TechStuff Classic: TechStuff Stares at Laser Eye Surgery
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So I very rarely get to do it because Tarez got some attitude on her. Let me tell ya, but today it's time for another classic episode of tech stuff, which means it's Friday today. We're going to look at an episode that originally published on October twenty. Fourth, two thousand eleven, Chris Pellett and I talked about laser is surgery. I found it fascinating. Chris turned about eighteen shades of green while we recorded this. It's been a long time since obscene Mr. bullet. But I remember how green he turned when we talked about the process. I have had laser eye surgery done, and now I'm a centrally a super human. I can see through walls and shoot lasers with my eyes. Maybe I guess we'll find out. Let's listen in on this classic episode today we're going to talk about laser eye surgery. We've had some people ask us about laser eye surgery and what goes into it and exactly how are used in the process. I think that's a record for your use of that version of lasers. Yeah. And so we're going to, we're going to kind of break it down and talk about what goes into a laser eye surgery procedure. And we should also mention, I should mention that I am very close to someone who has had laser eye surgery. No, right now not like physically. I was going to say, it's my, my wife. My wife had laser eye surgery, and she has been very heavily moving around without the need for glasses for several years now. And it was very impressive to me because my wife is not the sort of person who typically likes people, you know, messing with their eyeballs. Exactly. Yes. She's not high on her list of things to do. Today, but she did it anyway and we're going to kind of talk about the process and what you have to do in order to get laser eye surgery and what's actually being done to you. And I think probably the best place to start is speaking of eyeballs with the eyeball itself. Yeah, you might need laser eye surgery in the first place right to to understand this discussion. You have to have at least a basic geography of the eyeball. So let's talk a little bit about the I so so you're you're I, the outer coating is sort of tough. Outer coating called the sclera, and that's sort of what keeps the eyeball in its shape. It's it's kind of the the well, it's just it's the outer layer and then part of this outer layer about, I think one sixth of it is the cornea, which is the clear outer layer that goes over the part of your eye. We're light actually passes through to get to, you know, drive. All right. So the cornea is. The, it's kind of like a window in a way, or if you want to think of it like a a tablet device or something. It's the gorilla glass outside text the the, the innards and then behind the cornea. Well, first of all, you've got this sort of a watery clear liquid called the aqueous humor. And this goes back to the old humor's. Idea that dates back centuries where we used to think that our bodies were were were governed by a well, a small group of various liquids called humor's. Yes. We've somewhat developed beyond that at this point. Although I do think it's it's funny that even now we are referring to this particular liquid as a humor. Yes, the aqueous humor. It's this click clearly quid that's behind the cornea. It's also in front of the IRS and there's a little bit behind the irises. Well, so then that leads to the question, what then is the iris? Well, that's the that's the colored part of your eye. So for example, my Iris's blue because it lacks a certain amount of pigmentation which makes it a blue color. My wife's eyes are Brown, and this is the part of the other axes, like an adjustable diaphragm around the pupil. So the pupil is the that's the the dark center of your iris. That's the little opening actually, that allows light to pass through. Right. And of course, that's the part that. Enlarges or get smaller depending on the amount of lighten the room. Yeah, I, it's, it's, it's really an ingenious kind of approach. Really. It's the same sort of thing that we do with cameras when we have an aperture, the aperture of a camera and you may remember this view. Listen to our podcast about slow motion. We talked about the aperture quite a bit. That's what allows you to adjust how much light comes in through the camera's lens and hits the sensor. Same sort of idea here the iris is what will expand our contract around the pupil and us control the amount of light that comes in. So if you walk into a dark room, then the it's going to the the is going to allow more light pass through. It's going to allow more of the pupil to be exposed so that you get more light since you can maneuver through. Because you know you're going to be able to, you need to be able to see if you're on a really bright environment in order to protect the eye diaphragms going to close around the pupil to. To restrict the amount of light that comes then. Right. And of course there there's more than one analog as far as the eye and a camera short. We were talking about cameras, not too long ago where we, we talked about the lens and how light passes through the lens to the film on the other side or or an image sensor in the case of a digital camera. Sure. Well, in the I, you've got the retina which is if you will on the on the backside