Holy Crap! I can see! (or..My experience with PRK Laser Eye Surgery)

Yesterday at around 11am, I underwent laser-eye surgery on both of my eyes.

It’s something that I have wanted to do for a long long time, but have avoided because of the expense in Australia and also the risk that I would still have to wear glasses at the end of it anyway, making the reason for the surgery pointless.

However, I had seen an advertisement in the paper here offering Lasik for $299 for each eye. It always sounded too good to be true, so I didn’t do much about it, but over the last 6 weeks I had thought more seriously about it, especially seeing as though I am going home in just over a month. So, about a month ago, I went for the free consultation to see if I was a candidate for it. As it turned out I was. My prescription (-4.75 in each eye) was in the range to do it, and I only had a slight astigmatism in my left eye. My prescription has also stayed pretty much the same for 5-6 years.

The only problem was that because my cornea was a little thin, I would have to opt for the flap-less surgery, called PRK (Photo-Refractive Keratotomy) The difference, is that instead of cutting a small flap in the cornea and performing the laser treatment through there, they would ‘melt’ off the superficial layer over the cornea and then do the laser surgery through the cornea. The upside is, there is no cutting of the cornea. The downside is, there is a longer healing process.

I was actually hoping for the flapless surgery anyway, so I was glad to hear that the doctor was suggesting this route. I never liked the idea of anyone cutting anything near my eye.

So, after avoiding the first pre-op exam until last week, I took the steps to do it. Last Tuesday I had an eye exam where the doctor dilated my pupils and checked that my eyes were healthy and ready for the surgery (dilating is strange, and lasted a couple of days). Then I made the appointment for the surgery for November 8th at 10am.

It was a nerve-racking night before hand, but also exciting at the possibility of not having to wear glasses or contacts ever again. After another nerve-racking wait in the waiting room for an hour, I was ushered into the room.

The Surgery

I was told to lie down on a reclined chair and it was rotated under the laser device. The doctor explained the procedure to me previously in another room so I was feeling fairly calm about it. But it’s hard to keep calm when you know a laser is about to be zapping your eye in a matter of minutes.

So, the process for PRK is as follows. You are given anaesthetic drops in your eye, while the other is covered up with some gauze. The eye numbs and then he used a speculum to hold open my eye to make sure that I would react ok to it. Once he was sure that I was going to hold still he placed a small ring over my eye and dropped some liquid onto my eye which effectively ‘melts’ away the epithelial layer on my cornea. that stayed there for 25 seconds and then he carefully scrapes that layer away.

Mind you, I couldn’t feel any of this. I felt a little pressure on my eye, but there was absolutely no pain. Once the layer is removed, it’s time for the laser.

Now, the technology is so advanced with the laser that it follows your eye where you move it during the surgery. The doctor informed me that I couldn’t move my eye faster than the laser could follow it. Of course I was still pretty nervous and wanted to keep my eye as still as possible.

There was 7 seconds of zapping on my eye, but it felt like more. The sound is like those little lightning rods you see at Science shows, and there was the dlight smell of burning (freaky!). I tried to concentrate on breathing smoothly and not moving my head as it was going on. Afterwards the doctor put some steroid and antibiotic drops in my eye and then it was on to the next one.

The same procedure happened with both, although because my left eye had a little astigmatism, he did something a little different. with the laser setup. He also placed clear contact lenses over each eye which I guess is used to protect the eye for a couple of days till he removes them.
So, it was done. It only took 15 minutes from start to finish for both eyes, which is pretty amazing. He gave me a little pack with eye drops, pain relief drops and sunglasses and told me that he liked doing surgery on an Aussie because I was a lot more relaxed, did as I was asked and didn’t complain at all. He was great during the surgery though, talking calmly to me and letting me know exactly what to expect.

I sat up on the chair afterwards and felt a little light-headed, but after a few seconds I felt fine and walked out to the waiting room with my littl goggles on (to protect me from rubbing them mostly).

