This is what my vision looks like 3-days post PRK. Yesterday it was 20/30 and sharp!
I opted for a clinic in Portland with a good reputation. The pre-surgery screening went well and they found me to be an excellent candidate for either LASIK or PRK due to my stable prescription of 10+ years and thick cornea. This clinic used the Visx S4 laser which isn’t the newest excimer laser but has a proven track record. The competing brand is the Allegretto Wavelight system. Both systems do an excellent job, but I settled on a clinic with the Visx since it has iris tracking and is an older, more stable technology. When it comes to tech, I’m usually on the bleeding edge, but as an engineer I know that older technologies tend to have their bugs worked out. Before the screening I had already decided on PRK instead of LASIK. In fact, when the surgery coordinator explained my desired procedure to the surgeon, he took one look at my records and said, “good choice!”. He later reinforced my decision by stating he would also have suggested PRK. They were both impressed that I had done my homework, as their typical patient does no research prior to jumping head-first into a laser surgery.
If you are considering having your eyes lasered, spend many hours doing the research to learn as much as you can about the procedures and your options. Most people don’t know about PRK as an alternative to LASIK, and this fact is obvious since the vast majority of laser surgeries are LASIKs. While it’s true that LASIK has a much faster recovery time, the procedure also creates a flap in the cornea using a suction ring and a microkeratome (specialized knife). The creation of the flap can cause pressure in the eye, creating floaters in the process. The flap itself is subject to a multitude of complications and never fully heals. This is the reason why Navy divers (and pilots at one time) were disqualified if they had LASIK. The corneal flap essentially weakens the structural integrity of the cornea in order to preserve the epithelium, or outer layer of the eye. In PRK, the epithelial cells are removed and the surface of the eye is ablated with the laser. This results in less corneal tissue being removed and no flap creation, but longer healing times because the epithelium must re-grow and smooth out before the eye can see with perfect clarity.
Surgery Day
I showed up at the surgery center and waited for about a half hour. After I was called, they had me sit in a pre-op/staging area where they took my vitals and gave me a Valium pill. Although I didn’t feel nervous, my heart rate was measured at 99bpm, thus the Valium dose. After a quick eye exam by the surgeon, they escorted me into the surgery room which was very cold due to the low operating temperature requirements of the Visx system. After laying down on a reclining chair, I was given a blanket and some pillows for comfort. My eyelids were taped open and I was given some numbing drops. The drops worked well since I didn’t feel the sterile brush used to remove the epithelium. The brush itself resembled a Dremel tool with rotating bristles. It took a few minutes to remove the cells but I only felt some mild pressure. After the epithelium was removed, the surgeon poured some ice cold water into my eye to slow the metabolic process. This *was* painful, but only lasted a few seconds. At this point I was ready for the actual surgery, so they swung my pivoting chair into the Visx assembly. I could see a blinking light which was my focus target during the procedure. The laser itself sounded like a woodpecker going to work on a metal light post. The Visx iris register was able to track my eye at 200Hz while the laser delivered pulses at up to 20Hz. Even though my eye was moving, the laser was able to deliver precise blasts. The laser itself emits energy in the ultraviolet spectrum, but does have some components in the visible light range. During the procedure, which only lasted 10 seconds, I could see shades of purple and blue in my peripheral vision while the room filled with the smell of burning flesh. My vision in that eye also became progressively blurry during the ablation until a new set of cold eye drops was applied immediately after the procedure. Once the tape was removed from my eyelids, I could see perfectly with the post-op eye. Although my visual acuity wasn’t measured at this time, I’m sure it was near 20/20. I was given a bandage contact lens and an assortment of eye drops and then sent on my way.
The numbing eyedrops wore off after a few hours and the pain I had expected never fully materialized. Instead it felt like I had several eyelashes caught in my eye. I was able to control the discomfort with some re-wetting drops. My hour nap also helped, I’m sure. The surgeon gave me a call in the late afternoon just to check on me. I was doing well, but the gesture was greatly appreciated.
Post-op Day 1
I had my one day post-op appointment in the morning. The surgeon found no signs of infection or complications and tested my vision to be 20/30. Amazingly, one day after the surgery, I wasn’t in much pain and my vision was incredible. He warned me that my vision will deteriorate as the epithelium heals unevenly and it may take weeks to months to regain perfect vision. My pain level was minor, with some dryness easily treated with lubricating eyedrops. I was given a regimen of eye-drops, including steroid and antibiotic drops.
Post-op Day 2
At yesterday’s appointment, the surgeon said day three would be the most difficult. He was right. I had actually considered driving home yesterday since I am staying with my in-laws in Portland. Today, my vision deteriorated significantly. I would now guess I’m around 20/200 in my left eye with a great deal of blurring at all distances. I’m also seeing halos, starbursts and ghost images. The ghosting appeared first at the 8 o’clock position, but then expanded to an almost uniform blur. I’m hoping this is just due to the epithelial cells covering the corneal surface. At this point I definitely cannot drive and I’m in some pain. The lubricating eye-drops (carbomethylcellulose sodium) are helping significantly with pain reduction, although I have to apply them frequently.
My surgeon convinced me to do one eye at a time with PRK. I’m glad I heeded his advice!