A couple of months ago Tundraman asked the forum about laser eye surgery. Well I can now realy my firsthand experience as I just underwent PRK on Friday. My nearvision is still limited so please excuse any typos I make, reading this screen is rather difficult right now.
This is what I now know about laser eye surgery. There are basically 2 options Lasik and PRK. The only difference between the two procedures is how they expose the part of the cornea known as the stroma. With Lasik they make a cut which leaves a “flap”, the flap is flipped up and a laser is used to reshape the cornea. That flap is then flipped back down and left to heal. In PRK an electric-toothbrush type brush is used to “scrub” away the outer layer which exposes the stroma and the exact same type of laser is used to reshape the cornea.
Lasik yields more immediate results, but long-term results are the same for both procedures. PRK tends to be more uncomfortable as that outer layer heals, essentially you have a large corneal abrasion on both eyes. Both procedures have carry their own unique risks, but negative results are pretty rare.
My experience has been: Mild discomfort that began 2 hours after surgery, I slept most of Friday thanks to percocet and phenegran. Saturday I felt pretty good and went in for my first post-op follow-up. At that time my vision was 20/40 in my right eye and 20/50 in my left eye, prior to surgery I was 20/600 in both eyes. By Saturday evening I was pretty uncomfortable again and resorted to the narcs again to sleep. Sunday was probably the worst day, I was pretty uncomfortable all day, and the contact lenses that were placed onmy eyes as bandages are getting pretty dirty so my vision in rather blurry. Also I am very sensitive to bright light, so this SoCal sunshing is killing me. I go in for my 2nd follow-up today and I hope they will take off the contacts, and I plan to return to work tomorrow.
While yesterday I was questioning my decision, just because I was frustrated with the discomfort, today I feel better and I know that I will be satisfied with the outcome in a few days. From what I hear my vision won’t be completely corrected for 2-3 months, but considering how long I have been blind as a bat, I think I can wait a couple of months.
There is actually another option, which I did: All-laser Lasik. No knife touches your eye. The cut is all done by laser. Safer and more accurate. It cost about $800 more per procedure, but for me, it was greater peace of mind. I had my procedure at 5 PM and could see perfectly when I awoke the next day. Never had a single issue with the short-term side effects, such as blurriness and star bursts. I went to 20/15 vision, whereas my prior sight really sucked.
Why did you choose PRK over Lasik, just out of curiosity?
You guys have more guts then me. I have had glasses for 35 years and I am just plain used to them. There is no way I would risk the potential side effects, maybe it is a small percentage but being legally blind or having dry eyes for the rest of your life isn’t acceptable in my book. There are just enough horror stories to prevent me from ever considering it despite being very near sited.
My turn! I had LASIK done two Novembers ago with a free touch-up that February (2003). I really love it and I actually had no discomfort whatsover. THAT BEING SAID - I am one of the 1% or whatever that has had some side effects. Due to pupils that dilate a lot (both surgeries the prep nurses were commenting to each other things like, “wow, check these out,” etc), I have night halos. It doesn’t bug me at all and it was the same thing I had from contacts at night.
So, sure, I wish that was not a problem, but I still have no regrets. Went from 20/400 and 20/450 to 20/20 and 20/15. Now, I can actually read the alarm clock that’s a foot away from my bed a night! feel free to ask me if you have any questions. Oh, I went to a premier place so I paid on the high end @ $1600 an eye (but had a free touch-up which some places do). Use those flex benefits!
I went in for my day 3 post-op follow-up today. All the way to the clinic I was having problems w/ light sensitivity. I can hardly keep my eyes open for more than 30 seconds in the sunlight, when it’s cloudy I’m a little better. The big deal for this follow-up is the removal of the contace lens “bandages”. Unfortunately my corneal epithelium adhered to the contact lens and during the removal process some of the epithelium was torn off. Yes, it was as painful as it sounds, enough to make me rather nauseus and nearly pass out. So I had to get new lenses to wear as “bandages” until Thursday. Hopefully these new lenses will come off a little easier. My vision is still blurry, but I’m confident that with time I will correct to at least 20/20. Keeping my fingers crossed for Thursday.
