42 replies to this topic

[Espress0]

About a year ago there was a great discussion on the topic of laser eye surgery.  I'm seriously looking at getting the procedure done, and the industry seems to have progressed quickly since the previous thread dried up, so I thought I'd reopen the discussion.

My main reasn for this is that I have consulted multiple practices, and recieved different advice.  One thinks I'm fine for Lasik (cut a flap), the other has suggested ASLA (slide a flap).  When I questioned why ASLA, they said that 2 years ago they would have suggested Lasik, but due to the shape of my cornea - not the thickness of the epithelium (eye covering) - Lasik is not suitable.

The difference between the two tests? The Lasik clinic took about 15 mins and the tests were conducted by an unqualified practitioner. More of a sales rep.  the ASLA suggestion came after 90 mins of testing from an optometrist and far moremodern equipment.

Due to the fact that the industry is entirely unregulated, such a difference is frightening.  

I am close to moving forward, however I'm going to get another test from the second clinic, as I want an exact repeat of the test results before moving forward.

All of my firends and colleagues who have had LASIK, PRK or ASLA have loved the results.  I'm sick of carrying multiple sets of glasses everywhere, getting dry eyes from contacts, having contacts fall out in the surf or even slide behind my eye!  

Has anyone had the procedure or considering it?  Have you experienced the vast difference in clinical practices as I have?

[Ellie80]

I only went to one place which was the one that I researched and found to be most reputable looking (of course you never know). In particular the surgeon had a great deal of experience which was comforting. I had a raft of tests and they told me I needed ASLA, the reason being that my corneas were not uniformly thick enough to support the flap and that in future I would be in trouble if I got any cornea trauma or needed an update to the surgery.

I was happy with this explanation and would be asking the place who said to go for LASIK whether they can guarantee that it won't be an issue if you have issues with your eyes in the future, in terms of limited the surgery you could have (not necessarily vision related but general eye sight). The ASLA seems like the conservative option almost? And I am happy to be conservative when it comes to my eyes! The ASLA is more painful and a longer recovery - but I think my results were as good as LASIK would be.

[Espress0]

I too am happy to take the conservative approach when it comes to elective surgery on anything!

My main concern is the inbalance of infomation which is available, and the differing levels of expertise out there.  That said, I carefully researched the clinics and I'm comfortable with the ASLA clinic.

While I'm close to a decision, I am still in the decision making phase, amd have found a good site to help answer questions on possible post op issues http://www.visionsurgeryrehab.org.  It seems to be as weighted toward the warnings as the clinics are on the benefits, so in the end I guess we're left to take it all in and make up our own minds.

[Esstarr]

I've been meaning to post on the other Laser Eye Surgery thread for a while to update my experience. I'll post here instead, as this one has come up. I had ASLA one month ago. I went to the very reputable Sydney Eye Institute and Dr Sutton performed the operation. It took me about 7 months to make the decision to do it. I really weighed up the costs/benefits/risks. I was borderline suitable for LASIK, but opted for ASLA as it was the safer option. I was prepared for the longer recovery, and my partner took one week off work to look after me and the kids (6 & 3). The procedure was fine. Quick, not painful. The recovery however did turn my world up-side-down. The post-op drugs did not agree with me, and I found it VERY confronting not to have good eyesight for nearly 3 weeks. These side effects became a catalyst to an episode of major depression (never experienced it before). My partner ended up taking 3 weeks off work to care for me (I was non-functional) and the children. I also did not run for 4 weeks (another catalyst to depressive episode).

However, at exactly the 3 week mark, my eyesight finally settled to 20/20 and I started walking and going to the gym again. So my mood started to improve. I have now run a few times, my partner is back at work, my eyes are good and I am functioning well. I'm still following up the depression episode with my GP however. I'm a little concerned, never want to go there again.

I am now taking pleasure in not having glasses. A few experiences of note are: not getting drops on my lenses in the rain, being able to do floor work at the gym without have to worry about my glasses, not swiping people on the face when I kiss them hello, mucking around with the kids without hurting them, me or the glasses, and going in & outdoors without having to swap sunnies for regular glasses.

In the long run I will love it. No one was prepared for such a crash & terrible recovery though. So this is something to consider.

Cheers, Es

[ladyjove]

Espress0, on Sep 16 2008, 09:57 AM, said:

When I questioned why ASLA, they said that 2 years ago they would have suggested Lasik, but due to the shape of my cornea - not the thickness of the epithelium (eye covering) - Lasik is not suitable.

Different clinics will have different standards as to what constitutes a pre-op patient that may be at risk of post-op complications such as corneal ectasia/keretoconus. These standards may keep changing as technology develops, and they vary from surgeon to surgeon. It also depends on what equipment they have - eg. if they do lasik but do not have intralase (which can cut a flap very thin, precise shape and thickness) but can only do it with the blade they can't do the operation, whereas another clinic with intralase can do it easily and safely.

BTW the thickness of the epithelium does not matter, the thickness and shape of the cornea is what matters. Unlike the cornea, the epithelium does not provide the eye with any structural stability, and after ASLA or other surface procedures it grows back how it was. It is like the skins epithilium, if you get a light graze the top of the skin it grows back without scarring.

see: Corneal topography
Knowledge of corneal topography essential for LASIK screening

Espress0, on Sep 16 2008, 09:57 AM, said:

The difference between the two tests? The Lasik clinic took about 15 mins and the tests were conducted by an unqualified practitioner. More of a sales rep.  the ASLA suggestion came after 90 mins of testing from an optometrist and far moremodern equipment.

Due to the fact that the industry is entirely unregulated, such a difference is frightening.  

Yeah I found the same thing. Hence why I always tell people to go to a few clinics to get a feel for them and go for one you feel most comfortable. There are what I call 'chain' clinics, and other more independant clinics that are usually owned and operated locally by the surgeons themselves.

You will find the 'chain' clinic will eventually do a lot more tests, by the surgeon in the pre-op consultation on the day of the surgery. And if you just want them to just do the tests and have a chance to chat with the surgeon you will not get this consultation for free - I think I paid $50 - $100, which is 'refunded' if you go through with surgery. I also found they are less flexible and tend to want to do the same procedure on everyone. Eg. one surgeon I spoke to (that I didn't end up going to) does lasik with ultrathin intralase (100 micron flap) on 90% of his patients. If I were to choose that procedure I probably would have gone with him because he would be very experienced at it! The chain clinics get more patients through the door, hence are more profitable, hence usually can afford to have the latest whizz bang technology, glossy brochures, celebrity endorsements etc.

[Gadfly]

Nothing can beat doing your own research and looking around until you personally are comfortable wit the clinic/procedure...but could I also add that I would be looking for a practice where the person who performs the laser surgery has seen you beforehand.  

I know there are some clinics out there that have fully qualified staff doing all the pre tests and measurements...and then another person comes in to perform the laser on certain days and then back into the hands of the other staff.  

I'm not saying this doesn't work, but I know I would feel more comfortable knowing that the procedure was performed by someone I had met and would 'follow through' with my care also.

It certainly is a big growth area and the choices are huge...

[wobbly man]

(For what its worth) I took a year from the first tests to getting mine done and went through all the tests a second time - I guess I am a little cautious.  I used Noel Appins in Cheltenham who I felt was very very thorough.  After the juniors had done all the initial measurements and tests he re-did a number of them to verify the work. Your prescription MUST be stable before getting the procedure done.

I'm VERY happy with my results (better than 20/20) and just wish I had the money to get it done earlier in life.  It took me about a year to stop trying to take my glasses off when going to bed.

[Espress0]

Thanks for the posts.

An update form my end: I've been back a few times to get the tests re-done (I wanted exact repeats) and have also met the surgeon.  On top of that, I've trundled through multiple disater stories, success stories and as many stats as I could find.  Like Esstarr, I'm able to get LAsik or ASLA, but I've chosen ASLA based on the lower degree of short and long term risk.  I seriously hope my recovery is not as disaterous as yours though Esstarr, I'm glad to hear that things have settled for you.

I've read that depression is a common side effect for patients who have had issues - mainly battling with the fact that they out themselves into the situation they are in.  

All I can say is that I'm comfortable with the clinic I have chosen (Vista Eyes in Elsternwick - Dr Wolfe).  To date they have been excellent, and I haven;t shown them an $$, so it;s a good start.  Their equipment is current (wavefront, intralase etc.) and my risk profile is about as low as I could hope for.

