PRK Consultations, ICL Introduction, Doubts

So here's my next step in the process to having 20/20 vision: procedure consultations. I visited four different locations, most in the Beverly Hills area (just due to the proximity to where I live). This post is a bit long, but I wanted to put as much information down for anyone that is Interested.



Beverly Hills Vision Institute
Beverly Hills
http://www.beverlyhillsvision.com/

This was the first location that I found on Yelp that had an immediate appointment. The waiting room itself felt very standard for any office, so I was neither disappointed or impressed. The office even recommended the parking structure across the street as it had two hours free parking. Standard doctor's paperwork to fill out, as well as basic procedures. An optometrist checks your vision level, astigmatism, health of your eyes, a "map" of your cornea, and the thickness of your corneal layer. It was here I found out that corneal thickness and vision level really determine if you are a candidate for Lasik or not. Afterwards, Dr. Khodabakhsh came in to talk to me about my options. Being a relatively small clinic compared to some other places, seeing the actual ophthalmolog that performs the procedure brings some comfort. Dr. Khodabakhsh was very thorough in explaining to me why Lasik was not a good choice for me and recommended PRK ( ). Afterwards, the consultant talked to me about payment options, which came out to under $5000 for the procedure. There was no real "take home packet" besides a disclaimer form; most of the notes I had to write down myself. The office closed normally at 5pm but the appointment ran until 6pm, and most of the staff was still around to assist me.

NVISION Laser Eye Center
Torrance
http://nvisioncenters.com/lasik-torrance/

I had some reluctancy going to N-Vision, primarily since it was formerly a TLC (The Laser Center) location, which had many locations around the US. Reading up on how things were done here, there was some hesitancy on customer service post-op and how I might be treated as someone buying a car. Dr. Tooma, a well known ophthalmologist in Southern California had recently bought out a group of TLC centers in the LA area and re-branded them "N-Vision".

However, the initial paperwork and tests were all the same, with the consultant even showing me the actual surgery area. N-Vision also does Wavefront technology, so the tools weren't completely out of date. The more I thought of it, the more I realized that larger places such as N-Vision would have the latest technology as they have more capital to upgrade machines and tools to the latest units on the market. Dr. Looma was the person to do the surgery but he was out for the day. The consultant was very optimistic about my recovery, even after confirming PRK would be the best choice for me. They sent me home with a sizeable take-home packet with all the information I would need, even writing a prescription of all the eyedrops I would need before and after the surgery. In addition, they told me to start taking fish oil (Omega-3) and Vitamin C supplements to help with tear production and aid in the recover of my corneal layer.

Assil Eye Institute
Beverly Hills
http://www.assileye.com/

Compared to the first Beverly Hills location, this one was almost night and day. The lobby overlooked Santa Monica Blvd and the boutique shops, quite large with a few 50" screens on the walls, multiple computer stations for people waiting, and enough seating for about 40 people. Again, standard paperwork and tests. The corneal mapping test (one with the black/white concentric circles) took a bit longer as it felt they made me open my eyes a lot longer than asked for. Got to meet Dr. Assil, which was nice to begin with but automatically ruled out PRK as an option. I was taken aback since the last two locations told me PRK was the best choice, and now i was a bit scared what other options there might be. Dr. Assil told me about ICL (intercorneal lenses), which the first Bev Hills place also mentioned. On a scale of 1 to 10 (1 being worst for me), Lasik was a 1, PRK was a 7, and ICL was a 10. He then gave me reasons why PRK would not be good, such as potential scarring of the cornea due to the size of my pupils as well as possible contrast degradation after surgery. An example he made regarding contrast degredation was it being a rainy day and some kid running out to the street; PRK had a chance of degrading my contrast so the greys wouldn't be as crisp and thus I wouldn't see the kid in the street.