I had Lasik done in january. at my first checkup (18 hours later) i was seeing 20/15. i was 20/??bad with an astigmatism prior. on my one week checkup, i was almost 20/10.
I was in the OR for maybe 15 minutes and could immediately see very well although everything was cloudy from the eyedrops. i had discomfort for about the next 4 hours that i mostly slept through. for a week i had mild to moderate dryness. ever since i have a couple hours here or there of dryness - normal while the eyes fully heal over a 3 month period.
The thing about lasik is that it is almost entirely automated (to varying degrees depending on equipment) vs. prk that relies more on the hands. The conventional wisdom is to pick your doctor. While that is important, it is just as important to pick your laser. Lasres are somwhat created equal but do have different levels of automation and different diameters of treatment etc. Ex: the visix lasers have a narrower treatment diameter than the B&L. therefore, if you have larger pupils, you are at a higher risk for halos with a visix treatment. i picked my laser first and my doctor second.
for anyone thinking of getting their eyes zapped, i recommend doing some research on the FDA website. There is a lot of unbiased info from the clinical trial filings that is isn’t yet massaged into a marketing play.
I think eventually you will be very happy with your PRK results, do you know if the ablation you had was a “custom” ablation? Eventually you should be seeing very, well, and you are right, the end result (3month, 6 month, 1 year) data with PRK vs. LASIK is very close, almost the same visual outcome (visual acuity). The upside of PRK, is there are slightly less possibilty of intraoperative complications, (mostly flap problems), as well as a smaller chance of complications after surgery, as far as infection ,ingrowth of cell under your flap, inflamation under the flap, flap wrinkles etc. The “downside” , if you will call it that, which I personally wouldn’t, is longer “recovery” of vision, and discomfort (we never call this pain either )during the period where your corneal epithelium is regrowing.
Everyone heals at a little different rate, but is sounds as though you had a bit of an erosion as your lenses adhered during removal, which may just set you back a few days. All I can say is be patient, it will be worth it inthe end.
Some studies have shown better results with the new “custom” ablation with PRK instead of LASIK. The custom ablation, is “more” exact, and the actual thickness of the flap can interfere somewhat with the fine details of the laser correction. Custom vs. traditional Lasik is a whole different issue.
It sounds like you had a great LASIK result, like many others, but I would disagree with you on a couple of things. For others consodering LASIK , I would consider your surgeons qualifications, and experience way before choosing which Laser actually does the ablation. The FDA parameters on each Laser are somewhat different, yes, but the best Laser in the world is not worth anything in a first year ophthalomogy residents hands, even with all the automation. Many surgeons are qualified to work on one or usually two different lasers. Most Laser centers have one or two differnt lasers.
Your risk of halos, glare, light scatter etc, at night are a function of your pupil size as well as your starting prescription. There is a greatly decreased chance of subjective night vision problems with the new "custom "ablation programs. All the night vision problems are caused by higher level aberrations, which can be reduced with the custom ablation. What we have also learned is that “standard” LASIK sometimes induces some aberration in the visual system, this is why some people after LASIK have worse night vision then before. SOme LAsers have different ablation zones, yes, the larger the treatment zone, the less chance of night vision problems, but mainly the night vision problems are a function of the amount of 3rd, 4th , and 5th level aberrations.
I agree , checking out the FDA website is a good idea for basic LASIK info. I would pick a surgeon someone knows, has used, or you trust, and who is very experienced. If a surgoen tells you he has never had any complications, hes is probably not being truthful.The best , most experienced surgeons inthe world had to learn somewhere and somehow, and have had bad results. They all have, and the good ones learn from them and try not to repeat them.
)during the period where your corneal epithelium is regrowing.