Today I spent two hours in the ophthalmologist's office. They did numerous tests, made me look at various light shows, read charts and choose between lenses. But the outcome is positive.

It is safe for me to have lasik eye surgery. As my eyesight is poor (-6), there is still a great chance that I will need to wear glasses afterwards. However, when not wearing my glasses I will be able to see enough to function properly.

This means a great deal of freedom for me. I will be able to do things like swim, attend exercise classes, put on makeup etc all without feeling vulnerable and limited due to my poor eyesight.

I am concerned about managing my blood sugar during the post-op period, however. Managing the blood sugar is of course key to healing and preventing complications. The last time I had an op I was on rapid insulin, and my blood sugar yo-yoed like crazy. At the moment I am on metformin, but I fear that my current dosage will be insufficient to cover the post-op needs. I'm contemplating asking my doctor for a prescription for some long-acting insulin. This should hopefully get and keep my sugar down, without the exhausting yo-yo effect.

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Comment by Lizzie on March 6, 2014 at 6:51am

Hi there - I tell everyone that the money I spent on lasik was the best investment I ever made. My eyes were at a -8/-9, and now I have 20/20 vision (though I do have very very low prescription glasses for driving that I occasionally use at night or whenever I want things super-crisp. I also think I look cute in glasses...)

I'm a type 1, so I don't know if this will help you or not, but I just made very sure to keep my blood sugar as stable between 80 and 180 for the two-three weeks prior to the surgery so that my eyes would be my actual prescription and not high-blood-sugar-blurry. Afterwards, I again tried to keep things as level as possible to help with healing, but that was only a few days. After the first day, your corneas are "healed", it's just your eyes are still inflamed and a little swollen, so that's why they say your vision will adjust for a few weeks-months afterwards. I experienced no negative side effects from not having spot on, perfect blood sugars after the surgery. Also, if you're just on metformin, you probably won't have any low swings to worry about, just some highs at the worst.

My only recommendation is to make sure that you SLEEP as soon as you get home. I took tylenol PM to go to sleep, but apparently that just makes me jittery instead, so I had to feel the very unpleasant burning and pain during the 6 hours after the surgery. Do yourself a favor and sleep through that! After the 6 hours, you don't feel a thing.

Comment by Megan S on March 6, 2014 at 11:02am

Thanks so much for the reply, Lizzie. It must have been heaven going from -9 to perfect vision. Although I do hope that I will not need glasses, I am trying to be ok with any improvement I get.

I've been wondering about the effects of my blood sugar on the test results. I went for the consultation yesterday and my sugar was at 8 (postprandial). Also, I've been neglecting my diabetes for the last two months and my last HbA1C was an obscene 9.9.

Thankfully their machine is currently being upgraded and so they are not doing the op straight away. I'm hoping the extra time will allow me to pull my HbA1c down into a better range. I've certainly got a great reason to be motivated to do so now!

Thanks for the tip about sleeping. I will make sure I do that.

Comment by A on March 13, 2014 at 10:17am

I'd been seriously thinking about Lazik right before my Type 1 diagnosis and had done the initial consult that approved me as a good candidate. This had been backburner while I've been working to get all the elements of managing diabetes more stable.

My vision is also -9 and (2 years post diagnosis) my optometrist, endocrinologist, and opthamologist all say they don't recommend Lazik for me. Their reasoning seems to be along the lines of don't mess with the eyes, as they are already vulnerable for damage from diabetes. (My HbA1C = 6)

Wondering if others meet with this kind of resistance/lack of support with their med team when considering this option??

Comment by Megan S on March 13, 2014 at 12:15pm

Both my opthamologist and optometrist recommended Lasik to me. In fact, my optometrist told me I'm as blind as a bat and should just get it done. They were both aware that I'm diabetic, but that didn't seem to change their opinions.

Comment by Lizzie on March 16, 2014 at 8:29pm
My eye doctor and the surgeon had no problem with my getting LASIK with type 1. The only concerns were that my a1c was stable at below 7.5% for at least a year, that I didn't experience wild blood sugar-related variations in my vision, and that I passed all of the other tests required for everyone else. My current ophthalmologist has no problem with my having had LASIK either, and she's an expert retinologist. The retinas, which are typically where diabetes complications show up in the eyes, are completely different and separate from the LASIK procedure which focuses on the lenses and corneas.

I would talk to a LASIK surgeon with at least 50,000 procedures to get a real sense of what the surgery entails. I wouldn't trust my endo, who knows a lot about endo things, to be last word on my eyes. I think it helps if you haven't had diabetes for that long so that healing isn't impacted, but that's just my hunch. No one ever told me that. I was 3 years post-diagnosis.

Everyone agreed that, in my case, LASIK was the safest option between glasses and contacts. I was a lazy contact wearer and slept in them too often, and my prescription was so strong that glasses often distorted my vision because of their thickness. LASIK gave me my best shot at healthy, long term vision correction. Since I was so blind, having to rely on glasses or contacts was more of a risk, especially overnight.

It certainly wasn't a decision I made lightly since someone was going to cut my eyes open and then shoot lasers at them for a minute each. I was actually approved for the surgery a year before I went ahead and scheduled it, so I completely support taking your time, making sure your levels are as stable as possible, and being 100% sure that comfortable with your surgeon and the risk. To me, the benefits far outweighed the risk, and it helped that I could positively influence the risks by keeping tight control on my blood sugar.

All that said, the greatest LASIK in the world won't stop you from eventually going farsighted with old age, so you'll only be free from glasses for so long!
Comment by Megan S on April 4, 2014 at 3:30pm

Well, the Lasik machine has now been upgraded and is ready to go.

I did tell the opthamologist my blood sugar at the time, and he seemed satisfied with it. But I didn't tell him my HbA1C.

Having had some time to think about it, I'm going to phone the opthamologist and put off the op. They haven't phoned me to schedule the op yet, but I think I must take some time to get my sugars settled before I take a chance and truly mess up my eyes.

I have another HbA1C scheduled in two months time, so I will hold off until after that and I'm happy with the improvement. I suspect I might have to up my meds though, but will have to wait and see.

When I was first diagnosed, with a BG of 27 (468), I could barely see for a week. They told me then to wait for at least 6 months until my sugar had settled in to a lower level before getting new prescription glasses, so although I doubt my sugar has been that high I think 6 months is a pretty good waiting period.

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