So - this Friday I'm in!  It will mean not seeing the Grand Final, but the Bombers aren;t in anyway!  I'll definately be opting for a sedative, as I'm sure I'll be sh!tt!ng myself...  Can't wait to get rid of these glasses.

[AussieLeo]

Espress0, on Sep 21 2008, 02:15 PM, said:

Thanks for the posts.

An update form my end: I've been back a few times to get the tests re-done (I wanted exact repeats) and have also met the surgeon.  On top of that, I've trundled through multiple disater stories, success stories and as many stats as I could find.  Like Esstarr, I'm able to get LAsik or ASLA, but I've chosen ASLA based on the lower degree of short and long term risk.  I seriously hope my recovery is not as disaterous as yours though Esstarr, I'm glad to hear that things have settled for you.

I've read that depression is a common side effect for patients who have had issues - mainly battling with the fact that they out themselves into the situation they are in.  

All I can say is that I'm comfortable with the clinic I have chosen (Vista Eyes in Elsternwick - Dr Wolfe).  To date they have been excellent, and I haven;t shown them an $$, so it;s a good start.  Their equipment is current (wavefront, intralase etc.) and my risk profile is about as low as I could hope for.

So - this Friday I'm in!  It will mean not seeing the Grand Final, but the Bombers aren;t in anyway!  I'll definately be opting for a sedative, as I'm sure I'll be sh!tt!ng myself...  Can't wait to get rid of these glasses.

Hi guys,

I stumbled across this thread while researching laser eye surgery. I really would be interested to hear how things are going a few years out from the operations.

I have started a blog to document my journey of deciding whether I approach the laser surgery and who I will go with, please come along and comment on any of my posts to give me some feedback and motivation. http://lifewithoutgl...s.blogspot.com/

Regards

Leo

[steenbokpixie]

I got LASIK surgery a few months ago and it's been the best investment of my life! My vision is now better than 20/20.

[bec3263]

I have just booked in to have the prk surgery at medownick-has anyone gone through them or heard of any good/bad issues?

[MicrowaveJenny]

I had ASLA by Dr Sutton exactly 8 days ago and I'm still in recovery.

Surgery itself was painless and swift, so if you're worried about that part you don't have to! The pain during the first two days were horrific, and I don't think I expected visual recovery to take so long - although looking back they reminded me at each appointment that I was looking at a six-week recovery.

At this point in time my distance vision is better than before, but my close-up vision is TERRIBLE. As I work at a computer all day I'm falling farther and farther behind and am considering grabbing some magnifying glasses at the chemist just to get me through the next month.

At this stage I'm still glad I did it, but I think I was expecting a fairytale recovery. No amount of forum posts by post-ASLA patients would have convinced me that it wasn't going to be the picnic I'd prepared myself for.

I'll keep updating and let you know how my vision improves over the coming weeks.

[THE KEG]

I had Lasik done 12 years ago -one of the best things I've done. Eyes still great -had very bad eyesight beforehand.My eldest son inherited my bad eyes and had ASLA a year ago.( Same Surgeon). His eyes are great now.Should have got a spotters fee.........  

[RunningWhiz]

I had Lasik surgery done in June 2005. Five years on and i am very pleased have done it and wished had the lasers earlier. The first six months i just have to use  eyedrops 2-3X per week due to dry eyes side-effect. But the side effect could have been exacerbated due to windy conditions in the seawater while sailing. A change of sunglasses that encloses and protects the eyes from the wind fixed the dry, red eyes. Clear, enclosed glasses are also beneficial at night time for windy conditions during the few months after surgery.

Now, running against the breeze is not an issue.

[MicrowaveJenny]

Just a quick update re: ASLA. It's now been five and a half weeks since my op. I wasn't prepared for how much it would interrupt my marathon prep - it wasn't so much that I couldn't go running at all (I did miss a week while on medication and when my vision was too blurry to cope outdoors) the worst part was that I had to train indoors for the past month in case I got dust or grit or anything in my eyes while running into wind. More than 30 minutes on a treadmill does my head in, but 2hrs+ is revolting.

I am still suffering dry eyes, I use eye drops several times a day still and my eyes did sting a bit today towards the end as I got progressively more dehydrated. Apparently this will improve.

My visual acuity is incredible, however, and today's marathon was my first race where I could see everything. I used to run in contacts and found them quite irritating after about 60 minutes as my eyes would dry out, and getting dust or dirt in my eyes was so painful I would often pop my contact lens out just to finish the run.