of the eye, which is what records the image as as the light comes through the pupil, right? You've got, you got the pupil. That's the amateur. You also have a lens right behind the pupil, right? So the the lens is what is focusing that light directing that light so that it it hits the focal point. Ideally, which is the retina and the retina contains certain kinds of of cells, rod cells and cone cells. These are light censoring light sensors essentially. Since the presence of light and. Through a chemical reaction, send that information to your brain, and then your brain says, hey, I recognize that. That's a puppy also. Interesting point. If you weren't familiar with us, the image that you see when you're looking at something when it hits your retina, it's actually inverted. As it isn't a camera, but yes, so this, this is the basic part of the, I now, what happens when something is just not quite right, for example, Chris, I, I don't know. Are you nearsighted farsighted I am myopic. I am also myopic. That means we are both nearsighted and says, we both have our glasses off at the moment. We're both a little blurry. So myopia means that the focal point is hitting. It's it's hitting before it gets to your retina. So inside your I, there's a on the light is being directed by the Lynn's to your retina. Those the points of light are all converging. Right? And that point of convergence is the focal point. Now, the focal point for those with myopia is in front of the retina. It's not hitting the retina, just right. So that means that when we start looking around things, things tend to be the the further away. Things are the blurrier they tend to be yes. Now this can happen through various just well, irregularities. There could be a regularities in the cornea that can cause this to happen or in the lens itself, or it could be that the eyeball itself is a long gated, yes, so that the, you know, if the eyeball was not along gated, the focal point would be right there on the retina where it's supposed to be and everything, it'd be fine. But the I've always been stretched. Nice. Sound effect. Hank you doesn't Jonathan. Stricklin necessarily mean you that someone's actually gone in there and stretched your eyeball just means that that's kind of the way it developed now farsightedness which is a hyper OB hyper OB. Thank you. I'm glad you ready for that. One was ready. Yeah, hyper Obea. You've got the focal point. That's that's actually behind the retina. So when the lights hitting hitting the retina, it's not converged on that point. Like it should be and hyper Obea if you're hyper hyper rob pick with that, be correct. I think so. Hyper than that would mean that you know you would the the, the closer Suffolk is the more out of focus. It is the further away. It is the clearer. It is also in addition to being myopic. I, I also have an astigmatism I to have an astigmatism. I think he's just, you know, doesn't want me to have one more than he does. I, I only have one. Do you have to? Well, no. I'm saying. Are you. Have an has stigmatism me too me too. Abbas we affect one upsmanship anyway in an astigmatism. You have a difference in the shape of your cornea or the lens. And basically what happens is it creates an effect to focal points within your eye. And so basically that sort of confuses the way the light is traveling inside your eye and that you can have as we were both pointing out just a moment ago, you can have an astigmatism on top of another I condition. Yes, yes. It's really an uneven curvature. Yeah, the cornea or blends. And yeah, it's it, it can cause problems. So the thing is that the humans are clever and yeah, and we figured out a long time ago that if you use a lens of glass and it's Kirby just the right way, the curvature of the the glass can direct light so that it corrects for these problems. I can't imagine the amount of trial and error. It took to be able to figure this out, but. To correct your vision, you have to take into account what the focal point is doing. Inside your eye. So was it it's a little bit different between myopia and and hyper Obea. But anyway, the curvature of the lens depends upon the condition, right? You know if it's going to be a concave lens for one and a convex lens for the other. And honestly, I can't remember the one from the other. I guess it could stare my glasses, long enough and try and figure it out, but but the point being that that's what's going to direct the light the right way into your eyes so that it corrects for whatever problem you already have. Chris, I have more to say about laser, eye surgery. But first, let's take a quick break to thank our sponsor. I want to thank the Microsoft surface team for sponsoring this show. Now you might remember from a few episodes ago when I talked about the surface go, well, now you can meet the newest member of the Microsoft surface family. The brand new surface pro six. And this sucker has got more of everything you want has more power and has more speed and a ton more fun. You can get a peripheral keyboard and it will snap right on to the Microsoft surface pro six and you can type on it like it's a laptop you can could detach it just as easily and then draw on your Microsoft surface pro six as a new eighth generation. Intel core processor powering the thing that's incredibly powerful. It gives you up to thirteen