Name: James Sime Age: 54
Occupation: professional engineer
Surgeon: Dr. Jeffrey Daniel Gold

I have been interested for many years in laser eye surgery to correct nearsightedness, presbyopia and a slight astigmatism (left eye).

However, until recently, I believed the risks outweighed the potential benefits.

WaveFront-guided Custom LASIK is capable of correcting higher and lower order aberrations, however, I have been wary of the surgical technique because the surgeon must cut the eyeball and lift up a flap. This never seemed like a good technique to me as it seemed to me it must weaken the structure of the eye. Over the years, the Internet has been useful for tracking advances and issues (things that can go wrong) related to the flap, such as dry eye (cutting the flap severs a lot of nerves in the eye and nerves don't grow back anytime soon -- the severed nerves reduce the eye's ability to send signals to the brain to request tears when it's dry), and lack of healing or re-bonding of the inner-flap surface to the rest of the eye -- it seems that the edge knits back together but the inner surface only re-bonds over a very long time (up to 40 years), which means the flap could bulge or be dislodged under a variety of unfortunate circumstances. Dry eye and the potential problems with the flap, which could ruin the eye, represented unacceptable risks for me.

Surface ablation seemed safer to me, but PRK as I understood it, involved dissolving and manually scraping away the outermost layer of the eye (epithelial layer). This step seemed a bit crude to me and the imprecision was troubling, although in general the surface ablation didn't mess with the nerves in the eye and didn't structurally weaken the eye, so it didn't seem too bad. The recovery period following PRK seemed a bit long and I have to work, so I was concerned about estimates of how long I would need to wait for my eyes to heal.

Epi-LASIK, especially with WaveFront correction of higher and lower order aberrations seemed to provide a high level of precision (both in a tool to remove the thin epithelial layer and the WaveFront guided laser correction), safety (structural strength of eye is not compromised and no nerves are severed, i.e., a very very low probability of ruining my eyes), and fairly quick recovery (so I can return to work in about a week).

Overall, it seemed that if I could find an experienced, precise, careful eye surgeon, an expert in Epi-LASIK, then it would be safe to proceed with surgery and rid myself of the need for corrective eyeglasses.

I did some searching and sought recommendations from within the medical profession an In my profession, fact-based risk evaluations are key to our decision making, so I felt very good about this approach in Dr. Gold's practice. As I interacted with Dr. Gold, I came to understand that he is attentive to medial research and uses new findings to learn about and improve his knowledge, techniques, upgrade his equipment and achieve better results over time. Like an expert carpenter, it is always wise to measure twice and cut once, and Dr. Gold makes a lot of measurements with the very best equipment (VISX WaveFront) and has in place a solid system of checks and double checks on all the numerical data and calculations that go into laser eye correction. Another strong positive factor is Dr. Gold's attention to patient comfort. His treatment techniques, as I experienced them in July 2009 for Custom WaveFront Epi-LASIK (mono-vision) on both eyes on the same day, resulted in only mild discomfort, which I found to be remarkable. I followed all post-op instructions to the letter, which included lots of eye drops and pills, and today my vision is better than 20/20. Also, the left-eye astigmatism is gone. Based on what I have learned through my research and personal experience, I can recommend Dr. Gold without reservation to any and all. I feel confident that he would not proceed if risk factors indicate corrective eye surgery is a bad idea for you. Likewise, if corrective surgery is appropriate for you, I am confident that you are in excellent hands with Dr. Gold. By the way, a month after me, my wife selected Dr. Gold for WaveFront-guided Custom Epi-LASIK treatment (mono-vision) and had her surgery on Friday. It went well and perhaps she will write of her experience a month or so from now.

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