Dr. Assil then told me about ICL and how it would completely fix my vision since a lens sat inside my eye and i had enough space for the procedure. Price wise it was twice as much ($5k for PRK vs $10.8k for ICL), but never explained why. I was told about how there would be instant vision correction vs PRK's 1-6 week recovery time; however, none of the risks were mentioned. I was then whisked away to the consultant to discuss payment options. She mentioned that the doc would want to do more tests and a comprehensive exam and suggested i schedule something the next morning. I reluctantly agreed, was given a take-home packet, then sent home.

I later discovered that the comprehensive exam cost $300 that would be a credit applied to your actual procedure or refunded if refractive surgery choice was not an option. This price was never mentioned to me before I made the appointment or left the location, so I simply emailed them to opt out, saying I have more than enough time to re-schedule before the year's end.

Berg Feinfield Vision Correction
Beverly Hills/Sherman Oaks
http://www.bergfeinfield.com/

With my consultation at Dr. Assil just 48 hours prior to this one, I came in with more information and questions about PRK and ICL. This location's waiting room was just as standard as the first one, so back to some type of comfort zone without being wow'ed by a view or plush couches. Dr. Berg had come in (i later found out it he had just come from doing a PRK surgery) and immediately greeted me before I headed in to do my tests. The corneal mapping test was much better than the location, as I was actually given a countdown on how much time was remaining before the test was over. An optometrist numbed my eyes in preparation for the corneal thickness test, but forgot to take the test until Dr. Berg informed her that the results were missing.

After all the exams, Dr. Berg sat down with me to talk about my options. PRK, rather than ICL was his choice. He told me that the contrast issues would be corrected by the Wavefront mapping technology, as well as some of the halo issues. He also showed me a physical model of an eye and how the procedure would be done. There was not as much optimism about recovery as the other places, which I actually liked. Dr. Berg was very calm and collective, telling me the standard healing procedures, what to expect, and why he recommended PRK over ICL. The consultant then told me about how one should not expect a smooth recovery when getting PRK, which made me even more comfortable. Here was a location that gave the truth of what it took to get through PRK and was not afraid to tell me. I finally divulged that I had gone to multiple Lasik clinics prior to Dr. Berg and told her about Dr. Assil's suggestion on ICL over PRK. She informed me that Dr. Assil was involved in promoting the Versieye ICL product, and hence was the reason about pushing ICL so much over PRK.

The consultant also was knowledgeable enough to know what bilberry supplements were, giving me an example of how Navy pilots stationed in the Euro theater had better night vision than other areas due to snacking on bilberry pies while off-base. Lastly, she re-iterated the necessity of recovery time and how PRK was not as easy as Lasik. My eyes were then dialated, the health of my eyes checked, and I was out of the office by 9:30am.

-------------------------------------------------------------------------------------------

Overall, i'm glad I went to four locations. Each exam was the same, but the information provided was different. My biggest disappointment was Dr. Assil's promotion of the ICL, without letting me know about how the procedure was done, the need for PRK to correct astigmatism, and how the process was just pushed onto me through fear tactics. I've decided to go with Dr. Berg's office and will continue my documentation of this procedure in the next few weeks. For now, I'm taking Omega-3 pills, along with billbery supplements and vitamin C tablets. I definitely feel my eyes not as dry as I can keep them open greater than 6 seconds.

Below are some websites I visited to learn more about ICLs and  people's recovery journals

Hesitance of ICL Surgery and Professional Commentary
http://www.revophth.com/content/d/intraocular_lenses/c/22764/

Post-Operative Examples of ICL Implants
http://emedicine.medscape.com/article/1221908-overview

April 2008 ICL Surgery Blog - Four Year Span
http://myicl.blogspot.com/search?updated-max=2009-01-28T18:25:00-06:00&max-results=7

May 2010 ICL/PRK Surgery Blog - 2 Year Span
http://iclexperience.wordpress.com/2010/05/

Dr Kerry Assil & Lasik Surgery Blog - 2004
http://reallythink.blogspot.com/search/label/Lasik