and a half hours of battery life on a single charge. You can work where you want, how you want for as long as you want. So check it out the Microsoft surface pro six. What if we didn't want to wear glasses? What if we wanted something where it wasn't, you know this, this pair of frames sitting on our face. That's when we started to come up. Well, we could maybe make a lens that could sit directly on the I and do the same sort of correction. Yes, he's going to require a more precise approach because it's going to be a much smaller lens that by definition, I mean, you can't have an enormous Glenn's shoved into your eye in expect any sort of comfort. So that's where the contact lens idea came from where we started to kind of get you apply these same kinds of thought to a thin lens that could fit directly on top of the eye. But then we thought, hey, wait a minute. We're really just talking about lenses here, even even the cornea can act somewhat as a lens, the cornea on your itself directs light. So what if we were to reshape the cornea so that it corrected for whatever problems we had as a, you know, as far as vision problems are concerned, what if we just did that we wouldn't have to wear contact lenses or glasses or anything. And that's where the idea for corrective surgery comes from and and at its very most basic level, what corrective, what this laser eye surgery is doing is it's altering the shape of the cornea. So that directs light in a way that corrects for whatever vision problem you have. That's that's the basic, you know, when you get down to it, that's what laser eye surgery is all about. Right? So it's just it's that same principle behind grinding lens so that you can see, you know, in a. Survi- glasses, but now it's applied directly to our biology. Right it sadly does not mean you will actually end up with laser shooting out of your eyes will at least not for most people? No, I I would think that's a pretty rare side effect. So, yeah. Where would you like to start with laser? Eye surgery? Well, I was gonna talk about sort of the the process you have to go through before you get laser eye surgery done, and then we'll get into what is actually going on in a a laser eye surgery session. He had, because frankly, it's it's reminds me of a lot of life events. You know, the actual event itself doesn't really take all that long. Laser eye surgery only takes a few minutes. Yeah, it can be. It can take less than half an hour total, but there is quite a bit of preparation that need that you need to go through yes beforehand to make sure that everything goes smoothly and preferably not panicky, which is the reason that I haven't had it done. Yeah. So the first thing you have to do is you have to go through and we're talking about a reputable laser, ice surgeon. This is a good time for us to point out there. A lot of different facilities out there that offer laser eye surgery services, do your research? Yes, that's a great idea because I know for a fact that there are there's a few in Atlanta that have a reputation for being less than honest. Mike, they'll though what they do is they'll offer this amazing sounding deal. And of course we all know the phrase that sounds too good to be true. It was probably on the internet. And the deal. The deal would be something like two hundred ninety nine dollars an eye, which is about a tenth of what some ice surgeries cost. You know, you're thinking, wow, that's amazing. And then you know, it's got an official sounding name and that's going to be great. And then if you actually start doing some research, you'll see that there's often a lot of bayton switch involved where you'll go in and they'll do this initial eye exam, and then they'll say, oh, well, in your case because you have this particular, you know condition or whatever. It's actually going to be closer to fifteen hundred per I, and just that alone is a, you know, first of all, it's kind of shady business practice. But beyond that you don't, you don't know how far they're ethics, extend into say, not being a good doctor, so. So in other words, your research? Yeah, quick alert. So assuming that the the facility is got a good reputation. You go in. And you would get a very thorough. I exempt probably more thorough. In fact, I would argue definitely more thorough than you would get going to just get a pair of glasses or contact lenses. I'm sure, yes, because they have to be bath to be very careful if you're going to go for for lay thick. For example, your eyes have to fall within a certain set of parameters. They can treat myopia hyperplasia and astigmatism, but it has to be within a certain range. Now, of course, that's measured in diapers. Yep, that's kind of the degrees of prescription. So you know, if you hear someone say all have got minus three in this I and minus two point seven, five and that I there myopic. Yeah, they're myopic. Yeah, that's a negative number means myopia. A positive number is a hyper, and then astigmatism he can go either way. Yeah. Now we do have a great article on how it works on the website and according to research in there. The myopia treatable with Lazic can be from negative zero point, seven, five, two negative ten, which is a big, a big rain. And I should also add that depending on which doctor you go to. They made tell you that if your site falls within a