his surgery visit with a Valium. It is given to him to relax him before the procedure.

In the procedure room, he sits in a reclining chair, as Morin positions the equipment over him with the help of two assistants.

Anesthetic eye drops numb his eyes and prevent blinking. A camera produces a close-up image of Corrigan’s eye on a large monitor just above the chair. With a black penlike device, Morin marks lines on Corrigan’s eyes, which will help him realign the cornea later.

A sheet of adhesive holds Corrigan’s eyelashes out of the way, and some wire clips hold the eyelids open.

“This is the only part of the surgery you’ll find uncomfortable,” Morin tells him.

A device that Morin likens to a plane – the tool that slides across a piece of wood, shaving a bit off – is used to slice across Corrigan’s cornea, though not all the way across. The device stops, creating a flap the thickness of a human hair that Morin lifts and folds over, all visible on the monitor.

The “plane” device is so precise, Morin said, “I can cut a red blood cell in five pieces.”

Corrigan then is asked to stare into the laser device, looking at a light. He must look directly at the light, or risk having the surgery go wrong. This is when the “cold” laser vaporizes the correct amount of corneal tissue. Something like smoke rises from Corrigan’s eye, and an odor like burning hair can be smelled.

The prescription called for the laser to work for 25 seconds. “That was the longest 25 seconds of your life,” Morin said to Corrigan. “Pretty much,” he replied.

The second eye called for 32 seconds of laser.

After the laser work, Morin uses a small tool to lift and place the flap of cornea back in place, lining up the marks he made earlier. There is no stitching required, though Corrigan will have to keep his eyes closed for 20 minutes after the operation, and must wear a special patch at night to prevent him from rubbing the eyes.

Forty-five minutes after the surgery – which lasted less than 30 minutes – Corrigan is in an examination room, and is able to read the 20/40 line on an eye chart. That’s good enough to drive in Maine without having to wear lenses.

“There’s not a great deal of discomfort,” Corrigan said after the surgery. “You don’t feel anything.”

The prognosis is good for Corrigan’s vision to improve over the next month.

Morin readily agreed that no one knows what the long-term effects will be for those getting Lasik.

Will it last? “Probably,” he said, because similar procedures used in other types of eye surgery have lasted.

The number of people having Lasik has doubled each year in the past few years, but Morin is forecasting 20 percent growth in 2001.