PRK Right Eye - SLC, UT 05/15/2009 Left Eye 05/29/2009

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PRK Right Eye - SLC, UT 05/15/2009 Left Eye 05/29/2009

Postby cyfer » Mon May 25, 2009 12:54 am

Hello I had PRK 9 days ago now on my right eye and am scheduled to go in this Friday to have my left eye done. This is my experience so far, it has been a good one although not without an interesting moment or two. I'm not sure if it is appropriate to mention the name of my doctor or whatever, so I'll avoid that until someone lets me know whether it is kosher.

I have what I'd consider moderate-heavy nearsighedness, I don't have my perscription measurements on me right now. I'll make sure to get them next time I'm in and post them here. I cannot drive without glasses for sure.

After much research including this forum and many other places online, screenings by a couple of LASIK surgeons over the years and even having researched RK for a class project way back in middle school, I decided this past year that my financial and life situation had made it an appropriate time to give things serious consideration.

The place where I have done my glasses perscription for years occasionally advertises LASIK sales where they offer a discount on their normal--what I consider a little pricey but not outrageous--rates. I called in after a particularly good seeming sale showed up and discovered that the policy was you pay a $50 deposit to lock in the sale price then go for a screening and get the deposit back if you are not a candidate. If you are and choose not to have a procedure, you can apply the money towards contacts or glasses through them as well. If you had a procedure it was applied towards the cost.

Previous screenings indicated I was a good LASIK candidate right in the middle of the correctible range, very minor astigmatism I think, my vision seemed pretty stable over the last two glasses perscriptions going back 4 years. I just turned 28.

I went in for a screening in late March 2009.
cyfer
 
Posts: 3
Joined: Tue May 19, 2009 8:04 am

The Screening

Postby cyfer » Mon May 25, 2009 1:37 am

At the screening I brought the questionnaire from this sight. I had it up when I called in as well and had already asked as many general questions about things, like how many surgeries the doctor was performing a year and how many were PRK vs. LASIK etc. as I thought she might know the answer too. Enough that she passed me off to her supervisor to get better answers, they were willing to answer everything it seemed like they could be expected to know offhand and over the phone.

The screening was with a separate doctor from the surgeon, who handles all the pre-operative and post-operative care. My eyes were measured but not Wavefront-scanned. I do not wear contacts so they were not an issue. No indications of glaucoma, cataracts, etc. I was also able to bring my last pair of glasses from two years ago along with my current pair, which established what I knew already which was that my vision had not significantly flucuated in about 4 years+ I think there was a change between the two, but it was very slight. My BCVA reading the wall with my glasses indicated I was about 20/15 in both eyes.

He put yellow drops in my eyes and indicated that they were slightly on the dry side, but nothing that would disqualify me. Side note: I have rather dry skin as well and living in a dry place like Utah dislike how dry it is, but my eyes never particularly have bothered me, including that day.

In a darkened room he also said my pupils were on the large side but not disqualifying for LASIK.

My cornea measurement was plenty thick well over 500, I want to say in the 560 or 580s, not a concern.

I brought up PRK, in asking various of the questions off the questionnaire and all is answers tracked pretty well what was expected although a few things seemed slightly different. When we discussed outcomes he indicated that overall outcomes have continued to improve over time as improvements have happened to lasers and software. And that the outcome figures noted in the questionnaire are now typically exceeded not just by them but by most established surgeons using the latest equipment.

At this practice they have a VISX Star S4 http://www.fda.gov/cdrh/MDA/DOCS/p930016s025.html
And this improvement in overall outcomes over what the site survey quotes seems substantiated by its FDA labeling study, which reports LASIK 20/20 or better outcomes in the high 80%-low 90% range over about 160 eyes of varying condition studied up to a year out.

We discussed PRK which hadn't been mentioned until I brought it up, and his answers tracked with what I had heard, namely that it is about equivalent with LASIK in outcomes, with slightly lower risks due to the absence of a flap weighed against slightly increases incidence of corneal hazing. It is less popular than LASIK generally due primarily to the increased short-term recovery time and possibility for additional discomfort/pain. The pre/post op doctor offered without me mentioning yet that I was leaning towards it that he had PRK from this doctor about a year ago, which was about a year and a half after he joined the practice.