I would recommend it. Worth every cent.

[EatEm]

Dr Rick Wolfe is great ... you wil have no issues with followup.

I had a different procedure as I wasn't suitable for laser ... instead a small 'soft' contact was implanted into each eye permanently.
2.5 years on and all is great .....

[Olmy]

MicrowaveJenny, on Sep 19 2010, 09:18 PM, said:

I would recommend it. Worth every cent.

How was your vision before the surgery? I have often thought about it, but my vision isn't terrible, I can get by without wearing my glasses. Because of that I don't think I would be happy unless I got "perfect" vision from the surgery, which I don't think happens.

[andrewz]

Here what  i found -> laser eye surgery

[LINAR]

I had PRK surgery about 3 years ago.  While I found the recovery very quick and I now have excellent vision, I still get very dry eyes at night.  I have to put eye gel in my eyes every night and sometimes during the night I wake up and have to put drops in.
After doing some research I have discovered that this is a VERY common side effect, but one that is not talked about very much prior to the surgery.

If I had known about the dry eyes before the surgery I would still have gone ahead, but it is still quite an inconvenience.

[aDrain]

EatEm, on Sep 20 2010, 09:22 AM, said:

Dr Rick Wolfe is great ... you wil have no issues with followup.

I had a different procedure as I wasn't suitable for laser ... instead a small 'soft' contact was implanted into each eye permanently.
2.5 years on and all is great .....

Inter Ocular Lens (IOL)?

I've got em, but from having cataracts treated. In & out in an afternoon, eye patch off next morning (with magic vision straight away!), drops for a week, take it easy (to keep blood pressure down) for a month.

[msbriz]

I wear contacts most of the time, and glasses when bumming around home. I have considered laser eye surgery in the past but when doing research read about some of the side effects such as dry eyes and halos around lights at night time and decided I could live with wearing contacts. I believe you also usually still need glasses for reading once you hit a certain age?  My contacts don't give me that much trouble to make it worth putting my eyes at risk.  Maybe in the future as technology improves I would consider it again.

[williamshare]

Hi everyone,

The best suggestion from my side is,if we have an idea about the lasik and prk surgeries then it will be better for us, because some people don't know about the procedures of lasik.If we have an idea like what are the complications,procedures,and what are the side effects, and what are the cost details and etc..,because lasik is an expensive surgery but the price of lasik surgery varies from one place to another.And the other thing is based on the latest equipments and technology also, their will a lot of difference in price.Thank You.

[jpol3692]

I got LASIK on a Thursday and was running on the Saturday with no issues - best decision I ever made. Expensive, but worth it. Only downside is that I occasionally get dry eyes and have to be *extremely* careful around branches, leaves etc flying around.

[Arnoruns]

I had LASIK performed late Nov last year, best investment I ever made!
Occasional dry eye still but not too bad... Progresively each month my eye requires less and less lubrication.
Halo's aren't too bad, i believe it has to do with how the protective layer heals back over the lens. If my eye is dry its worse but still not terrible.
I would definately not say its like super noticible, only at nights when my eyes are dry.

If i knew this is how my vision would have turned out before surgery i would have done it in a heartbeat!

[Runadict]

I have just signed up to have ICL surgery in August, which involves inserting lenses inside the eyes.  The lenses are made to measure, and I believe they are ordered from the US, which is why I have to wait so long.  Has anyone else has this procedure?  I know loads of people who have had laser surgery, but I was unsuitable for LASIK or PRK, and I don't know anyone who has had ICL.  I am very excited at the prospect of being able to wake up in the morning and see, but would also like to know how soon I can expect to be running (especially as the surgery takes place in the middle of my Melbourne marathon training!).

[aDrain]

Runadict do you mean IOL (inter ocular lens)? If so I've had it done in both eyes, separate occasions, to fix cataracts.

Bottom line is that I've had absolutely no problems at all. Quick op, wore a patch overnight which the doc took off next day. Some antibiotic eye drops for a couple of weeks and that's it.

I did have to take things easy for a while - elevated blood pressure could pop the stitch. Check with your doctor but I'd say that training will be on hold for a few weeks.

Remember to take your sunglasses for when the patch comes off as everything is suddenly so bright!

Edited by aDrain, 24 May 2011 - 06:49 PM.

