PRK Recovery Log

Yesterday I had PRK done to my right eye. After consultation with my doctor, PRK was apparently my best option. Lasik is certainly attractive with the instant gratification, but he said the reduction of structural integrity to the eye from Lasik could increase the risk of Keratectasia. So he recommended PRK.

I decide to do one eye at a time so I can continue to function through the healing process.

Upside: well-known procedure. no incision and flap, therefore structural integrity of the eye intact

Downside: long and potentially painful recovery that necessitates time between each eye surgery

Marketing data used by the doctor to persuade me that PRK is not the step-child/lesser option: the air force allowed PRK for years but only just approved Lasik, three out of five eye doctors at the clinic have chosen PRK over Lasik…

Day of surgery, May 13:

A final test before the procedure. I am told the right eye will be first. I ask if this is another verification. Feels like I have done about ten tests in two days. Several are repeats. Not sure if that’s a good sign, showing thoroughness, or an indication that the results are inconclusive. I am told to relax my eye and imagine something distant — “Open as wide as you can and don’t focus on the red light”. I find it harder not to focus when someone says “don’t focus on the red light”. There is nothing else to look at. Just a semi-circular light with a bright center. I start to think about work and the operator says “great, that’s it”.

I am offered 5mg of valium. I decline, saying I’ve never had it before and feel relaxed. The operator says it’s like having a glass of wine. Ok, why not offer me a glass of wine then, I wonder. What about a shot of whiskey? A Californian Gewürztraminer would have gone well with the Architectural Digest in the waiting room. Not sure what Valium goes with; Reader’s Digest? I am led to the operation chamber without wine or valium.

I lay down in a recliner. They put a hair-net on me, a patch over my left eye, and then mold some kind of rest around my head. I’m comfortable even though the room is a bit chilly (feels like data center temperature).

The doctor spins my chair under the laser machine. I see a slightly orange fuzzy dot blinking. It’s in the center of a large bright white circle, and two white lights shine in from the bottom. “Hello HAL” I think to myself.

A few drops are put into my eye, my eyelids are taped back, a cylinder is placed on my eye and the procedure begins. Swabs and drops go into and over my eye, interspersed with pulses of light. The light blinks. It becomes clear and round, then very blurry, then clear, then very blurry again as the procedure progresses. There is a clicking sound when it is burning out the old bits, and an unmistakable smell.

I begin to wish I had taken the valium as things continue. I find it hard to relax because I keep wondering what exactly is happening. It is different from the dentist where you can not feel or see anything, but only smell. I discover that being prone and seeing your own eyeball burning is a truly uncomfortable moment in time, no matter how relaxed I am (or think I am).

The doctor says a few nice things during the procedure. I start to think about clockwork orange. I realize I am at the end when the orange blinking light suddenly has unbelievable clarity. It is no longer a orange blob, but instead precisely round. It is almost too clear to believe. I sense success. Then a few things are dragged across and around my eye (probably the contact/bandage procedure) and things go blurry again. The clear round orange light becomes a long blurry sausage-looking thing. Sad, as I really enjoyed the moment of clarity.

The procedure takes no more than ten minutes. The doctor says everything went perfectly. I look around and notice I can see more clearly, but not crisply. The assistant asks if I have clear vision and I say things are blurry. “Better than before though, right?” I agree but who really knows. I was warned not to expect instant results with PRK so my sights are set low.

My pre-op bag has a set of cool sunglasses so I put them on and off I go.

My vision in my right eye soon starts to get very blurry and it goes dry. I first use eye drops without preservatives (I was given a set of four) and when those run out later in the evening I use “Blink” eye drops. Each time my eye starts to feel a little scratchy/dry, I put one or two drops in. After the drops go in I sometimes get super clear vision, but it soon goes back to blurry. Perhaps most disappointing is that I have lost the ability to focus my right eye on anything near. Suddenly my left eye feels amazing, like it has the most impressive clarity while my right eye has been totally screwed up and struggles along. I find it hard not to worry about recovery. What if it never gets better? Recovery was said to be slow, and so I lower my expectations again.

I pop out the right lens in my glasses, as suggested by the doctor, and that seems to work ok in situations where I do not need sunglasses to protect my eye. My right eye has basically become blurry all the time, aside from the second or two of clarity after eye drops.

I take my daily dose of 1000mg of vitamin C as recommended by the doctor for recovery.

Day one, May 14:

I wake up and have clear vision. Very cool. It soon goes blurry again. I get a few seconds of clarity later in the morning, but then it goes totally blurry. Surprisingly, all close vision in my right eye is gone, but distant comes in and out. Left eye for reading, right eye sometimes available (after drops) for distance. I liked the crispness of my close vision.

Visit to the doctor and he shines a light and says “looks perfect”. I am asked about pain. None so far, although my head does feel abnormal. I guess the best way to describe it is the feeling of having sand in your eye, or a scratch, long enough to where I develop a dull headache. Reminds me of being a little kid and crying and crying for hours. Sore eye, dull headache. I feel like sleeping a lot, or laying down and closing my eyes. No big deal. I have found that watching any kind of screen (TV or computer) dries my eye out almost instantly. So I do short stints and use lots of drops. “Tomorrow you could have a lot of pain” the doctor tells me and reminds me to fill my prescription for pain killer and relaxers to prepare. I ask about the close vision and he says it’s normal.

I have never used eye drops before this operation, but right now this seems to be the key to recovery and hope. It’s almost addicting to lubricate since it brings clarity. Four drops of two different liquids per day (Flarex and Vigamox — the assistant suggested using a regimen of once at breakfast, once at lunch, once at dinner, and once before bed) plus as many lubricant drops as necessary. I started with a sample they gave me of Blink, and am now using Refresh. I liked Blink better. My eye feels so much better (less scratchy) and my vision improves for a few seconds after the drops, so I really do lubricate often. Starting to get good at the procedure. Drops now usually go into my eye instead of on my shirt or down my ear. Progress.

I fill my prescriptions and take my first pain-killer. Head feels a bit better. It wasn’t horrible, just mild discomfort. Bracing for tomorrow. Drinking a lot of water seems like a good idea too.

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