St Thomas’ Hospital

I had LASEK in my left eye on Friday 6th December. I Selected Dr D. O'Brart for his expertise. When I keyed his name in Google I found several pages of references to his publications etc...He IS a top Surgeon. As I had deep concerns regarding LASIK and the cut of the flap (with its never ending list of complications) I selected LASEK which seems a much safer method as there is no cut of the cornea, therefore not much that can go wrong. I was told during the preliminary consultation that the chances of a nasty complication was 1 in 5000: I was confident with that level of risk. the results are as good as LASIK, and for me better as my pupils are every wide, less risk of halo with LASEK as the surgeon will treat a wider area in such case.... The surgery was dreadful! Not painful but the cut of the Epithelium layer took much longer than I expected and you can see everything! Very impressive! The laser bit was over very quickly. I spent the rest of the day and Saturday laying in bed in the dark. My eye was very sore and I couldn't keep it open more than few seconds. It improved a bit on Sunday and I managed by the afternoon to watch a bit TV. My advice is : Stock on those recorded books, as it gets boring! I was in quite a lot of pain, but the surgeon warned me of this as I was very nervous during the surgery, and apparently the more nervous the more pain after! On Monday I went to the Hospital to get the bandage contact lens removed and my eye checked. The surgeon was very pleased with the result so far. My vision went very blurry once the lens was out. By end of the day my upper eye lid started to feel sore, as if I had some grid in my eye all the time. I went back to work on Tuesday for half day. My vision improved a lot by then but still blurry. On Wednesday I started to worry about the pain in my eye lid and I phoned Liz (Dr O'Brart wife) who called him. I went to see him at lunch time in his Harley street consultation where he checked that all was fine. Apparently the pain is due to the surface of the eye which is still healing and not smooth, causing pain every time I blink! Not much to do....it could last up to 2 weeks! :-( I'm seeing him again tomorrow evening for a check up.

Several months on and my eyesight is excellent. I still have very minor night vision disturbances, but remain absolutely delighted with the outcome of my operations. I would recommend Mr. O'Brart to anyone who is thinking of having laser eye surgery.

I decided to have corrective surgery this year as I was no longer able to wear contact lens, due to a new job and terrible air conditioning. My sight at that point was –2.00 in both eyes so fairly mild. My initial research pushed me towards the LASIK procedure which seemed very quick and convenient. However, I then found this excellent site, and some others, which raised some doubts. The more I read about peoples’ experiences the more doubt I had. Eventually I discarded LASIK as an option and decided on LASEK which seemed to have the best of both worlds. The next decision was where to have it done. As I figured eyesight was pretty important I decided to forget the issue of price completely and think only of who would do the best job. Along with this I wanted someone who had wide experience and knowledge and not just able to perform a procedure. After looking at all the options I had no doubt that David O’Brart at St Thomas’s would be the best person. I had my first consultation and was more than pleased with my decision. David’s knowledge on all matters to do with eyes was very reassuring. He also seemed to have genuine enthusiasm for his chosen field as well which always inspires confidence, in me at least. Now if only I could find a Plumber like that…. My first eye was booked in for May 2002. I was not particularly nervous on the day of the procedure. It was fairly quick and there was no real discomfort. It was actually a very weird experience and although I wouldn’t say enjoyable, certainly interesting. It was completed late afternoon and by the time I was home the pain had set in. Not really that bad and in fact nowhere near previous experiences of waking up with a hangover and a, forgotten, lens still in. The following day I had one painkiller dose in the morning which turned out to be my last. The next few days before my return to the hospital were OK except for the discomfort of the bandage lens. The hospital return went well and my eye had already improved. Over the next few weeks it improved dramatically to near what it is now. As I had a low’ish prescription I found that there was no real need for glasses/lens after the first week. It was now just a case of when I could fit the next one in which turned out to be August 2002. A month before my second eye was due, I began to experience a few problems with it (this is my uncorrected eye!). I was waking up in the middle of the night with bad pain and lots of water streaming out of it. This happened a couple of times before I was due back at St Thomas’s. In view of this I was somewhat unsure of having the procedure done. Once again, choosing someone with in depth knowledge paid off as David recognised the condition I had immediately. Luckily for me, one of the cures for my ailment was based on laser surgery and hence the procedure would in fact solve both problems. A bargain! The second eye procedure was a slightly different experience. It seemed like I could feel a lot more of what was going on and the procedure seemed to take a bit longer. There was still no pain though and I suspect that a certain amount of it was psychological as it didn’t feel like the anaesthetic drops were as strong . I did feel a bit sick and had to have an extended lay on the table. When I returned home that day the pain was worse but still controllable through the tablets. It did take about 8 doses over the next few days but at no time did I feel the need to use the aesthetic drops. It has now been a couple of months since my second eye and I have just had a check up. Everything is great and I am now 0 in one and +0.25 in the other. Eyesight is excellent and the ghosting I experienced for a few weeks after each one has gone. I am not aware of any problems with night vision. Having perfect eyesight after 17 years (I am now 37) is truly amazing. It’s certainly money well spent and if you are going to go for this I highly recommend David O’Brart at St Thomas’s.