[Runadict]

Thanks aDrain, it does sound like a similar procedure, although I have been told no stitches.  Perhaps it is different when treating cataracts.  I am having the two eyes done on consecutive days, with a post op check the day after.

I have been told that I should be able to resume normal activities after that, but I guess my 'normal' activities (running most days plus 3 gym seesions per week) may not be the same as other people's 'normal' activities, so I agree that I had better check carefully.  I know I have to avoid washing my hair for a few days, so that I don't get water in my eyes, so if I did do anything too strenuous I would end up with a smelly head!

[russell2pi]

Hmmm "occasional dry eyes" (a complaint made above about surgery) is pretty much the only complaint I have about my extended wear contact lenses.

I have always thought I'd consider surgery one day but this thread tells me that day has not yet arrived!

The other great advantage of contact lenses is the ability to chop onions without crying  

[fatboyslim]

I had laser surgery this morning. I asked the surgeon when i can run next and he said whenever. But the valiun night make run in a not so straight line. Seriously they said 1 week should be fine. Watch this space and i will update after the next run

[Action]

fatboyslim, on 10 June 2011 - 08:07 PM, said:

I had laser surgery this morning. I asked the surgeon when i can run next and he said whenever. But the valiun night make run in a not so straight line. Seriously they said 1 week should be fine. Watch this space and i will update after the next run

Well done.  I had mine done years and years ago and it has been great.  Had both done in the afternoon, drove home (I know, a bad example, shouldn't have, but did) and was running with perfect vision the next morning.  Haven't looked back (pun absolutely intended!). No contacts, glasses, dry eyes, problems... nuffin.  All good.

[chonky]

Action, exactly what procedure did you get done? There are a few different types. I suspect if you had it done years ago it was the one where they cut and make a flap. I have been looking at the latest method called intracor where there is no cutting although i am still doing a bit of research.
regards chonky

[Action]

chonky, on 10 June 2011 - 10:02 PM, said:

Action, exactly what procedure did you get done? There are a few different types. I suspect if you had it done years ago it was the one where they cut and make a flap. I have been looking at the latest method called intracor where there is no cutting although i am still doing a bit of research.
regards chonky

yes, cut and flap.  Lasik with Dr Ron Binneter.  I just googled him and it looks like he has done well.  When I had it done it was in his North Sydney office. Highly professional, very relaxing, and other than the faint smell of something burning, it was all good.  His mum held your hand (really) to relax you during the procedure  

[fatboyslim]

chonky, on 10 June 2011 - 10:02 PM, said:

Action, exactly what procedure did you get done? There are a few different types. I suspect if you had it done years ago it was the one where they cut and make a flap. I have been looking at the latest method called intracor where there is no cutting although i am still doing a bit of research.
regards chonky

I had mine done by Dr sebban (eye.net.au) he didnt cut but scraped the eye(didnt feel a thing) 2 min per eye. They are in Darlinghurst. Very happy with the whole procedure.

[fatboyslim]

I love running with no glasses. I ran 1 week after with no problems except for a little bit of in and out of focus. Would highly recommend it.

[williamshare]

fatboyslim, on 10 June 2011 - 08:07 PM, said:

I had laser surgery this morning. I asked the surgeon when i can run next and he said whenever. But the valiun night make run in a not so straight line. Seriously they said 1 week should be fine. Watch this space and i will update after the next run

That's pretty nice..........

[redbackrun]

i'm thinking about laser eye surgery in Brisbane. anyone had it done in Brissie & with who & costs (did a search) involved. The different procedures is now making it hard to choose. thanks in advance.

Edited by redbackrun, 22 September 2011 - 09:13 PM.

[Davo]

redbackrun, on 22 September 2011 - 08:36 PM, said:

i'm thinking about laser eye surgery in Brisbane. anyone had it done in Brissie & with who & costs (did a search) involved. The different procedures is now making it hard to choose. thanks in advance.

Redbackrun, have a look at the earlier posts on this thread. Lady Jove is from Brisbane. I recommend you contact her.