certain range like saying, let's say the the negative point, seven, five to say native one point, five. They might say, you know what? The the experience you're going to have the the near vision you're going to have is may not be so dramatic as to warrant laser eye surgery. Again, reputable clinic is going to tell you if the the result is going to be truly noticeable for some people, it may not be I for at least years ago when my wife got done. I was right there on the the border lying like, you know, I could have done it done, but it may not have been that dramatic. And when you're talking about that kind of expense, really do you want to go in for that? My wife. However, she had gone to the point of. Vision where they no longer use the I chart, they would say, how many fingers in my holding up. So she was an ideal candidate. Well, you have to hold them up. Oh yeah, the bull. You need some surgery, hyper PA that they can treat with les thick ranges from plus zero point, seven, five, two plus four. And then they can treat a stigmatism for plus or minus zero point, seven, five, two plus or minus four. So that's a pretty pretty decent range of vision that they can. They can correct, right. They also look at a the cornea thickness and it has to be five hundred microns or greater. Right? That's well explain why the cornea has to be at least that thick coming up. And that's going to be the these squiggly squirmy part where we're both like, okay, so here's what happens next tell you going out for water. Chris. Might Chris go by for for about five minutes. What was that thud? Yeah, there are other types of laser eye surgery that you can pursue. If your cornea is not of that thickness, if if it's thinner than that, there are other types of laser eye surgery you can look into so to speak right. And then your pupil should be no more than six point five millimeters in diameter. Although, you know, there are advances now that allow you to work with up to eight point five also. So if you're VIN diesel from that, that movie where he's got those huge cornea or the huge pupils that just wouldn't work lady Gaga from that one video. Yeah, those those folks, I'm sorry or practically any dizzy character because I mean, have you seen tangled that girls is are huge. Yeah. Sailor moons not going to have it done either. Yeah, so yeah. And also if you're pregnant, have heart problems, severe heart problems anyway. If you're taking drugs such as medicine for migraines or Agni, you have a condition called a chaotic conus. I'm hoping I'm pronouncing it right at check the pronunciation, but if they thinning of the cornea condition and actually I might be I might not be eligible either because certain conditions like auto immune diseases, one of which I have vascular disease, different kinds of I disease and diabetes. All these things might prevent you from going through with a Lazic procedure. So these are things that the doctor is going to have to talk to you about. Yeah. Entre medical history. Yeah, you need to be honest to, you know, even though you may not want to wear glasses. You know, this is serious business and then you could end up with results that you are not happy with complications as well. I mean, even yes, it could be that everything goes well, but you have some complications during the healing process. And if your medical history means that you can't have certain kinds of drugs to to help that healing process alone, that could be an even bigger problem down the road. So yeah, it's very important and then the actual exam, you're going to be looking through lots of different devices that are going to be measuring how your eyes are receiving light. This actually technically mapping out your is the inside of your eyes. There's a thing called a corneal topographers the that's where they type on your eyes right now. That's tougher the glasses back top Gerber. It actually maps the cornea. So it's it's looking at the actual shape and thickness of the cornea, and it's to to really determine exactly how the light is behaving. Hits that part of your eye. There's also the people ometer which is another device that's looking specifically at your pupil. I mean, there's not a big surprise there. Right? You have a student in your eyeball. Yeah. And then the their software, very powerful software, but working behind the scenes that's mapping out your eyes so that the surgeon is going to know exactly what sort of of adjustments they're going to need to make to your cornea in order for it to to direct light the way you need it to be so that you don't have to wear glasses or contact lenses anymore. So it's it's pretty complex stuff. I mean, it's pretty fascinating to see and also laser eye surgery procedure often requires two people, a surgeon and a well beyond the patient. Oh, two people to actually to to do the procedure, the surgeon, and then there's usually a an operator who's working on one of the the laser machines. I hate to interrupt while we're strolling down memory lane, but it's time for us to take another quick break to think our sponsor. I want to thank today's sponsor Caserta by lutron, smart lighting control brought to you by lutron pioneers in smart home technology with Caserta. 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We live in a world that's creating a I in abled everything. A world with more. I o t devices than people today. Technology has never been smarter, but smart only matters when you put it to work where it matters. When we put smart to work, we can help save species increase crop yields and make progress, but not just for a few of us for all of us. So let's get to it. Let's put smart to work. Find out how at IBM dot com slash smart. We've talked about the process where let's say that you've gone through. You've had your eye exam. You've done your medical history and they've determined your of what is called an ideal candidate. Now that does not mean you are the perfect person to have had laser eye surgery, just means that you fit those parameters that you don't have anything outlying any of those parameters that would that would cause concern. It appears that it will work out. Yes. Now is the time where you start to to to actually go through the surgery. And I think I think we can walk through the Lazic process because that's still fairly common. I mean, that's that's actually probably one of the most common forms of laser eye surgery out there, but we'll also talk about how the other kinds are a little different. So I when you arrive to get your laser eye surgery done, one thing that's happens fairly frequently is that they offer you something to calm your nerves. Yes, because it turns out would a lot of people and they're thinking they're going to be laying down on the table with so much shooting laser beams into their is they get a little anxious. I can't imagine why. Actually, that's not the part that makes me anxious, but we'll get into that. So it's the part demurely before the laser gets shot here. I, that would be the part. Yeah, that's the part where is gets all score me. Yeah, so, and yeah, I mean, basically they're going to set up an appointment when you do the your your. Yep. Preoperly. I don't think that they actually would take you back immediately and go right Illit. Good. Let's go. No, it's usually it's usually a day or two between speaking from my wife's experience. Yeah, she went in and had the the, the work, the preempt work done, and then it was a couple of days later after they had had a chance to really look at the data and they arranged for the time. And you also have to go there with someone else to drive you home? Yes, because you will not be able to use your eyeballs. Yeah, you for that. Yeah, exactly. You're going to have some limited eyeball. Use vehemently afterward. Can't wait on them. Yeah, exactly. Crutches. So I. Are those apple products. The lower case I e y e. I see. So the next thing they're going to do once you, you're sure you wanna go through this. Of course, they also make you sign a waiver saying that you understand that there are things going on where they're gonna shoot lasers in your eyeballs, and there are risks involved with that. And part of this depends a lot on your cooperation, like staying still and not running from the office naming again, I'm just imagining what would happen with me. They assuming you're your nerves of steel are hardly are holding. They will go ahead and put some topical anesthetic in your eyes. Yes. So this is to numb your is because they will need to touch them. Yup. And and once you're once that started to take effect your lead into the uprating room where you lay down on a table, usually a padded table and they physician you so that you're going to be under the machine. It goes ping and. And and then they have to while they have to secure your eyelids so that you're not going to be blinking? Yes, because you cannot blink so they may be using usually a combination of things. There's usually some sort of of tape that safe to put on your leads to keep your eyes open. There's also a device that will sit on top of the bottom part and top part of your eyelids to keep those them stationary. This looks a lot like the device that was used a famous documentary called a clockwork orange the from. Yeah, it's a little freaky. If you're looking at someone who's getting this done, the eyelids speculation. Yeah. Yeah. It's toehold those islands in place. Because of course, if you blink one, the laser's going, it's going to totally mess up the procedure so they have to, they have to stabilize and and keep your eyelids from moving. And they also put down a a ring around your eye that that stops you from being able to move your IRA and you're looking directly up are directly straight straight ahead is the best way to putting it not up as in your eyes are turned up, but looking straightforward just because you're laying on your back, it just happens to be up. And then as they the next step is the squiggly part. Are you ready? No, but let's do this. Okay. So they pull out the micro CARA Thome? Yes. See they have to the, they're going to put some marks on your cornea. Yeah, to identify where it is a little green where they're where they're going to use the micro Thome basically when you're dealing with something as sensitive is vision and and you know, the professionals wants to do a good job. They're going to want to be as accurate as possible. So they're going to Mark your your cornea. To make sure that they use the micro CARA Thome Ryan. I don't even wanna talk about it. It's a surgical instrument. Okay. It's a blade, a very fin blade, and this blade is used to cut a flap in your cornea, which is then pulled back so