Continuing on from my earlier dramas.... Friday 13th September came ... but we decided to leave the correction of the aborted left eye for another couple of months as the scan showed that "filling in" of the erroneous ablations was still taking place. Concerning my left eye, it is now back to it´s original -9.00 state (Yippee!!). So ... rather than waste the appointment, we went for LASEK on the -9.00 right eye instead. We used the same laser as before even though David had just taken delivery of a new wave front machine (which is almost portable would you believe). The weekend following the op was quite painful even though the epithelial flap was undamaged and successfully replaced I had to force myself to go easy on the anaesthetic drops so as not to interfere with the steroid action.It was like having a piece of grit in your eye ... but you couldn´t touch it.I have to say though that after 25 years of wearing contact lens, my eye was more rebelling against the surgical lens rather than anything else.Notwithstanding that, vision even at the earlier stages looked promising. The check-up a week later showed an over-correction to +2.00 ish. This was within David´s calculations. The eye looked physically good, which is perhaps more important. I went back last week and the eye had moved to +1.25 ish. David reckons it needs another month or two to settle to it´s final resting point. But hey .... I can do general day to day stuff (except drive and read PC screens) with this new eye without having to put a corrective lens in the left. And those of you coming from -9,00 or thereabouts will know that this is truly magical. Plan now is to get the right to a stage where I can see a car numberplate from 25 yards before attacking the left again. It´s all looking good at the moment. I´ll keep you posted.

I have just had my first eye treated with the LASEK procedure by David O'Brart and I was so surprised I could see better straight after the operation but my sight did go blury after a while and I am now slowing getting clearer vision. There was slight pain in the first 24 hours but after that the bandage lens I had in my eye, just left me feeling like I had grit in my eye, but once that was removed it was fine. I am now looking forward to having the other eye done. I would certainly recommend Mr O'Brart.

I had my first eye LASEK'd by Dr David O'Brart on August 31st 2001 and the other eye done on 1st March 2002. It was a long time between having my eyes done because I had various holidays and things already arranged. Upon reflection I wish I would of had the second eye done sooner! I would definately recommend David, he explains everything to the minutist detail and the operation is quick and painless. I myself had very little pain afterwards, more like what I would call a 'mild stinging' for 36 hours (like conjunctivitus). I am extremely pleased with the outcome. Before the operation I was: Left eye: -1.25 Right Eye: -1.25 (6/15 on the snellen eye chart) After the operation I am: Left eye: 0 Right eye: 0 (I can now read 6/5 on the snellen eye chart, better than the average person). I also had astigmatism in both eyes. I have still have a very small amount in my left eye, but hardly enough to notice. I have no side effects such as ghosting, halos etc, these soon disappeared within a few weeks after the operation. My pupils are 7mm dialated. My girlfriend goes in for her first eye to be LASEK'd next Friday. I will make sure she lets you all know how she gets on!

Well it has been 1 year now since I had my left eye done and 6 months for my right eye. Having read some of the problems other people on this site have had, I can honestly say how happy and grateful I am for the success results of my operations. My right eye which was approx (-1.5) is now perfect and its as though there was no treatment on it. My left eye was (-3.5), 1 year on the vision is perfect in daylight. No dryness or any other complications. At night, in very dark conditions, my left eye tends to dilate and this can cause slight eye strain and halos around rear car lights. But generally the halos are reduced when using both eyes. Its only when I use my LEFT eye on its own when halos are significant. As soon as I use both eyes, the halos pretty much go. This is not a major factor anyway as I am right eye dominant. Overall, very pleased with the outcome and now just need to book and appt with Mr O'Brart for that 6 month check up!

