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Fig 1. Pre-ReLex® SmILE Me

If you’re reading this, you’ve probably spent some time scouring the interwebs for more details to encourage you to get on this journey of **pErFeCT** eyesight and a lifetime without glasses.

And welcome!

Most of these posts usually start off with a sad personal background about how the authors became bespectacled because they spent their entire childhood with their heads buried in storybooks – I’m no different, but I’m trying to be a little more special with my introduction here.

My first exposure to the term “LASIK” came when my dad embarked on his own journey in 2006, when it still wasn’t that much of an “in” thing. He boasts two LASIK corrective surgeries per eye (honestly, not something to be extremely happy about) and what I remember most clearly from that period was him covering one eye and staring into the lush greenery from our balcony. During those days, patients were advised to perform surgery on one eye first (in the event of, you know, complications) and he was just constantly staring out of the balcony to my amusement. Anyway, his surgeries were successful (ultimately) and he enjoyed somewhat good vision until his cataracts and old flower eye came. But that’s a story for another day.

Anyway this blog post is about my journey doing ReLex® SmILE – not LASIK per se, because it’s a different technology but basically an option for laser eye surgery to correct myopia, astigmatism and hyperopia. For the sake of my sanity and yours, I’ll just loosely refer to this refractive surgery as LASIK.

Why?

Truth be told, I didn’t see myself doing LASIK (or its equivalent) anytime soon but I jumped the gun and did it last week in view of the COVID-19 situation… long story short, my clinical postings got cancelled and e-learning came into play. I thought to myself, if not now, then when?

I guess everyone has their own reasons for wanting to do refractive surgery, with most of them being non-urgent (please correct me if I’m wrong), so there’s always time to consider and ponder about the risks and the benefits. For me, this decision was really spontaneous but I still did my due research. (When my doctor asked, he said “By research, you mean research journals right? Not blogs where people write their own thing?” Oh the irony.)

Also some prerequisites that you should meet or else you should stop wasting time reading:

  • Above 18 years old
  • Not pregnant
  • No significant change of spectacle prescription over the past year

Keep in view significant past medical history and family history of eye diseases as well, if any!

Where?

I don’t have a good answer for this question, because I went with my gut feel. I didn’t really know any of my peers who did LASIK and a quick Google will reveal some of the big players in the field in Singapore. Ultimately, I decided on LSC Eye Clinic in Paragon Medical Centre. Don’t ask me why! Of course, given my only experience at LSC, I’m unable to do a comparison of other clinics also la. Feel free to continue hunting the internet for reviews – there are plenty!

One nice thing about LSC is that same-day surgery is an option, so chop chop!

How?

So I knew I wanted to do some sort of laser surgery to my eyes, but there are several existing options I could consider. Obviously, your ophthalmologist will/should explain to you these options in great detail and advise what surgery you’d be suitable for after the pre-assessment (and you should definitely heed their sound advice). But in this day and age, we all want to be accountable for our own decisions and hence, we’ll be doing our own reading up, which is exactly what you’re doing – this enthusiasm should be applauded!

For me, I knew I wanted to do ReLex® SmILE – this isn’t random caPitAliSaTiON, it stands for Refractive Lenticule Extraction Small Incision Lenticule Extraction.

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Fig 2. Here’s me inserting a picture of the technique I know you wouldn’t be reading.

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Fig 3. Attempt 2, basically just note the size of the wound (thick blue line). 

Here’s why I chose ReLex® SmILE over the other options:

  • Minimally invasive
  • Shorter procedure time
  • Shorter recovery time
  • No LASIK-like flap
  • Reduce post-surgery dry-eye discomfort
  • Supposedly less night vision issues (halos, starbursts, glares)

Just to share, I was about 500 degrees short-sighted and my astigmatism was around 150 degrees – in other words, completely non-functional without my glasses.

Moving on to my actual experience at LSC :-)

 

Pre-Assessment Before Surgery

It’ll be nice to make an appointment before popping by, but some things to note would be:

  • As much as possible, ask someone (whom you like) to accompany you – besides possibly being bored and having no lunch buddy, it’d be ideal if someone could take you home after the check-up (dilating eye drops can cause blurry vision) or the surgery (self-explanatory)
  • If you’d like surgery on the same day, give your hair a good rinse and your face a good wash as you may have to avoid water for 48 hours anywhere near your eyes (i.e. your hair and face)
  • The check-up may take up to 3 hours to complete and surgery typically takes place in the afternoon at around 2pm or later

The pre-surgery assessment basically includes doing the typical eye test (reading ‘em alphabets), going from machine to machine with kind + lovely optometrists and saying hello to the doctor to understand your options & to make a well-informed decision. Somewhere in between, eye drops would be given to dilate the pupils and this can cause some issues with vision – lights becoming too bright and near-vision being blurry. For some people, their pupils can dilate rather quickly but for others, a few drops may be required. Since we cannot control our pupillary dilation, let fate decide for you!

Anyway I was given free rein (p.s. not reign) to choose whichever options I wanted as I was eligible for them all, so I happily picked ReLex® SmILE! The only unpleasant thing about it is its cost, at $5k+ compared to $3k+ for LASIK, but given the pros I shared above… you cannot have your cake (i.e. perfect eyesight) and eat it too (you cannot eat your eyes… sorry pardon me).

