My Experience with PRK

Let’s take a break from information security for a few moments so I can tell you about my experience with Photorefractive Keratectomy, or PRK.

I got my first pair of glasses as a young child in elementary school, and wore some kind of corrective lens ever since. For those of you that live with glasses or contacts, you know how much of a hassle they are—or better yet, you know how much of a hassle it is when they are not working properly or when you are missing them.

I had bad eyes. Really bad. I couldn’t see the big E on the chart without corrective lenses. I was between a -9 and -10 diopter correction, with astigmatism, in both eyes. That means that if I had a prayer of seeing what time it is in the middle of the night, I had to buy a clock with BIG digits, keep it close to the bed, and squint really hard to make it out. My eyes were so bad, in fact, that I wasn’t even a candidate for LASIK (here is an explanation of the difference).

PRK, Courtesy of Stahlvision.com

After much personal reflection and discussion with my wife, family, and friends, I decided to go to an eye surgeon to see if there was anything that could be done to correct my vision. I learned that I was a candidate for PRK and set my surgery date. My surgeon told me that PRK will provide me a much more stable long term result than LASIK would, but the recovery is much longer and more involved. LASIK patients tend to have 20/20 vision within weeks, where PRK patients could take months or up to a year to fully settle into their permanent vision.

On my surgery day, my wife and I made our way after breakfast to the surgery center. The butterflies started as I walked into the operating room with the big laser. Not like James-Bond-strapped-to-the-table big laser, but a large room that was 2/3 machine and 1/3 people. Had I been wearing my glasses, I am sure I would have been more intimidated, but I was being lead around by “handlers” that put me on the big table while my wife watched through a window.

The actual process of being under the laser was not that bad. The most painful part was the speculum that kept my eyelids open. It pressed on my cheekbones and caused me quite a bit of discomfort, but there was no pain from the laser itself. While the laser was going, I was instructed to focus on a little orange dot. Sounds easy, right? Well consider that you can see (and smell) the laser vaporizing tissue from your cornea. It looked like a lightning show, but again, no pain. After 60ish seconds under the laser for each eye, my handlers lifted me up and asked me to read the clock.

I COULD READ IT!

My vision was not crisp or perfect by any means (read the differences between PRK and LASIK to understand why), but I could see orders of magnitude better on my way out of the big room dominated by the machine. After a minor post-op exam, I was sent home with a shield over my eyes that would have looked fashionable only inside a chemistry lab. The drive home was where my discomfort started. See, the doctor prescribed a smorgasbord of drops and pills, but not until after my surgery. As the drugs used to numb my eyes started wearing off, I felt quite a bit of discomfort. It was a combination of aching pain and what I can only describe as sand grit. Think about walking into a sand storm, opening your eyes for 30 seconds, and then blinking. It felt like that all the time. I kept my eyes closed with the seat leaned back and prayed for the pharmacist to fill those prescriptions rapidly. One tip, if you decide to go through with this surgery, URGE YOUR DOCTOR to give you the prescriptions BEFORE you have surgery so you can fill them in advance and take the pain medications as soon as possible.

I got home, laid in bed, and waited for the drugs. My doctor prescribed a pain medication as well as an anti-anxiety drug to be administered several times throughout the day—the primary goal being to sleep the weekend away. My eyes needed to rest and stay closed to promote healing and regrowth of tissue scraped away during the PRK procedure. I literally lost that weekend. I have only flashes of memories here and there and for the most part I slept.

The next week saw me getting my bandages out (basically clear contacts to protect the cornea) and slowly returning to work. How much time you should take off of work will vary with the kind of work you do. I would highly recommend taking a full week. I found it hard to read my computer screen during the first week of my recovery, and often had minor headaches that would test my concentration.

The most frustrating part of my recovery was waiting on my vision to improve. While LASIK patients dance around with 20/20 vision within a week, PRK patients take longer to get to the same level. When I used my clear drops, I could see a perfect 20/20 for a few seconds until my eye absorbed the medicine, and then it would go back to anywhere from 20/60-20/100. In fact, I couldn’t read the 20/20 line without correction until almost four months later—and even then it was blurry. I was paranoid about my vision problems, but just needed to be patient (as do you if you are reading this post-op). My vision improved week by week (it was hard to track daily improvements), and then month by month. Over the last four to five months, the improvements have been so subtle that I didn’t notice them until I spoke with my doctor and we reviewed my history.

I still have a few side effects that I am told will not clear up. I have trouble when light is shined directly in my eye or looking at bright objects when ambient light is low. Traffic lights at night have tiny starbursts around them. If I go to a concert with moving stage lights, I have a hard time seeing the stage when one of those lights moves over my face and near my eye line. I’m finally off my steroid drops (and the additional drops I had to use to keep my internal eye pressure under control), and I am now dealing with dry eyes. When my eyes get tired at night or dry, I don’t see a crisp 20/20—more like 20/30. My doctor told me that these could get better or even disappear over time.

So, was it worth it?

Every penny. I would do it again in a heartbeat. Even with the long term side effects, I can read 20/15, and recently read 2/3 of the 20/10 line at the surgeons office. During my recovery I would notice new things on a weekly basis, but the one thing that made the biggest impression on me was something that happened at 3am one night about a month after my surgery. I was sleeping on my side, facing my wife’s side of the bed and woke up. Wondering what time it was, I lifted my head up a bit to read the small clock on HER side of the bed. I instinctively looked at the clock that would allow me to move the least, and then I had one of those adrenaline fueled moments where I said (not aloud, wife would smack me), “Holy crap! I just read a clock that was six feet away from me in the middle of the night!”

Choosing your doctor is important. I would not choose a doctor that treats LASIK and PRK like an assembly line, and if you choose PRK you should ensure your doctor does plenty of those procedures. You want a doctor that will his time with you and focus on your needs. You will pay more for this, but it’s your vision! You elect to travel to find a doctor as well. Dallas has a high concentration of experienced refractive surgeons advertising prices anywhere from $500 to $3,000 per eye. Before booking your trip, make sure you talk to your doctor about how long you should wait before flying home.

I’ve been free of glasses and contacts for over a year now. It’s the little things that remind me of how cool this is. Things like opening my eyes under water while swimming, reading the clock in the middle of the night, and not being crippled when the tiniest spec of dust floats into my eyes. PRK may not be for everyone, but it was definitely for me.

One Response to “My Experience with PRK”

  1. alicewonderland0 Says:

    when i went in for my lasik consult, they said that not only am i not a candidate for lasik, i’m not even a candidate for prk. stupid corneas :( chris had lasik though, and he was 20/20 that same day. unreal.

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