I'd been thinking long and hard about getting Lasik for over a year now. It's not that I absolutely hate wearing glasses, and actually a lot of people say they suit me, it's just I find them a little annoying when it comes to travel, exercise and even just trying to eat a damn bowl of ramen. And, if I'm honest, I don't feel my prettiest in them, despite what others say.
I could go the contacts route but, while aesthetically they'd fix my problem, I've always felt like they might be just as much of a pain, if not more, especially when travelling off the beaten path. Rather than simply putting on my glasses, caring for contacts sounded like an added ritual that I might not be able to keep up with. So as the time for getting some new glasses was approaching, I started seriously considering the Lasik option. Sure, it's not cheap, but the cost of glasses over the years hasn't been either, and the freedom of being able to see well with my naked eyes was something I was really beginning to crave.
I had thought about getting it done some time when I'd be back in Australia, but when a friend of mine had a successful surgery at a well-known clinic in Tokyo, I started thinking about my options in Japan. The summer holidays were approaching and it seemed like the perfect time to do the surgery and recover without having to miss much work or attend meetings sans make-up.
There are many things to think about when going into any kind of surgery, but even more so when you're thinking about getting it done in a foreign country and dealing with a second language. This was not something I could just wing when I didn't understand; I'd have to be sure of what was going on.
Making the appointment
So when I was finally ready to make the appointment, I asked a Japanese friend to assist me. She called and was quickly told that if she made the appointment on my behalf that she would have to come to every session with me as my translator, including all follow-up consultations. As I didn't really feel that was necessary, I decided to see how I'd go with making the phone call myself, knowing that she was there if I got stuck. It took around 30 minutes to make arrangements for the surgery day and next day appointment, and for the receptionist to take me through all the necessary information. She used some words I didn't know, but I was able to understand with some explanation.
Finally the receptionist directed me to the homepage and told me to read the section for first-time visitors carefully before surgery day. I did, checking over all the kanji that I didn't know and making sure I understood each step. The list of what to bring on the day, however, was confusing as it conflicted with what I was told over the phone, and included things like documents on Lasik surgery guidance and consent forms, as well as eye drops. These all sounded like things they would give you on the day, but it wasn't worded as such. I showed it to another Japanese friend who said it also sounded strange. She ended up calling to check because she was worried that I might have some problems on the day if I didn't have all these things. In the end, though, it was as I had previously understood on the phone. They should really update their website!
What to bring on the day
- ID (passport, insurance card or driver's license – any are OK as long as it has your current address printed on it)
- Your current glasses
- Your personal seal (inkan/hanko)
- A letter from your doctor in Japanese listing any medications you're on and the dosage, and confirming that they believe surgery to be safe while taking those medications
- Discount ticket (if you have one)
- Money (cash or credit card)
- Sunglasses for after the surgery are also advised
The clinic offered a one-day option, that included the initial tests and screenings to check whether you're a candidate for Lasik. Should that all come back fine, you can have the surgery the same day. I was told that the cheapest surgery cost was ¥154,000 and the most expensive around ¥300,000 (prices for both eyes). I was told to think about the type of surgery I wanted before coming. I did lots of research and ended up deciding that their most expensive Amaris Z-Lasik procedure was the one I wanted to go for.
Before the procedure
As far as I could see, the website didn't mention anything about the use of make-up or fragrances before surgery day, but as my friend had been told to stop wearing make-up three days before and not use any moisturisers, face creams, deodorants or fragrances the day before, I decided to follow suit to be on the safe side.
On the day
- No make-up at all – including products that aren't even close to your eyes such as lip creams.
- No moisturisers, deodorants, fragrances, hairspray or hair products.
- No turtlenecks or any clothes that produce static electricity, hoodies or caps. Wear something that is easy to remove after surgery without coming into contact with your eyes.
- Wear easy to remove shoes (as you'll need to change into slippers for surgery).
- Bring along a cardigan or jacket (you'll be hanging around most of the day and may get cold).