[redbackrun]

[quote name='Davo' timestamp='1316728341' post='685511']
Redbackrun, have a look at the earlier posts on this thread. Lady Jove is from Brisbane. I recommend you contact her.
[/quote


thanks Davo i will. some good advice on the thread & will have to research a lot more to what i feel comfortable with.
cheers

[Road Runner]

I had PRK performed on my right eye in December 2004 - since then, my sight has regressed, requiring me to wear a +2.00 contact lens for normal vision.  Even though I'm not happy with the company that did the procedure, I'm reluctant to name them publicly, for obvious reasons!

Edited by Road Runner, 18 May 2012 - 12:16 PM.

[Blue Dog]

I had Lasik surgery with Dr Margaret Kearns at the Sydney Eye Specialist Centre on May 11 this year. They gave me 'mono-vision,' which is perfect long-sight in the dominant eye (left for me) and perfect reading vision in the right eye.

True to what I had read prior to surgery, it took my brain around three weeks to get familiar with the new changes, mainly when changing focus from near to far or vice versa.

Two days after surgery I was spectating at The North Face 100 in the Blue Mountains and remarked to my wife that I could cry .... I could see across the huge Jamison Valley and the horizon was as clear as it could possibly be.

I didn't realise how much my longer vision had deteriorated over the years, but the results of the Lasik surgery were amazing, I was seeing like an eagle.

Reading vision took a few weeks longer to 'settle in', but with similar results. Being an avid reader, I had almost given away reading in bed at night; it was simply too much strain on my eyes. When doing the daily crossword puzzles, I would enlarge them to 150% on A3 paper on the work photocopier so I could read the clues without getting a headache. Now I have no problems at all with any of these things.

Extremely happy with the result.

Cheers, Blue Dog.

Edited by Blue Dog, 07 October 2011 - 04:23 PM.

[chonky]

Thats a good story blue dog, I have made enquiries about laser surgery with my problem of perfect vision to see long distance
but struggle to see close up. But what ive been told if i get one eye done with a lens implant that will enable me to read close up
but it will reduce my long distance vision slightly. Has anyone else had this done with that same result?
regards chonky

[CurlyGIrl]

I had laser surgery in Adelaide nearly 10 years ago (I think that's the time frame).
I was one of the very earliest patients for this particular eye surgeon. To the best of my knowledge I was one in a group of 5 people that were his first patients.
In fact, he had a surgeon from Queensland (where he purchased the equipment) to assist in the procedures as he was new to the technique.
I have had some serious issues, but the REAL issue I had is that this very well known surgeon does not consult after the procedure/s. There is one follow up visit and that is the last I could see of him. I phoned several times over the ensuing months and even years but as soon as they find out that I've already had the procedure I'm told 'sorry we don't consult' you will need to see your optician. It's a viscious circle, because when I go to see the optician or GP they refer me back to the surgeon who won't see me and they refer me back to the optician.
At one stage a GP actually phoned the surgery whilst I was sitting in her office and the surgery made out like it wasn't a problem and I could definitely make an appointment to see the surgeon. When I got there I was given a check up by a junior optician and didn't get to see the surgeon even though he was at the clinic.
So when I see advertisements that talk about how many procedures the clnic has done or how many years they've been going for - I get really cross.
Certainly in this instance, this surgeon has absolutely no idea of the long term results from his earliest patients.
What anyone should be aware of when considering this procedure is that for surgeons such as my Adelaide guy, he's not a health care specialist. He's not someone who got in the industry because he wants to help people regain their sight. He is never going to volunteer overseas in third world countries or do pro-bono cases, these guys are in it for the money. It's big, big business for them - you are going to be in and out that door like a piece of furniture and then you could very well be on your own in the long run.
For me, I am now color blind – I can’t tell the difference between hues, eg navy blue or black, purple or grey, moss green or lilac etc. I also have such a severe case of ‘dry eye’ that even using specialised eye drops and gels my corneas still get ulcerated. One optician I consulted said to me that he wasn’t surprised, “after all you have had a considerable amount of your cornea shaved off”.

[Road Runner]

CurlyGirl,
Sorry to hear of your bad experience.  Have you thought of getting legal advice?

The clinic I went to (in Hoddle Street, Richmond), told me initially, that if the procedure didn't work properly, they would do it again at a substantially reduced rate.  Because the end result wasn't what I expected (see post 39), I asked them about doing the procedure again, but they told me I was no longer suitable for PRK, and the only way they could give me 6/6 (formerly 20/20) vision was with a lensectomy, paying full price!  I'm sticking with the contact lens for the moment.