My wife wanted Mr O’Brarts phone number to go and see him, so I looked it up from this site. I then read my reports from now over 1 year ago! So how have I got on? Well I haven’t done eye number 2 yet. The dryness I used to get is now much much better, but I do still get some dryness, although now I find a little moisture and all is fine. I have not had the rush to the bathroom for tap water whilst in pain for well over 6 months, so that is now behind me. The night vision is now perfect. The brain has now compensated perfectly. So why haven’t I done eye number 2? Well I now have 20/20 vision, so why risk the operational risk. So I am content to stay where I am. A year on I have 20/20 vision, don’t wear glasses, and have no trouble with my night vision. A very small amount of dry eye, which I believe will completely go over time is a fantastic result.

Now here’s something different - and you might be wondering why I´m posting a score of 5 when ..... Anyway, read on.
As noted earlier on this website (PS glad that Ariana had the courage to migrate) I went for LASEK on the left eye on 14th June. The eye was anaesthetised, alcohol solution applied and the epithelial layer carefully pulled back. David O´Brart placed me under the laser and the zapping started. David had informed me that the operation would take about 30 seconds ... so I was surprised when he shut down the laser after about 5 seconds. He then said those words which none of us want to hear under these particular circumstances "We have a problem. I´m aborting the procedure as it´s not safe to continue".
Bloody hell! David guided me back into the waiting room and informed his waiting patients that they should go home as there was a problem with the laser.
David apologised profusely and was totally perplexed. Apparently, after about 3000 safe operations - and 4 to 5 of those immediately before mine (they were subsequently checked out and are fine) - the laser, despite it’s multiple fail safes, decided to misalign of it’s own accord DURING the operation. Now, remember what I said in my first posting to this website - my Rolls Royce analogy on man v machine. So there I am, under the laser, and David notices (percentage by luck, but largely through experience I would guess) some "fluorescent flashing" on the masking which is laid over the eye. Now THAT shouldn’t have been happening
So, what happened next!
Concerning the laser, technicians were called - and were equally baffled. The only conclusion they could come to was that the machine had received a heavy knock - and we are talking about a substantial knock here. Trouble is, no-one can think how this could have happened. Certainly neither David nor I had done anything of the kind. I am informed the machine is back in use and is working 100%.
Concerning my eye ..... At the time it was too early for David to assess what damage - if any - might have been done to the eye. His advice to me was to leave the eye open and unprotected by the normally applied surgical contact lens. He told me it would be very painful but it would be the safest course and he would see me again on the Monday. Well, pain was not an apt description. I needed knock out tablets to get me through the night and during the day I had no choice but to over-prescribe myself on anaesthetic eye drops which would give relief for up to 30 minutes at a time. No joking, it was like having a huge piece of grit under the eyelid and not being able to touch the eye in any way. The pain lasted the full three days - and then diminished rapidly thereafter as the epithelial layer started to repair itself.
Results .... For four weeks after the op I was experiencing two disturbing side effects. Firstly, you’d be looking at lines (say, in the road) and they would double up and separate with distance - although the image would be weaker than the actual line. And then there was the doubling up of all images - especially disturbing at night with lights. All cars had four stoplights - plus halo effects.
I have to admit I was worried up until very recently. Over the past week the double imaging is much reduced and my eye seems to have settled to within, say, 10% of the original starting prescription. I have seen David about 4 times since the operation and at all times he has been attentive - even calling me a few times to see how I was over that first weekend. (He was just as upset as me about the whole episode. Quote "My patients come to me and expect to leave in a better state - not worse").
I delayed this follow up report until today because I was in England last week and took the opportunity to have some further scans on the eye. Looking at the scans, it appears that the laser was aiming a fraction of a millimetre above the targeted area - and you can quite clearly see that the area of ablation was still in the process of "filling in". This means that there is still a little improvement to come and this will hopefully get me back to within a couple of percent of where I was before all this started.
Next steps ..... David has been looking at some new wave guide (?) lasers in Germany and I understand he’ll be using these in the future. I had already expressed a lack of confidence in his current kit and we originally mused over the idea that I would be put under the new technology. However, we have decided that it would be far better to continue the treatment under the current machine as we know exactly where we have left off and what we have to do to finish the job- we didn’t really want to introduce other variables.
We have also agreed that the left eye would be re-zapped on ..... yes .... Friday 13th September. Foolish or what?.
In summary then, I’m really glad I went for a someone of David’s calibre. I am convinced that as machinery can and does go wrong, you really do need an expert to spot that fact very quickly indeed. I am also lucky, I suppose, in that I chose LASEK. With LASIK, the cornea would have been sliced and the damage would have been done inside the cornea, thus requiring further cutting on the same lines in three months time. All other aspects of the operation went fine. David got a "really nice" edge on the epithelial layer and he was able to return it with very little loss. I had no dry eye, I had no other after effects.
Lessons to be learnt...... 1. Machines can cock up. 2. Get the best man for the job. 3. If at first you don´t succeed.....
I´ll keep you posted but it’ll be all quiet for a while until after I’ve had my second op.