that the list through shape Courtney. This is this is this is retaining and painful to watch. This is part of the grosses me on. I'm sorry. Okay. So yeah, so they're actually and this is lazing. There are other versions. Do not use us in some of them. Don't even use a microcosm. Thome blade. They have a special laser that will cut this flap, but in in lazy geyser drained, there is a flap that's cut and pulled back so that the laser can start to shape the cornea without that outer layer in place. And and so this point the the laser which is called in well, is an exa Mer or exile. Her x. c. I m e r. actually look up the pronunciation, but this is the laser that does the actual shaping if asserts to vaporize parts of the cornea and wants doing is it's shooting ultraviolet blasts. The lasers in the ultra violet lane range, which means you can't see it rides outside the range of human site and what it's doing is exciting. The molecules in the cornea to the point where the molecular bonds breakdown. So it's actually that's wanted to talk about vaporizing. It's not. Heating, the eyeball up, no cool laser. I expect you to break down and when I mean cool laser, I don't mean that it's like super awesome. Although it is. I mean, it doesn't heat up the tissue bay. Remember earlier I mentioned that your cornea has to be five hundred microns or greater when they start this procedure. And that's because when they're done using this laser, there has to be a between two hundred fifty to three hundred microns of thickness once they're done. So there has to be enough for them to leave the proper amount once they're finished otherwise you can't do this. So now now using this laser to vaporise these molecular bonds and to reshape your cornea. That's essentially the same thing on on a grand concept level as grinding a glasses Lynn's gonna been light the right way. It's the same thing is just we're using lasers and your actual I to do it, which is pretty phenomenally awesome. Also kind of scary, not the end of. After it might take, I don't know seventeen to twenty seconds to do this, Chris, we. Okay. Okay. Yeah. Pry they've then replaced the flap back down on your eye and it heals I it sets down in place and is healing as soon as it touches back down. That is one of the very cool things I think about that. Yeah, they the the doctor will also probably put a little antibiotic on the flap just to make sure that there are no bacteria in there, but it it starts to heal, which is pretty phenomenal. The the whole process only takes, like I said, about twenty seconds pry. And usually when you're down there, you'll hear people talk about how the doctor told him to look at, say like a blinking red light, that red light is not the laser. That's just a light that led you to focus to folk. You're supposed to focus on that while this ultraviolet laser is blast in your your corn. No way. And then once the flap comes down, you usually you're given several different kinds of eyedrops before you leave. There's a moisturizing I drop because after you get this process on your eyes are going to have a little bit of difficulty generating the right kind of moisture to keep you arise comfortable. So you're going to have to actually ended. I drops in on her Preregister basis. In fact, the first couple of days it's it's like every hour. You've got to add eyedrops. And then as the time goes on, you have to use them less and less frequently. And my wife at this point rarely ever uses I drops, but for the first year she was using them on on a fairly regular basis. Although that that scheduled changed overtime, like after the first three months at the need to be as frequent. And now it's it's rare when she needs them. But occasionally she does. And then you met also have anybody drops that you might have to add every now and then and some places apparently put give you a kind of gel that you put on the inside of your lower eyelid so that when you're asleep, it keeps your eye moisturised while you're sleeping my wife. I don't remember her getting that. I should've asked her before. I left the house this morning, but I do not recall her getting that kind of stuff. I do remember the other kinds of drops though. And then they, of course, schedule as a lot of surgical procedures. They also schedule regular appointments and even as as soon as the next day to make sure everything's okay. And then gradually, as time goes on. You know, they check less frequently. You know they'll be a year checkup, but you know, it's one day and then they'll check the next week the next month, an increasing increasingly longer periods just to make sure everything's healing the way it's supposed to just to make sure that they are this. Your eyes are doing what they're supposed to do and you're not suffering any ill effects from the surgery. Because in the case of, I mean there there are times when the flap can get a wrinkle in it. Yeah, I was wondering if we're going to get into that. Yeah, they can having like that that can cause a little bit blurry vision and may require a second surgical procedure in order to to get it straightened out, so speak. Yeah. Also, you know, there's a possibility that they may remove too little or too much of the cornea. Yeah. They have to be you. They have to be. That's why they wanna check. That's why they're doing that whole long section