I didn’t have many questions at all, but my mama, being a worrier, did. HAHA. I love my mama.

As spontaneously as this Lasik thing came about, we agreed to have the surgery in the afternoon – after a delicious lunch at Din Tai Fung. I love DTF, especially the crispy golden prawn pancakes.




 

Before the Surgery

There were some things I was worried about.

Basically every time after I eat, my stomach has the tendency to growl insanely and I was quite bothered by it, as I was sitting in the waiting area. It was pretty embarrassing but no one else seemed to react to the growling going on.

The helpful nurses will help you into disposable footwear (actually shoe covers in the operating theatres), gown (over your clothes, I don’t even know why my sister asked but I thought you may be curious), disposable hair net and of course, numbing eye drops.

Because my eye was widely dilated, I had to go through 3 rounds of eye drops to constrict my pupils which added 1.5h to my surgery start time, originally scheduled to be at 2pm. I spent my time listening to the classic Disney songs (piano version) that were humming softly on the speakers, as well as the next patient making calls to his company. I’m not sure if it was my fault his surgery got pushed back late as well, so I’m not going to comment further. HAHA.

Despite being a medical student myself, there was a nagging thought at the back of my head:

 

WHAT IF I GO BLIND?!

Happy to announce it didn’t happen, but do take note that legal blindness is an extremely extremely rare complication from laser eye surgery. 1 in 10,000 may suffer from an infection and blindness may result, but yeah, these are risks that must be talked about before the operation yes!

The lovely nurses will also explain to you your eyedrops dosing regime as well as some dos and don’ts.

During the Surgery

Basically I entered the OT… and came out… within a few minutes I believe.

I find things to be quite disorientating without my spectacles and I stepped in with extremely bad vision and stepped out with a hardly-improved one. Everything was blurry and misty – there was no immediate miracle!

Once you enter, you’ll be helped onto this cool table that swivels inwards – your job is just to look at the green light, hear “suction on”, remain as still as you can for 15s or so with the doctor gently cooing positive reinforcements like “very good! well done!” HAHA. There really isn’t much to do – I’m going to admit there will be some mild discomfort with the eyelid clamping device, you’ll experience a whiteout and you may feel some gentle prodding, but there’s nothing painful about it. It’ll be over before you know it! x2 the experience for both eyes, and you’ll be good to go after a quick slit-lamp examination within the OT.

 

After the Surgery

Like I said, no perfecto vision right after!

Once I got home, I took a tranquilliser (because I wanted to see what it felt like, not because I was in great discomfort) and fell asleep from 5pm all the way to 10am the next day.

Of course, I woke up in between… to brush my teeth but I promptly fell back asleep without eating anything at all hahaha it was nice sleeping in for so long. I felt sooo much better waking up the next day though.

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Fig 4. These are the actual 3M shades they give for free HAHA.

For me I didn’t really feel a need to wear them because I didn’t find light very glaring but I wore them anyway more for protection. If you have your own fashionable shades, feel free to wear them.

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Fig 5. A very unpretty way of sticking the protective eye shield – wear when you’re sleeping!

So post-op Day 1, I went for my review… and my vision was 6/7.5 – ideally the benchmark is 6/6 la but everything still looked quite blurry and misty, which was normal and to be expected post-surgery.

Apparently because my incision from ReLex® SmILE was so small, it sealed up nicely already and I didn’t exactly have to keep wearing the shields to sleep. The doctor also said that I could rub or poke my eyes and even wash my hair/face – just keep The Eyes closed!

Right now as I’m typing this, it’s Day 2 post-op.

I want to say I have the clearest vision in the world but that’s not true – objectively I can see 6/7.5 and objectively I can drive, but right now compared to the gold standard with glasses, things are still looking a little blurry.

It can take up to 2-3 months for my vision to stabilise – I’m not expecting a miracle, and its important to be patient and to wait for my eyes to heal!

My experience at LSC has been an amazing one to be honest, even though there really isn’t anything to compare to, but Dr E Tay was friendly and approachable + the staff members at LSC made everyone feel welcome and at ease. They also have a lovely machine that dispenses thick Milo so definitely seek comfort in that HAHAHA.

The clinic itself also looks very nice and pleasant, there’s really nothing to complain about!

If you’re trawling online for good reviews, I’ll recommend them :-)

Would also be updating this post subsequently.

I’m due for two more follow-up sessions – check out the LSCeye website here for pricing details!

At this point, would I say refractive surgery is life-changing?

I’m not so sure because it is definitely not a NEED need, but I don’t miss blindly reaching out for my glasses on the bedside table and wiping them excessively (because I 100% cannot stand dirty marks on my glasses – I have a microfibre cloth in all my bags for this purpose.)

Let me know if you’ve any questions – I’ll be happy to help answer some before you go for your own visit to the ophthalmologist :-)

The aim of this post is to share my genuine experience and not to sugar-coat the journey – do not expect clear crispy 6/6 vision immediately post-surgery.

As I’m typing this, my eyes are blurring and I can’t exactly see like I used to with spectacles – there’s like a cloud/thin mist in front of me and the words tend to blur a little. I think I need to rest my eyes HAHA.

Seey’all, hopefully in HD soon!

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Fig 6. Me post surgery but not feeling nearly as fabulous – hopefully so in a month!

P.S. Please pardon any errors, not feeling up for vetting my post at the moment ahaha.

 




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