My vision was quite blurry, but I could already see that my vision was way way better than before. It was hard to keep my eyes open for long periods of time though and there was a definite scratchiness and discomfort.

I felt pretty disorientated on my way to the car, but thanks to Pip for someone to grab on to, and to Aggie for the transport as I don’t know what I would have done if I had to metro or cab it home!

So I have a selection of drops that I need to keep using. There’s Zymar (Antibiotic drops which are $50! ouch), Pred Forte (Steriod Drops) and he gave me some Refresh Liquigel. I had also bought Refresh Plus and Refresh Celluvisc as comfort drops. The Liquigel is to be used if the pain gets bad, but I am supposed to avoid using it too much as it hinders the healing of the epithelial layer.

The Afternoon of the Day of the Surgery.
That afternoon was spent mostly closing my eyes and trying to sleep. It’s not easy to sleep when you had so much gloop in your eye and you are wearing clumsy goggles (that look a bit like ski goggles) and trying to forget about the irritation. I had some Panadeine Forte, thanks to Michael, and I took one to try and take away the stinging in my eyes. It came and went, but I almost always had a throbbing in both my eyes. When I could open my eyes for any length of time I was happy to see that I could see pretty well! Still very blurry and hard to focus, but I could definitely see much better than before.

The evening was spent trying to watch a bit of TV, but it was not easy to really see too much and I am sure my eyes were closed at least a quarter of the time.

So, I went to bed after putting the regime of drops and tried to relax.

The First Night

I slept well until about 3.30am, and then I woke up. I glanced at the clock and was happy to see that I could read it clearly! Sweet! I decided that I may as well put my drops in. So I did and then dozed back to sleep.

I woke again at about 5.15am and felt a strong pain in my right eye. It was also weeping a lot every time I opened it. My left eye felt pretty good in compasion, but the pain was pretty bad and I took another Panadeine. I slept on and off until about 8 with my right eye still giving me grief. At 8 I decided that I should put in the Liquigel to try and relieve the pain. It seemed to help and I slept some more, until around 10.30.

Day 2

So I am writing this on Day 2 at about 1:30pm. When I woke up at 10.30, my eyes felt a lot better and I looked around a bit and tried to appreciate my new sight. I put the drops in again at 11am and then the pain and discomfort seemed to come back. I don’t know why the drops seem to bring it on but every time I put them in I find it really hard to keep my eyes open for any length of time. Right now I am 30 minutes before the next lot of antibiotic drops and I am feeling ok. The screen on my laptop is not clear at all though and I am blinking every few seconds.

I took another Panadeine at around 12:30 and I think that really helped. I have my followup appointment at 5.30 this afternoon, so here’s hoping that they’ll tell me things have gone well.

Day 3 & beyond…On Day 3, the doctor said that my epitheal layer had pretty much grown back 100%, but he left the contact lens in for one more day. After other appointment on Day 2 he put in some drops to dilate my eyes and the pain went down considerably. By Day 3, there was no more pain at all and my eyesight improved.

On Day 4 he removed the contact lens and I could see the 20/30 & the 20/25 line on the chart.

Day 5 was great and I even went to see Cirque Du Soleil and could see everything. No halos on lights and things were generally clear, although I had to keep applying the tear drops to keep my eye lubricated.

Day 6 was the best yet and I was really happy with what I could see, but then Day 7 – 10 my eyesight deteriorated, and I found it hard to focus on things and there was a definite blur to things, even close up. I called the surgery at this point, and they advised that it was normal and I should expect fluctuations in my eyesight for the next couple of months.

Today is Day 13 and it has been great over the weekend. I have another appointment tomorrow, but I can definitely see clearly at the moment and have been to the movies, using the laptop and have not had any problems at all.

………

I will update this entry with the progress over the next days, weeks and months (I’ll also fix all the spelling mistakes that I couldn’t see!) and I hope it helps other people who are thinking about getting PRK Surgery done. I read some other accounts of the surgery (including this great comparison with LASIK), and it definitely helped me get an idea of what to expect.