I have new eyes!

I enjoyed perfect vision until my mid 40s. Then, as happens to most people, my lenses gradually hardened, making focus more difficult, especially close up. This condition is called Presbyopia. By the time I was in my late 50s, my distance vision was affected too. I switched from wearing reading glasses to multi-focal glasses that I could wear most of the time. They worked pretty well and weren’t expensive but I just hated wearing glasses.

I had started researching surgical fixes for presbyopia back in 2013, but wasn’t encouraged by what I found: many methods, none sounding great. In 2019, while I was riding through South America, my Danish friend Jens mentioned that he had heard RLE (Refractive Lens Exchange) was now the way to go. RLE is commonly used for people with cataracts too. He is a little younger than me and maybe had slightly worse vision. When we said good-bye in Salta, Argentina, he promised to let me know what he found out about it.

Four months later I was back home and Jens texted me:

Encouraged by this excellent news I started looking for a local doctor. I looked at quite a few, watched many patient “testimonial” videos, read reviews and finally settled on an office nearby in Mountain View. I made an appointment and was excited to see if I was a candidate. Then the damn corona virus hit and everything was locked down. My March appointment slipped to April, then to early May but finally I got to go meet Dr. Liu at Peninsula Laser Eye Medical Group. I spent a couple of hours there being tested by many machines and talking with the doctor and the surgical coordinator. I decided to go for it and they said they’d call once they had approval to restart non-essential surgeries like this. There are a number of lens choices available, but I decided to go with what sounded the best, not considering cost: the PanOptix Trifocal IOL. It has been in use in Europe and Canada for several years but was just approved in the US in September, 2019. Dr. Liu does lots of these.

AcrySoft IQ PanOptix Tri-focal IOL: 13 mm in diameter with a central optic of 6 mm. The 6mm optical zone is composed of a central 4.5 mm diffractive area with 15 diffractive zones and an outer refractive rim. Compared to a 17.91 mm US dime.

California and Santa Clara County relaxed the stay-at-home order at the end of May so on June first I was able to have my right eye done. The surgery really did take only about 15 minutes although I was at the surgical center for 2 hours, mostly waiting for eye drops and other drugs to take effect. I had never had Valium before and was super relaxed but completely conscious throughout. There was not a single bit of pain – you see three bright lights during the procedure and I was instructed to look one direction or another a couple of times. It did take quite some courage to actually walk in that door and let the doctor poke a tiny ultrasonic vacuum straight into my eye to destroy and suck out my old lens. There’s no going back from this surgery for sure! If you’re brave, watch this video (warning: I did not watch this until after my surgery – you might not want to either as you can’t unsee it).

Minutes later I was sitting in the recovery room looking around, VERY happy that I could see though my right eye. It was encouraging that text looked more in focus than with my untreated left eye. Even though there was haze clouding my vision, I believed the doctor when he said it went perfectly. I had a long nap at home (due to the drugs I guess) then had a fun time that night, staying up reading and watching videos until 2am, noticing my vision getting better each hour. The next morning, the haze was gone and it was hugely better. It was so much better than my other eye – I marveled at how my brain was able to take the two different images and blend them, and see such better focus than before. In the afternoon, I had a post-op check up and Dr. Liu said the placement of the lens was absolutely perfect. All I had to do was keep up with a regimen of three different types of eye drops, four times a day, and just enjoy my eyesight getting better.

Selfie when I got home: right eye very dilated

A week later I had another check-up and my vision was approaching 20-20 in the right eye (about 20-70 or 20-80 in the left). It was a miracle. It wasn’t perfect but I didn’t need glasses for driving or reading (except really small print). There were certain things on computer and phone screens that looked slightly funny/out of focus. There was a weird texture to the print when reading a Kindle book on my tablet. Biking has been fantastic now that I can really see my bike computer, I learned about several nice features I couldn’t use before. It is clear and crisp and super easy to read.

A week after that, I had the second surgery. It went the same as the first one, also a little scary to walk in, but, really, no problem. Grace drove me home again, another nap, then better vision by the hour and no haze and miraculous vision the next morning. I notice “halos” around bring lights and reflections – a known side-effect. But it’s not a problem at all and supposedly reduces over several months.

It’s been a week after the second surgery and glasses are a thing of the past. My close-up vision is amazing. I can read any size font. Distance vision is great. Other than occasional halos, there is nothing wrong or strange about my vision. I’ve stopped eye drops in the first eye and have another check-up in a few days. My vision should continue to improve slightly for some time.

I think this is the best investment in myself I ever made. If you’re wondering how much it costs, it’s not cheap. I paid $5807 per eye, including everything. I read that with mono-focal lenses, the cost averaged $3800 per eye in 2019 in the US and the multi-focal type I got costs at least $1500 more. One nice thing is that this type of surgical correction is permanent. I would 100% do it again – I wish this had been available a few years ago.

[Update about a month later] It is phenomenal! I can read anything, see anything, I don’t squint any more and my eyes don’t get tired!

[Update mid August, 2 1/2 months after the first surgery] While my new vision was awesome and I didn’t ever need glasses, my new left eye never got quite as good as the right. I had a couple of check-ups in July and at the final one, Dr. Liu told me my problem was astigmatism in the left eye causing the focus to not be as crisp as in the right. I had this before but for some reason it had worsened since my first surgery. While my right eye was seeing 20-20 or better, my left was 20-30 or a little worse. Both together worked fine, but he offered to do a simple procedure in his office called Limbal Relaxation Incision (LRI) to improve it. He offered this at no charge so after some research, I scheduled an appointment and had it done. The incisions themselves took maybe a minute but numbing eye-drops and sterilizing the area etc made the total time more like 15 minutes. After the incisions, he put a “0 power” contact lens on my eye. At this point my left eye vision wasn’t any better or worse.

I got used to the contact lens after a couple of hours and for two days applied an antibiotic eye drop four times a day. Then I went back in for another exam and Dr. Liu was very happy with the healing. He removed the contact lens and I drove home. During the drive I noticed my eyesight seemed better. When I got home and looked at Grace’s face – wow, it was even higher resolution than before! I am so glad I had this second procedure! I continued the eye drops for a final two days. Now it’s been a week since then and I pronounce the whole thing a 100% success! I donated all my old pairs of glasses to charity and both eyes are 20-20. It’s like a new life.

4 thoughts on “I have new eyes!

  1. Great write up Nathan. And you reconfirmed everything for me in Amsterdam this year.
    I am seriously considering the procedure – even if means I have to come up your way and use your doctor! Thanks for sharing your experience.


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