so that they can determine that as precisely as possible to to reduce that risk as much as they can. And of course, again, this also depends a lot on the the patient, you have to be able to lay there and be still while you're I is being held open and laser being shot into it after someone's kind of flap in it. It's a little bit of a challenge for some of us. Let's talk really quickly about some of the other kinds of laser eye surgery besides Lazic. Okay. The one of the the precursors to Lazic and it's still in use, and a lot of places is PR k. laser eye surgery or photo refracted, career tech to me. Oh, I didn't know is going to be able to say that this one, they actually scrape away the outermost layer of the cornea with the laser and then reshape the tissue on the underlying surface of the cornea, and then they, and then you have to allow the the protective layer that was scraped off to grow back. So there's actually a longer healing period with PR k. then with Lazic they can use that process to to work on nearsightedness and stigmatism at the same time, which is nice. And then there's lazy check with an e. The Lazic we're talking about is with an I, but lay zek is a slightly more advanced version of PR k. that uses alcohol and solution to soften and then remove the epithelium which is that protective layer that almost layer of the cornea. Yeah, lay sack is laser epithelial carrier, Todd, mill usas. I didn't mangle that terribly. Yup. And then there's epi Lazic the modified version of that that uses a separator. So that the because then in the traditional as you're actually removing the epithelium entirely and epi Lazic, you're creating a separator so that you preserve that epithelium and then replace it on the is. So it's like you take the cover off fiddle around a bit and put the cover back on. It's probably I bet I search is out there. Just love me for saying that. There's LT k or laser Thermo carrot to- plastic. Now that was fun. It's used mainly for farsightedness nece stigmatism. And in this case they actually are using heat. They're using the heat of a laser beam to shrink and reshape the cornea rather than removing it. So they're actually reshaping it. They're pushing the stuff around as opposed to cutting it away, and it's supposedly a a much faster healing process than most other kinds of corrective surgery. And it's generally considered to be less invasive. So it's. That's an interesting approach. There's also there's a custom view Lazic conventional intra Lazic custom view intra Lazic. These are all variations on the basic Lazic approach, physically sick. And there are of course complications with some of these. We mentioned some before I've, I've known people to undergo Lazic and complain of some problems with night-vision where they see halos. Yeah, there's a lot of that where everyone looks like master chief. No, no. Basically when you look at a light source, it looks like it has a ring circle around it. Yeah, yeah, especially things for like if you're driving at night and you'll know halos around headlights. Yeah, things like that. Where sensitive to bright light? Yeah. Yeah. Your light sensitivity, especially for the first few days, it's probably going to be a little a little rough, but for some people have just it stays that way. So like my wife, she wears sunglasses a lot more frequently than she is too and for for some people to. I've heard that in some cases it is possible for your is basically to slowly regress to where they were before. I don't know exactly why that is. I have read reports that that happens. But in in, you know, some people who have in, you know, enjoyed the benefits of the surgery for years. And then there are others who gradually return to to the way they were before. I, I'm sure that it'd probably since since part of the cornea has been removed, I would imagine that it's probably not as drastic a change was, but I've, I've read that that that can happen. I would imagine if you have some sort of condition that continues to change the shape of your eyeball, that would be a big problem because the focal point would constantly be changing or gradually be changing. Well guys, that's it. That's another classic episode of tech stuff in the books. I really love looking back on these after recording more than a thousand episodes of this show. It's sometimes a journey of discovery for me to go back and look at these old episodes and also it's just fun to think back on working with Chris. Paul at he was a great co host and editor. So Chris, if you're out there listening to this, we miss you buddy. If you guys have suggestions for future episodes of tech stuff, whether it's a technology company person in tech, maybe there's someone you would like me to interview on the show. Let me know. Send me an Email. The addresses tech stuff at house, two, four dot com or drama line on Facebook or Twitter, the handle of both of those tech stuff. HFS w don't forget. You can find our merchandise over at t public dot com slash tech stuff that's t. e. public dot com slash tech stuff. There's all sorts of fun designs in different products. You can get every single purchase goes to help the show, so we greatly appreciate it. And, oh, also we're on Instagram. You should be following us and I'll tell you again really soon. 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