PRK and me!

February 2, 2008

This is going to be a rather lengthy post with lots of detail but at the moment it’s cathartic so bare with me.

 Alright so about 24 years ago when a friends older brother had corrective vision surgery the seed was implanted in my brain.  I’ve revisited the topic many a times in my head keeping up with developments as time has gone on.  About six years ago I decided on a whim to go to one of the McDonalds of laser surgery to check if I could have Lasik done.  Genetically both my mom and dad have thin corneas so it seemed remote but worth a shot.  Shockingly even though I consider them to be like breast implant clinics, they turned me down.  They could do it but not to 20/20 vision and refunded a small deposit.

 So two years ago the FDA approved corneal implants (designed for people really who had cateracs with 10.5+ diopter myopia or so their site says).  I’d done some research and I knew whick doctor I’d have check my eyes once again.  I went through the customary lets check your eyes exam albeit technology has come a long way since my last one.  Sat down and talked numbers the girst of it 5.25 diopters of myopia on both eyes no astigmatism and a dim light pupil size of 7mm.  He said I could actually have Lasik, PRK and that the corneal implants at my age with my script would be a rather aggresive treatment.  Food for thought really but then some more numbers I have a corneal thickness of 480 microns.  The minimum amount you want remaining after Lasik is 250 microns.  With the flap and removable I would end up with a conservative 275.  And closer to 330 with PRK.

So some thought here and decided to finally take the leap and schedule PRK surgery (both eyes) on January 24th.  I am not advocating anything but any one who wants to have vision correction surgery, forget what the doc tells you, do research, long and hard research prior to comitting to anything.  Any ways PRK vs Lasik.  It’s really a short heal time with a flap incision of about 90-110 microns on your eye that will never fully heal.  Versus PRK which is a removal of the epithelial (about 30-40 microns) which does grow back but you run into longer healing and possible infection issues.  These are the short term risks there are many other long term risks I wont get into with both procedures.  With my corneal thickness it seemed like a no brainer as far as which to me.

A slight sleepless night prior, anxiety most likely either that or I just don’t really sleep well any way.  I’ll give you a brief run down of what that surgery is like:

  1. Lots of checking double checking of prescription levels.
  2. Pictures taken of eye during normal dilation
  3. Valium (small dosage) administered
  4. Dilation drops and more checking of prescription levels, permanent marker used to give reference points on the eye
  5. Manual checking of prescription (this might be out of sequence but it was in there).  This is the 1 or 2 test.
  6. All this takes about an hour
  7. Brought into surgery room (it has video cameras should any one wish to watch from the outside)
  8. Right eye sealed up with some pads
  9. Numbing drops applied
  10. Retractor clamp to keep eye open
  11. More drops of unknown nature applied
  12. Scrubbing with what felt to be a q-tip (this removes the epitheleal and smooths it for the laser)
  13. Stare at the red light, nasty hair burning smell, 1 minute laser time.
  14. More drops that are timed before removal (30 seconds would be my guess)
  15. Icy cold saline type wash over the eyes.
  16. Place a bandage contact in (this stayed in for 5 days)
  17. Repeat for other eye.
  18. All this took about 15 minutes

So if you read all the propaganda about healing times, you should be functionally seeing in about 4-5 days with PRK and 1-2 days with Lasik.  Now if functionally seeing means no pain, you can read a computer screen, sun light doesn’t scorch your eyes and the world seems to be bathed in fog where everything is a blurr.  Then yes the standard lasik, PRK propaganda does not lie.  Now every one has different pain levels, healing rates and so on.  I figured I was probably one of those extreme cases.  A few people thought ZOMG can’t see 20/20 after two days this has gone totally wrong!  I knew this would take awhile to heal and this would be more painful but I’ll give a bit of a reality check to the propaganda nazi’s out there.

it seems most people I have spoken to, read and so on experienced similar / some times worst / some times a bit better recovery periods.  I’d say I am dead median at the moment (although this is only my 9th day post op).  The pain for the first 3 days was intense.  It’s described as having sand in your eye.  I think we all know what this feels like, but it’s a rough reference point, since it’s a constant piece of sand in your eye that you cannot wipe or sooth away combined with intense light sensitivity.  Enough so your eyes just want to clamp shut.  This was greatly alleviated for me when the contac badage was removed and while I could see pretty clearly by the 5th day with the contac in (it smooths your cornea as well as protects it) once it was removed I lost the foggyness but my vision went to shit.

Most people I’ve talked to and I can count my self here felt that it was 2 weeks before they could function (and this is to the point where they could read a computer screen, drive…you know function).  It’s a very slow process for this and while at the moment I’m taking shortcuts so I can work (like getting cheapy reading glasses and bumping my fonts to as high as they can go).  It feels like an eternity.  Wish me luck as this can take up to a year to get back to normal (assuming no complications), I’ll take the usual 3 months though, please?

So this finger is to any one who has ever uttered the words, “no big deal!, was fine the next day, it doesn’t hurt a bit” and to any one who write marketing shit for the Laser dudes of the world.  One I know it’s a lie! (ok maybe it wasn’t for you but any ways ) and two if any one reading this desides to have eye surgery alot more than a week for recovery.  You might not need it but it sucks if you do.  Personally I’d say 2 weeks vacay minimum just to be safe.