I did PRK laser eye surgery on September 24th, 2015, at Bochner Eye Institute in Toronto. In this blog post, I’ll document what I’ve discovered. Hope it helps someone out there!
Why PRK and not LASIK?
The most important thing to know about PRK is that the recovery process for it is much, much longer than LASIK. So why the hell would anyone choose it?!
PRK is actually the “original” LASIK. It’s very straightforward – shave off some thickness from the surface of your cornea to correct the refraction of light into your eye. The problem is that it’ll take several months to regrow the surface of your cornea a.k.a. the epithelial layer of the eye. LASIK was invented specifically as a way to eliminate this lengthy healing process. By cutting a thin flap in the cornea, the thickness can be shaved from beneath, and no need to regrow the epithelial layer! Unfortunately, LASIK doesn’t work for a lot of people because there is not always enough thickness in the cornea for both (a) the flap and (b) the corrective shaving. And thus, PRK remains a staple in the laser vision correction industry despite the obvious advantages of LASIK. Okay, so if you have a bad prescription and/or thin corneas, your doctor may have recommended PRK to you. So, how bad is the recovery for it, really? Should you do it? Keep reading below to get the full picture. The explanations that even the best surgeons give are incomplete and there is no substitute for a full length testimonial.
Day 1 – The Surgery
I found that the surgery was actually very entertaining! It’s kinda like your eyes are going through a car wash. After popping a Valium, you relax and just lay on your back while the surgeon does everything. Thanks to plenty of freezing drops, you can’t even tell when the surgeon touches your eye – you just watch it all unfold like a movie.
She starts the surgery by clamping your eyelids open. Every 30 seconds or so she’ll spray some water on your eye to keep it moist. She uses this polishing tool to rub the epithelial layer off (much like a buffer for your car’s waxing job, shown to the right). More water spray. Then before you can blink, the laser correction is done. Really fast - maybe 20 seconds. You can’t even see it happen, and how could you – if you could see the laser that would mean it’s cutting your retina, not your cornea. She now squeegies your eye to remove any debris from the laser. More water spray. Apply bandage contact lense. Remove the clamps. Done. Next eye. After both eyes are complete, you sit in the waiting room just long enough to make sure you feel okay and for a quick checkup with the doctor. When all is well, you’re free to go until the next checkup!
For the record, my surgeon was Dr. Albert Cheskes, who is great. We even took a glamour shot outside the operating room right after the surgery was complete!
Day 2 - Regrowing the epithelial layer
The same day of the surgery, I didn’t experience any pain. In fact, on the way home from the clinic, I was comfortable enough to drop by the grocery store with my girlfriend to stock up on snacks. There was a haziness over my vision, but I was able to read text at all distances, which felt great.
It was only on the evening of the next day that I started to experience pain. The reason for the pain is that the cells in your epithelial layer are slowly replicating and spreading back over your cornea. As the cells grip onto your cornea, it’s kinda like your eye is literally poking itself. This was really painful, very similar to the stinging feeling you get when cutting open onions in the kitchen or perhaps getting pepper sprayed, except it doesn’t go away for maybe 48 hours. There’s no way around it – just take the pain killers provided, try to sleep it off. Think of it like the muscle soreness/pain in the days after a workout – no pain, no gain. Visualizing the surface of my eye being healed back to normal definitely helped me get through it. By the morning of day 4, the pain had mostly subsided. I would experience only occasional stings throughout the rest of the day (presumably, the last few cracks in my epithelial layer being filled in).
Day 5 - Learning to live away from the keyboard
By day 5, it was pretty obvious that the epithelial layer had regrown. It seems like the surgeons have figured out that it usually heals within 5 days, because they had prescheduled my followup appointment for day 5. When I got to the clinic, the surgeon took out my bandage contact lenses. We did a quick look at the Snellen chart, and I was able to distinguish characters on the 20/40 line, but not without a some real difficulty which I’ll explain below.
As soon as the pain had subsided on day 4, I started paying close attention to how well I was seeing. By looking at very distinct shapes, such as the time on an LED clock, it was easy to determine exactly what was happening with my visual acuity. Since I’m a photoshop wiz, I made some mockups so you can see for yourself.
Shown is a pretty close approximation to what I was seeing with my right eye. As you can see, there’s double vision, which makes it very hard to read text without getting a headache. My left eye has the same amount of ghosting but without the double vision, which makes reading bearable. Presumably the double vision is because of a line that formed in the surface of the right eye. I’m praying that this problem will smooth over sooner rather than later, because it makes it very difficult to get anything productive done without getting a serious headache.