After the surgery
- The day of the surgery, no work or driving.
- No showering or face washing. The doctor will advise if you may shower the day after when you attend your first check-up the next day.
- Don't touch or rub your eyes under any circumstances for at least several days. Avoid doing so throughout the healing process. Sleep with an eye patch to avoid rubbing your eyes while you sleep.
- No eye make-up or alcohol for 3 days. However, up to a week after only very light make-up is advised. You may wear face make-up to subsequent check-ups but none around the eyes.
- For one week, no overseas trips, hot springs, sauna or heavy exercise.
- No flu shots or vaccinations of any kind for one week.
- No pool, beach or contact sports for one month.
- Wear protective eye wear when outside/exposed to sunlight for the next 1-2 weeks.
My examination appointment was scheduled for 9am and my surgery pre-emptively scheduled for 3pm. The basic schedule is four hours of tests, a break to eat and then surgery time. You'll have to wait 30 minutes after the surgery with your eyes closed before going home. Make sure you have someone to escort you!
While I felt fine to do follow-up appointments on my own, my Japanese friend kindly came with me on surgery day to assist with the very important pre-examinations and consultations, and of course Hai was there too for support and to help me home after.
On arrival at the reception, I was asked for my name, discount coupon and letter from my doctor (they were expecting the latter two based on the information I gave during the booking process). Those documents won't apply to everyone.
Then I was given a consent form to sign and a medical questionnaire to fill out – it requested all usual personal details, along with medical history, allergy information etc. If you have any medical conditions and/or are taking medication – be sure to have the names of the medications handy as you'll need to write these down at this point. You'll also need to check the type of procedure you are thinking of having. Of course, it doesn't lock you into that particular surgery but will let the doctors know what your plans are. They may suggest changes based on your test results.
Once I had completed the form, the receptionist checked over it and cross-checked my address with my ID. With the initial paperwork taken care of, I was told to proceed to one of the waiting rooms (there were several as it was a big clinic, so they were assigned numbers). I was told I could pop my things into the lockers on the way.
Not long after, I was called along with two other clients to another room. The first stage was the genetic test that checks whether you may have any genetic conditions that could make you incompatible for Lasik. They make you watch a 1-minute video and then you are given a long Q-tip to take swabs from both sides of your mouth. You simply pop it back in the tube and hand it back to the staff member.
One thing to note that is mentioned nowhere in the preparation materials on their website, is that you shouldn't eat chocolate before this test. Under usual circumstances I wouldn't have, especially at that hour, but Hai had bought some chocolate croissants in the morning as a nice breakfast before the surgery – he knew I was nervous. In the end it wasn't a big deal. They just confirmed that I had rinsed my mouth out after and since I had brushed my teeth, I was fine to go ahead with the test.
Then it was back to the waiting room again. The waiting room had a large flat-screen TV and some magazines. Soon I was called to another room – this time individually. I had to look into four different machines while they did different checks on my eyes, including the one where they puff air into your eyeballs. It didn't hurt at all; only made me jump a little. Then I was asked to sit on a chair in the hall, before heading into another room. This was your more standard eye examination – as you would have when you're getting your eyesight checked at any optometrist. After that I was taken to a dark room for more tests – basically looking into the machines and staring at a light for certain periods while they took scans of my eyes. Then they put in some eye drops to dilate my pupils for upcoming tests. It would take full effect in 30 minutes and in the meantime my vision might start to blur. For now, it was back to the waiting room, during which time I did start to feel my vision getting hazy.
Test results and choosing the surgery
Then I had to speak with a staff member about my surgery prospects. I was told that with a corneal thickness of 500 microns that my corneas were too thin and also that my nose was too big for the type of Lasik that I had selected. I'd have to go with the older Intralase option and also get a second surgery known as cross-linking. They said it was possible to do the Lasik without cross-linking but it would be risky as I may develop corneal ectasia in the future and be in need of a corneal transplant.
After the explanation, I was taken to another room where the same staff member put anesthetic drops into my eye and tapped my eye balls with a metal instrument. The anesthetic worked virtually instantly. I could only feel the sensation of the first few taps – but no pain – and from then on nothing at all.
I was kind of in a dream like state when I went back to the waiting room where I started quickly Googling cross linking – a procedure said to strengthen the cornea for those with weak ones and one that I'd never heard of before a few minutes ago. From my very brief search, there was some evidence to suggest its effectiveness in avoiding future eye problems, especially due to Lasik done on people with thin corneas. But most sources ended with some variation of there needing to be more studies and results being inconclusive. Some said the whole thing was rather unnecessary and that it should never be done along with Lasik! I'm not a doctor and don't claim to be, but what I knew is that I didn't want to go ahead some life altering procedure based on a 5 minute Google search and simply because one staff member suggested it.
Then I was called in to see the doctor. He had another look at my eyes – I guess that was what the pupil dilation drops were for and he went over my test results again and recommended course of surgery. He said that I shouldn't do Lasik without cross linking, and then he explained that there were two types of machines used for cross linking I could choose from, one more expensive than the other. In the end, with my discount coupon, the whole thing with the better machine would apparently cost ¥330,000 (about US$3,300), around ¥70,000 (US$700) more than the state-of-the-art Lasik procedure that I had thought I would go with in the beginning. This was the last part before the “lunch break” and while he said I could confirm which cross linking machine I wanted when I returned, he wanted me to make the decision about everything else then and there.
What went wrong
Things may have sounded OK up until this point in the post, but I was already starting to have doubts once I spoke with the first staff member who was the first to tell me my corneas were too thin for the more modern Lasik procedures and that a second procedure would also be necessary. It wasn't the fact that he told me what I didn't want to hear, but how he was trying to sell it to me. He was so eager to get me onboard with this cross linking idea that I could have sworn he was getting commission for it. He even said he could “do a deal” for me, saying he would speak to the doctor and do what he could to get me the best deal ever. It was like something out of a used car sales yard.
Hello! These are my EYES! And unlike a replacement set of headlights, there's nothing I can do to undo the damage done if I make the wrong choice here. Then he started saying how other clinics may be cheaper but are nowhere near as good as them, that they don't use the same equipment and that they are, quote, “idiots”. While I don't mind if you give me a rundown of your experience and facilities, to put down other clinics – whether there is any truth to his claims or not – just comes across as unprofessional. He just seemed like a salesperson willing to say anything to get me to sign on the dotted line.
I also found the whole nose argument a little strange. Apart from my corneas being thin, I apparently could do more modern Lasik procedures if I did cross linking first, but it was my nose that was getting in the way. I was told that because my nose wasn't as flat as the average Japanese person's, the newer machine wouldn't be able to reach my eyeball and suction properly, but that this was possible with the older Intralase machine. When I asked whether this was a universal design or whether their machines were just fitted for a Japanese clientele, they said I would have this problem in any country. Again, I'm not a doctor, but people get Lasik done all over the world and I hardly think my nose is out of the ordinary. I just found the whole argument hard to believe, at least the way they were presenting it. Coupled with the fact that they kept on changing the reason I couldn't do the modern Lasik surgery with each new sentence – one second it was my corneas, the next my nose, then cross linking was necessary, and then not – I wasn't even sure they were following what they were saying.
I already thought about cancelling at this point but went on to see the doctor for the next consultation anyway to hear him out. This first stage was supposed to check your eligibility for Lasik anyway and I hadn't committed to anything. Although he went over the options again, he quickly grew impatient when I asked lots of questions and showed concern over getting the second procedure. He wasn't interested in discussing whether this was something worthwhile for me, considering that with the technology I'd have to go with I'd only get 5 years of good vision, after which I'd have a whopping 50% chance of regression and needing to wear glasses again anyway. For the corneal tissue that I was going to be giving up, the discomfort and potential risks of the procedure, and for the amount of money for such a short time span, it was far from ideal and not something that should be decided idly.
I ultimately decided to cancel the procedure because:
- I wasn't an ideal candidate for Lasik.
- The sales pitch was uncomfortable and I didn't feel like the staff had my best interests at heart.
- I didn't want to make such a big decision on the spot.
- I wouldn't get to meet the doctor performing my surgery and therefore had no idea of their experience in dealing with cases like mine (they just had a team of doctors on standby and do the surgery on whoever is next in line).
- I wanted to get a second opinion on the nose argument.
Even though it was disappointing that I couldn't get Lasik done as I had planned, I felt completely at ease in going to the reception and cancelling my surgery. That's what my gut was telling me. I knew it was the right thing to do, which was quickly confirmed by my being taking into another room to speak with another doctor who demanded why I cancelled. Was it an issue of money? he asked. Because I could go with this other machine that's cheaper; and they could do me a better deal. I'm sorry, do you mean that machine that you really didn't recommend 10 minutes ago. Either that one's fine and you were just trying to sell me the most expensive option and hoping that I'd go for it, or it's not the best choice for me but that's better than losing the sale. Either option doesn't inspire much confidence. I told him in no uncertain terms it wasn't about the money, it was the fact that I was unable to get the procedure I had planned on and didn't want to proceed with another without having done adequate research about my options. He pressed further saying that they had given me all the information I needed to know and that they would make me pay ¥10,000 (US$100) if I didn't go ahead with the surgery the same day. When he knew he couldn't sway me, he waved me and my friend to the waiting room, where we had to wait again until called to the reception to pay. As we were leaving, my friend told me that she thought I definitely made the right choice. We both couldn't wait to get the hell out of there.
What I learned through this process of attempting Lasik in Japan
1 day procedures (examination immediately followed by surgery) are not for me
At first, the one-day session was appealing. It makes total time sense to get everything over and done with in one day, and I think I would have found it convenient if I was a clear candidate for Lasik and could go ahead with the procedure I had researched and felt comfortable with. But when the test results don't come back as you'd hoped, there is very little time to consider alternative options, especially if they are ones you were not aware of before. In this case, the small time frame just amounts to pressure and surgical procedures are not the time to be making quick decisions.
I prefer more personal customer service
While I'm not saying that all large clinics are like this, this one felt like some kind of surgical farm, designed to get people in and get them out. If I go through with any surgical procedure, I want to be able to meet the doctor performing it and have my concerns properly addressed, and not be ridiculed for requesting more time to think about it. Any reputable clinic who values its clients should encourage them to be fully informed and help them to make the best decision for their health needs.
My gut knows me best
While it was disappointing that I couldn't get my eyes fixed, my gut made the decision very easy for me. Had I'd gone ahead with the procedure just because I had been anticipating the day so much, because I had already arranged a week off to recover or because I didn't know when I'll have the chance to do this again, I fear I would have made a big mistake. At least at this clinic. If something doesn't feel right to you, I'd suggest cutting your losses and making a b-line for the door. You don't owe anyone anything and don't let anyone pressure you into something that you're not comfortable with, least of all surgery that will permanently alter one of your most precious organs.
So what now?
For now I'm just going to sit on the idea of Lasik. One very important piece of information I now know thanks to the tests I undertook is my corneal thickness, so I can do more research and possibly approach other clinics in the future with this in mind.
What I do feel is that 5 years isn't enough for me to warrant the procedure at this time. My eyesight really isn't that bad compared to what a lot of people deal with every day. Lasik technology will only get better and, who knows, perhaps a procedure for thinner corneas with better eyesight retention won't be too far off in the distant future, or another doctor might have some other suggestions. In the meantime, though, I think I'm just going to pick up another pair of frames so that I can have more fun with my look, and I am flirting with the idea of trying contacts for the time when I really don't want to wear glasses, despite being kind of freaked out about putting something in my eye.