An Unusual PRK Account.....currently 3 months post-op
Pre-surgery prescription –1.75 both eyes
The first time I went to see if I was a candidate for LASIK was back in 2005 and was turned down, all they said was my pupils were to big. So recently I had been thinking it might be worth another try. I did a lot of research into the best lasers, learned about the Optical Zone and the Treatment Zone. I was mainly concerned with night vision problems since I had 8mm pupils.
So I found a place with good reviews and the best lasers and made an appointment. They said I wasn’t a good candidate for LASIK because of large pupils and a thin cornea but said I was ok for PRK. They put some dye in my eyes to check my tears and make sure I didn’t have dry eye. Prior to surgery I never even noticed my eyes, even with contacts my eyes never bothered me except maybe if I had them in all day they might get a little itchy at night.
I spent a few weeks looking into PRK and scheduled the surgery before Christmas so I would have at least a month off to heal before going back to work. This also gave me 2 more months to look into PRK, which I really didn’t do as much as I should have. I mainly just read a few personal experiences, looked at what the recovery was like and compared it with LASEK and Epi-LASIK.
A few weeks before surgery I called up to check on the appointment and was told I needed to reschedule since the date they set up for me was no longer available!? So I took an appointment 45 min away from home so that I could keep my date in align with my vacation time.
The day of the surgery I made it to the office and had my operation with the partner of the surgeon I was hoping would originally preform the surgery. As soon as it was my turn one of the assistants said that the surgeon felt he could perform LASIK on me safely and offered it to me as an option!? Which I turned down because I was originally told I was not a candidate for LASIK and after my research still preferred PRK to LASIK. So I was a little put off that this guy was just willing to throw all caution to the wind and try out LASIK on me after a 5 minute decision. But I think when you’re sitting there in the waiting room and everyone just seems to be going about there business as usually it kind of make you feel like any doubts you have are probably just in your head and if you mention anything everyone’s just going to treat you like you're crazy anyways so what’s the point.
So I went through all the pre-pre surgery crap and watched the little videos. Then talked with the surgeon and was mainly concerned with night vision problems since he was talking about a treatment zone of like 6.7mm and I had 8mm pupils. That’s when I was reminded that they really want to keep as much tissue as possible to limited other side effects like corneal ectasia and the bigger the Treatment Zone the more tissue they need to burn away.
It was at this point that most of me really just wanted to walk out of there, regroup and do some more research but then there was this little voice saying "just do it and get it over with, it’s now or never." So we walked into the surgery room. I had Custom PRK ($7,000) with either the Visx Star S4 or the Wavelight Allegretto Laser, Wavefront technology included.
The surgery went pretty much like usual but mine was kind of sped through with not much information given to me. After the right eye was done I was kind of hoping he would have walked through the surgery and said when he was starting the laser and how long it would take so I asked him to tell me on the left eye. He seemed a little put off by that but managed to let me know when he was frying my eye the second time round.
The one unusual part of the surgery was that he didn’t do exactly the same thing to the left eye as the right. On the right eye he, used the alcohol solution, removed the epithelium, rinsed my eye with water, used the laser and put on the bandage lens. On the left eye he used the alcohol solution, removed most of the epithelium, rinsed with water, used the laser then smoothed out what remained of the epithelium over my cornea and put on the bandage (Performing some sort of Epi-LASIK-PRK hybrid.) I asked him “wha…what are you doing?” he said “I’m just smoothing out some of this epithelium so that you’ll heal faster” and I started to say “isn’t that Epi-LASIK not PRK?” But I couldn’t remember if it was Epi-LASIK or LASEK I was thinking of so I just stopped mid-sentence.
It wouldn’t have matter to me but I had recently looked into Epi-LASIK and LASEK. I read some studies that said the nerve regeneration after refractive surgery was directly related to how well the epithelium layer healed and how thick it was. It also said that the epithelium healed best with PRK. So I would have preferred that he just dispose of the dead alcohol soaked cells he scrapped of my eye instead of reapplying them to “speed up healing.”
After the surgery my eyes basically just felt like they had been burned with a laser and were pouring tears the whole way home. Plus my nose was running like crazy from all the tears. The pain pills I got were completely worthless (I’m 6’2 210 lbs.) I didn’t feel any different at all and got around a 2 or 3 hour of sleep that night. The next day was pretty much spent putting in drops and trying to get some sleep.
My drop schedule was Vigamox, Omnipred, Polymyxin B Sulfate in Trimethoprim Ophtalmic Solution and pain drops for 5 days, 2 or 3 times per day. (I only used the pain drops once)
The day after surgery was my first check-up and the vision test was pretty much a joke since I could hardly open my eye let alone see anything. That was also when I was told to buy some artificial tears to keep my eyes wet. But the doctor that day forgot to mention to get preservative free drop so my dad got me two bottles of drops with Benzalkonium Chloride in them.
It was at the 5 day check up that the lady checking my vision told me I should be using preservative free drops. On the 5th day I also got my bandage lens taken out by the doctor I originally wanted to perform my surgery. After checking out my eyes and with little comments like “Oh the flaps look good” and “ Oh wait you had PRK not LASIK” my confidence for this clinic certainly wasn’t very high anymore. Also next time (ha) I’ll take the bandage lens out myself since the doctor scratched the hell out of my eyes while trying to get them out. You wear contacts for 6 years but THEY have to be the ones to take them out this time. You’d think they could at least cut their nails every once in awhile.
So now the contacts were out and my eyes could do some real healing on their own. For the first week my eyes were open maybe 1 or 2 hours a day and the second week maybe 2-3 hours. I just tried to heal as fast as possible and listen to some audiobooks a couple of times over. At the 2 week point I was seeing 20/20 probably 20/15 but they never tested me for 20/15 till last week. Things were blurry and I had some very minor ghosting/ halos during those 2 weeks but really I didn’t have my eyes open much so who knows what else was going on. Also keep in mind my prescription before surgery was only –1.75 and they only had the laser on for a few seconds so my eyes probably didn’t really have that much healing to do.(not that they're completely healed yet)
A month after surgery I was also put on FML steroid drops to see if they would help with the dry eye. I took them for 2 weeks morning and night with not much effect.
That’s it, now I’m at three and a half months and the right eye is now my main eye even though my left eye is my dominate one. The right eye seems like a normal post PRK eye (slight dryness at night but otherwise not very bad.) The left eye still feels like 2 weeks post operation; dry as hell, constant burning but drains tears 20 times faster than before surgery. I also get what feels more like nerve pain in the left eye from time to time. It’s a burning feeling sometimes with little flicks of pain in the cornea. The only time my left eye produces tears is when I yawn 6 or 7 times. I’m also trying to put in less drops cause I’m starting to get chapped lid margins from overuse and currently use Refresh PM as a kind of eye ChapStick.
For more info on my unusual circumstances click here>>> Hey Everyone, 3 Months post PRK, Left eye drier, Refractive Surgery Studies link
Last edited by PRK; 27-Mar-2011 at 12:55.
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