He also said that with regard to pain, they used to give out things like Loratab and other heavier pain killers, but find that now most patients seem fine managing their pain with Tylenol/Advil although stronger alternatives are available if needed.

I asked about the possibility of doing one eye at a time. He said it was fine to do so, no additional cost or concern to them, but that few people do for other than the occasional insurance purpose--one eye in December, one in January. I was interested because A) I'm conservative by nature. I can be patient, especially when well-informed but I don't like to take undue risks and B) I work heavily with computers and don't like relying on others for transportation more than necessary, so I wanted to minimize the time I was unable to drive and work as much as possible.

We took a look at the laser briefly and discussed it some.

I left and took a long time to think things over, although I had liked everything I'd heard and the openness and all the responses of the doctor and staff.
cyfer
 
Posts: 3
Joined: Tue May 19, 2009 8:04 am

The surgery: Right eye

Postby cyfer » Mon May 25, 2009 2:07 am

I may miss things in this retelling, didn't think to post until after the surgery and it took me a bit of time to get approved. Want to get it all down for anyone who cares, I have had a good experience thus far and not enough of those make it on here. Sorry if this is a bit long, trying to break it up into reabable chunks.

I decided to have the surgery and scheduled it on a subsequent pre-operative visit. That went well, no dryness that time (although I decided to start using eye drops with the doctor's approval) leading up to the surgery just to make things as smooth as possible. I also took the time to read all the paperwork (which amounts to--there are no guarantees in life and doubly so in *elective* surgeries like this), nothing surprising.

When I arrived they gave me a kit containing OmniPred (to control inflammation) and a perscription for Vigamox (an antibiotic), and Nevanac (for pain, inflammation--this one specifically because I was doing PRK), instructions for using them, eye drops, sleep eye-shield, sunglasses. They then had me put a Valium under my tongue till it dissolved with some water and a lifesaver type candy to help with the taste.

They did the remeasured my eyes and did the wavefront evaluation since I was intending to have wavefront if I was a good candidate. I called in the perscription order while I waited for the Valium to take hold and touched base with my ride home and a family member. I also had to pay and it turned out we had a minor disagreement about what the sale price was. However the staff member was very friendly and quickly accepted the price I had been quoted although that quote was slightly lower than their usual sale price according to her. I believe the person quoting it may have been making a mistake, but would probably have delayed more to verify, had they not been so good about it. A few of the staff I worked with didn't seem to realize I was only doing one eye, apparently it is pretty unusual, after I realized this I was careful to make sure it was clear to the techs and the doctor before we entered the surgical room.

The procedure itself consisted of laying down in a chair, them administering some anesthetic drops and moving me under the apparatus. They used a speculum to fix my eyelids open. Then the alcohol solution was applied and given a moments. I was warned I might feel something and didn't for the most part as they removed the epithelium apparently. I did feel it slightly near the end but just a sensation no discomort really. The doctor then told me my vision might go black as they applied some minor pressure, I think affixing whatever holds things in place so the laser can track. Things did go black for just a few moments. After that it was just staring at the same blurry dot, something else was moved into place nearby. I was told I might smell something burning a little and that this was normal. I heard some clicking for a few seconds and then we were done. They spent a few seconds pulling things out and I recall seeing the previously blurry dot come into focus as a light source quite impressively as they finished. I was not anxious throughout, largely thanks to having expected most things in advance, but especially the procedure itself was anti-climatic. The prep for it would be where most anxiety could come from it seems.

I stood up and could see the clock on the wall of the room several feet away clearly. Switching between eyes showed a good contrast. My right eye, which we chose to do first because it was worse than my left seeing much more clearly than my uncorrected left eye. Oh they had put a bandage contact in as well before I stood up. I went out to the lobby, called my ride and family contact and sat and waited. I felt no pain and could see clearly at first in that eye.

It took my ride a while to come and at some point I noticed my vision degrade a bit, with slight double vision. I also felt minor discomfort I attributed to adjusting to the contact. My ride and I went to pick up the Vigamox and Nevanac which ran nearly $150 together (a slight discount through my insurance but not much; I have an HSA so I paid all of it since I have not yet met my deductible) I went home and went to sleep easily.
cyfer
 
Posts: 3
Joined: Tue May 19, 2009 8:04 am


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