I´m 45 and have always lived with -8.00 in both eyes. Over the past few years my eyes have become lass and less happy with prolonged use of contact lenses (soft, daily replacements) especially as I live in Madrid where absolutely everybody smokes the most repulsive cigarettes you could possibly imagine, the fumes not only sticking to your clothes but also, seemingly, coating your contact lenses.

I am very physically active (any Hashers out there) and I have finally decided to take the plunge. I am a very cautious person by nature and I spent a few weeks trawling various web sites and I came across Ariana´s pages which I have to say are excellent from the point of view of setting one off in particular directions of research. In the end I came to the following conclusions.

Firstly, I would not have the op done in Spain. My Spanish is good but I didn´t want a single word of misunderstanding between myself and the surgeon. I would therefore go back to England for the procedure. Secondly, and particularly in the US web sites, I was beginning to see more and more clinics writing about the "new improved" PRK procedure known as LASEK - with an "e". I must say that when I first saw LASEK in print (on this website actually) I thought it was a spelling mistake. But it´s not. I won´t get technical here but basically the LASEK procedure does not involve slicing the cornea - which is good because it is exactly this part of the procedure that introduces most of the risks of corrective surgery. Instead, the cornea is zapped on it´s surface. It is similar to the tried and trusted PRK procedure as I have said but the main difference is that the epithelial layer which runs over the cornea is "lifted" but then placed back over the zapped cornea. The result is that there is less post-surgery pain than before and with the use of the more modern lasers and with new "bandage lenses", LASEK seems to be now coming into favour. OK, so my mind is made up about LASEK - but who does it?

Step forward David O´Brart MD, FRCS, FRCOphth whose specialist interests are Refractive, Cataract and & Corneal Surgery. All the websites recommend that you investigate your surgeons. Even the best laser equipment in the World can cock-up in a big way if in the hands of an idiot. Just because you have a Rolls Royce doesn´t mean that you are automatically a good driver - you can still cause a lot of damage.

I chose David because of his deep general knowledge of the eye. It also transpires that he takes on cases where people have had bad corrective surgery. He didn´t seem to me to be a "machine operator" - he seemed to know the biology and physics of the eye. He also offered both LASIK and LASEK and I thought that he would be more likely to guide me to the correct process whereas other clincs would only offer you the one.
In addition, he himself did the tests and he himself would do the surgery.

And so it was that I phoned his assistant to make an appointment. Liz - his wife - gave me the low-down on David and, funny, but I felt I was talking to normal people Do you know what I mean?.I made an appointment to see David on Monday 22nd April for a consultation.

The day came and I must have asked David 100 questions. He took time to answer them all in a very non-technical way, which was very good. He made it clear that the best operation was no operation and that nothing could really beat glasses from the point of view of risk.

In the end we agreed on LASEK. a) because of my -8.00 eyes and b) because the risk of cutting the cornea is not present. I got the distinct feeling the David is sold on not cutting corneas if that can be helped. He should know. Another thing that "sold" me on LASEK is that it´s PRK ancestry has 12 years of post-operative statistics to back it up. And LASIK??? About 2 years. Well ....!

So here I am, writing this introduction to what is sure to be an interesting journey. I have my first operation - one eye at the time, as recommended by the expert - on June 14th. If all goes well the right eye will be done 3 months later. David will keep close track of my op because he is an academic and he also keeps meticulous records for subsequent publication. Another good point I feel.

I´ll keep this column informed of my progress.