Electromechanical reshaping, an alternative to laser eye surgery

> [re: PRK] This regrowth can be ... rather painful

I'm here to tell everyone to listen to the doctor about pain medications and sleeping after PRK. I have a repeatedly-demonstrated very high tolerance for pain, and didn't bother to follow the directions.

As a result, I spent about an hour seriously considering whether it would hurt less if I physically scooped out my eyeballs by hand. That's not a metaphor -- I had to mentally restrain my hands.

And the punchline is that 12 years later I again need glasses for computer work, which is what I do all day.

> As the epithelium does regrow naturally however, [PRK] is less likely (both in theory and in medical literature) to lead to dry eye

This is exactly opposite to how I understood and experienced healing after Trans-PRK. My eyes are still very dry 6 months post surgery. Being at the upper limit of Trans-PRK yourself, did you actually go through with the surgery? If yes, how was your healing process? I would be very interested in chatting about it, since I am not particularly happy with mine, and wondering what can be done (and whom to blame).

This is why I decided to go with PRK. Recovery time is rough, but after a week I was able to go back to work as a programmer. Well worth it to avoid the complications of severing the nerves in my cornea.

I'm not candidate for LASIK or any other eye surgery due to the thinness of my cornea :( I would love to see this new approach. Maybe I'll be a candidate for it.

> SMILE... is severely more expensive

This is the first I've heard of this. In my area it seems comparable in price, within 1.5x the cost of LASIK. Considering how relatively cheap it is (a couple months' rent, or a fraction of the price of a car, to correct your vision for decades) I've never seen cost mentioned as reason to choose one over the other.

I saw a Japanese YouTuber talk about her ICL procedure. https://my.clevelandclinic.org/health/treatments/25050-impla...

She said a Collamer lens was inserted into her eye and the procedure was reversible. I assume this is also available in the US?

I had PRK. It took exactly 6 months to see clearly again. Wild experience. Glad I did it. Wouldn't necessarily recommend it.

There are also intrastromal corneal rings to correct myopia (but not astigmatism) -- in the US (Intacs) for -1 to -3 diopter, while in the EU they go up to -6. They're inserted though a small hole to surround the cornea, and they can be removed. So overall less effective than lasers, but also more safe (though much less common, so harder to find a high-traffic expert surgeon).

What does any of what you wrote have to do with not trusting this new technology?

How horrifying. I have lattice degeneration, which makes me very nervous. What were your 'wonky' symptoms?

Agreed, going from 20/10 vision to "I've given up trying to read small text 50m away" as I age over 40 doesn't affect my quality of life, but it doesn't help my self-esteem.

https://phys.org/news/2019-04-molecular-surgery-reshapes-tis...

Halos and glare at night are usually a sign that something in the eye is scattering light. Sometimes it’s just uncorrected prescription, but it can also come from things like dry eye, early cataracts, or the way the cornea focuses light. Glasses can’t always fix that because they only correct the main focusing errors, not the little imperfections that cause glare.

Contacts (especially the rigid or scleral kind) can sometimes smooth out those imperfections, but if you’re not interested in them, the next step is usually an eye exam to look for things like lens changes or surface dryness. Cataracts, even very early ones, are a common culprit for glare driving at night in the U.S.

Laser surgery can sometimes make halos worse, especially if someone already has them, so you’re right to be cautious. But it’s not the only option. Treating dry eye, using anti-reflective coatings on your glasses, or addressing cataracts (if present) can all help a lot.

In short: it’s not hopeless, but the “fix” depends on what’s causing the scatter in the first place. A detailed eye exam is the best way to pin that down.

Sounds like astigmatism, which I also have. I don't know if this procedure, unlike LASIK, can correct astigmatism. I know you said you weren't interested, but for me personally, wearing contacts (not glasses) completely fixes my astigmatism and makes it much easier to drive at night.

I think the word you're looking for is "astigmatism".

As in, you have this without any eye surgery? My dad had LASIK and that gave him 20/20 vision but also what he described as horrible halos around all lights at night, to a point where he really found it difficult to drive in the dark. He had it done about 15 years ago so I wonder if the state of the art has improved in that area.

There’s a current product that does simple mechanical remodeling: sleep with this chunky contact lens in and the next morning you see better. But it wears off in ten hours or less.

Yeah, but knowing the analagous name for lasik is 'slicing off your cornea then gluing it back on', this one is immediately more appealing.

I heard about this research six years ago and at the time it was called "molecular surgery".

i mean the competition is lasik, which sounds like beaming a laser into you eye, doesn't really sound safe either

As both Presbyopia and Cataracts come for us all, it is generally not advisable to do laser eye surgery once the former has set in. Both are a result of changes to the lens (and the ciliary muscles to some extend), so long term, a lens exchange, whether partially covered by (public) insurance as part of cataract surgery or as an expensive elective procedure is the only effective surgical option we have currently available.

That brings me to one of my personal pet peeves which is selling pensioners that qualify for cataract surgery on an expensive, but in fact identical but privately paid for IOL.

Same with selling some Myopic+Presbyopic person on laser eye surgery of any kind. At best you get a few short years out of the expense before it catches up with you or you tolerate mono, at worst you spend thousands to suddenly need reading glasses you didn't require before.

Course, if you are financially solid and Presbyopia is starting, getting a high quality lens exchange can be a very neat luxury, with the added benefit of not needing Cataract surgery later in life. Do note though that artificial lenses, while incredibly advanced, still cannot accommodate as well as the real deal as of now.

Have you tried being severely myopic to begin with? :D My presbyopia has kicked in surprisingly quickly (at a guess, 1.5 diopters over 2-3 years) but that just means I can look past my glasses at close things, like the opposite of your stereotypical half-moon reading glasses. Hey, I should make some of those out of an old pair...

Reshape as in grind down and fill? Or reshape as in all of them with braces?

LASIK is almost the same as grind down and fille, isn't it? In the sense that the lens is a new shape when it's over. We replace lenses too.

Braces are essentially forcing teeth into new positions mechanically. Once they're in those new positions, we glue on wires and wear retainers to keep them in place, often for the rest of our lives. This doesn't sound like a comfortable eye procedure.