During this first week and possible through to the second week, you will most likely not be able to read or watch anything. Make sure you’ve prepared some audiobooks, stand-up comedy, or podcasts to tide you over until week 2. As a creator myself, I was INCREDIBLY bored during this first week. There’s only so much you can listen to before you feel like a prisoner in your own home. Just remember it’ll be worth it!
Day 9 - Smoothing the epithelial layer
On the morning of day 9, I woke up to find that the double vision in my right eye has finally disappeared!! Just some directionally ambiguous hazing, but this is MUCH more bearable than the ghosting. The funny thing is, I think it’s because I rubbed my eye the night before. One of the rules of laser eye surgery is that you must avoid rubbing your eyes at ALL COSTS for the first month. Tough luck with that! But I think rubbing my eye helped to smooth out the crack in surface of my right eye that caused the ghosting. How funny is that? I can tell the surgeons weren’t joking though – my right eye has gone back to feeling the way it felt on day 4, just after the pain subsided. Feels a bit raw again. Not gonna rub my eyes again, but I’m really happy with how this accident turned out, lol!
Just a note that prior to today, focusing on the computer screen has been too frustrating for me to do anything more than a couple hours of work before getting a headache. So if you’re a computer programmer like I am or something similar where you are sitting at the screen all day, be prepared for the possibility that you might have to take a second week off work. I know, it’s not cool – but remember it’ll be worth it!
For the second week, I ended up reducing the resolution of my computer monitors so that everything gets bigger, and that made it possible for me to be productive with anything except programming. I was forced to find ways to be productive without programming, e.g. getting as many of my errands out of the way as possible, and working on some presentation or design work that I had.
Day 20 – Final touches to the epithelial layer
On the morning of day 20, I realized that my ability to distance vision for street signs had gotten quite clear, so I reverted my computer monitor resolution back to normal, and to my surprise I was able to get by. I had to sit a bit closer to the monitor because there was still minor ghosting, but I could manage and be completely productive again. Thank goodness!
At night, there are still quite a bit of starbursts and glowing halos around lights, but it’s not too far off from what I experienced wearing contacts in the past. At this point, I am quite happy with the results and it’s clear to me now that the vision will reach 100% clarity in a few more weeks. I have to admit I was a bit worried that one eye would have better results than the other, which leads to one eye being dominant and and a very imbalanced feeling. In fact, the first few weeks were like this, with the left eye being dominant due to the double vision in the right eye. When the double vision went away, the right eye became dominant as there was actually still more ghosting in the left eye. And now, it seems that the ghosting has tapered off quite well in both eyes, leaving me with balanced vision. Wooot!!!
Day 28 – One Month, focusing on distance vision
Today is my 4 week mark. I’ve been working at full capacity for the past week, but just need to sit a bit closer to the computer screen in order to get past the ghosting. Really happy about that, since I’m a programmer lol. However, now I’m paying more attention to my distance vision, and it seems like my left eye has gone back to being the dominant eye. If I close it, I can see some slight double vision in my right eye in the far distance. So it feels like my right eye has gotten worse, but it might just be my left eye getting there faster and my expectations rising.
My Flarex steroid drops go down to a 2 drops per eye per day now. I’ve read in other blogs that the improvement really becomes profound after you stop taking the steroid drops – but my surgeon insists I follow his schedule until the 8 week mark.
Month 2 – “Forgetting” and Beyond
UPDATE: March 7th, 2016. Was reminded that I need to update this blog post by a comment notification from Emily below. It’s been half a year, and for the past few months I’ve completely forgotten about my past life where glasses and contacts were a concern. I guess it first occurred to me around the 2 month mark that I could go several days without thinking about the surgery and that I was fully recovered! It’s a pretty freakin awesome feeling.
How is my vision today? I’m very satisfied – no glasses/contacts, no dry eyes (except when I first wake up in the morning), and no more hesitations to go about my regular day life. But, if I HAD to complain about one thing, it’s that my right eye never fully caught up to my left eye – it still sees slightly worse. It’s not noticeable when I’m working up close or outside in the brightness of the sun, but it is a bit bothersome when I am in a modestly-lit + far distance situation (such as looking at price signs in a grocery store). In those situations, my right eye sees the numbers ever so slightly blurrier, and it’s a bit annoying. However, if your eyes were as bad as mine before the surgery, this is not nearly as bad as what we were used to from before with glasses getting foggy/sliding down your nose etc. My surgeon and I agree that it’s not worth it to do a touch-up surgery, as I am mostly happy with the result, but should I decide I want it, he’ll do it for free (with no time limit). So make sure you find a surgeon that has lifetime guarantee as part of their policy.
I think that’s it, the end of my story. I’m 99% satisfied, and just going to go on with my life now. Hope this helped someone out there
I found these testimonials from other people really helpful when I was researching PRK: