10 days post-op after PRK, and I have some concerns

[MN_PRK]

Hi,

I'm a 27 year old male, and I had custom wavefront PRK ten days ago in my left eye only. Prior to surgery, my correction was -2.25 in my left eye (it is -1.50 in my right, dominant eye). My corneas thicknesses were 638 and 648 (I didn't write down which was which).

I got PRK because I wanted to be a little more functional without glasses. I needed them to drive, and see faces clearly at medium distances (maybe 20 feet or so). I elected to get PRK because I thought it was a safer procedure than Lasik, and got only one eye done as an insurance policy in case there were major complications, and so I could see if I was happy with the results before I chose to have the other done.

The surgery was quick, and my recovery so far has been pretty uneventful: I only had a little discomfort the day after surgery, and my says my eye is healing nicely. I've rigorously followed the post-op care instructions (to the point of having timers sound every half hour to remind me to put drops in). I had the bandage contact taken out on the seventh day.

So far, I haven't noticed any halos or starbursts that are any worse than my uncorrected eye (even at night). My vision has steadily gotten sharper, and it's now about as sharp with a plano lens as it was with a corrected one. However, now my eyes are straining all the time. Before surgery, I used to take my glasses off to read and use the computer, but now I have to leave them on (I think because my eyes are so different now), but they still get strained and tired. I even bought a cheap set of reading glasses and popped out the right lens, and those seem to help a bit (+1.50, to match my other eye).

I'm worried I may have been over-corrected, or that I would've been more comfortable keeping my myopia or just getting a partial correction to maybe -1. Literally 90% of my day consists of reading and computer use.

Questions:

1. How much regression can I expect after the 10-day mark? I'm really hoping to have some. I was very happy with the result a few days after surgery when my vision was 20-25 or so.

2. How would regression occur? Will it show up as steadily increasing myopia from where I am now, or will it be back & forth?

3. How feasible would an "enhancement" be to get me to maybe a -1 in the left eye?. I think this level would give me what I was looking for in the first place: marginally better and more flexible distance vision, and I was most happy the first few days afterwords, before my eyes had healed and my vision was still a little blurry.

4. How realistic is it to expect my brain to adjust to having my left eye at 0 and my right eye at -1.5? I didn't realize how big the difference would be. Will I ever be comfortable with my glasses off again?

5. Could the eye strain I'm experiencing with my glasses (plano on the PRK eye, corrected on the other) be temporary?. Would getting PRK in the other eye help?

[LasikExpert]

1. How much regression can I expect after the 10-day mark? I'm really hoping to have some. I was very happy with the result a few days after surgery when my vision was 20-25 or so.

You should not expect regression of effect at all, however you may be experiencing corneal edema (inflammation), which will change your refractive error. You had a relatively low amount of myopia (nearsighted, shortsighted) correction and would not likely experience any regression.

2. How would regression occur? Will it show up as steadily increasing myopia from where I am now, or will it be back & forth?

Regression would be a slow and steady change from where you are now toward where you were before. Resolution of inflammation would go the opposite direction because inflammation of the cornea induces myopia and would be likely to fluctuate somewhat.

3. How feasible would an "enhancement" be to get me to maybe a -1 in the left eye?. I think this level would give me what I was looking for in the first place: marginally better and more flexible distance vision, and I was most happy the first few days afterwords, before my eyes had healed and my vision was still a little blurry.

Better is the bitter enemy of good enough. It is way too early to start considering an enhancement and since we really ave no idea where you are, it is unreasonable to suggest your options. You need to wait 3-6 months for your eye to settle down.

4. How realistic is it to expect my brain to adjust to having my left eye at 0 and my right eye at -1.5? I didn't realize how big the difference would be. Will I ever be comfortable with my glasses off again?

With your right eye dominant you are forcing monovision in reverse. This may lead to a change of eye dominance, which can result it odd convergence, accommodation, and depth perception issues. People deliberately have plano and -1.50, but commonly it is the non-dominant eye that is -1.50.

5. Could the eye strain I'm experiencing with my glasses (plano on the PRK eye, corrected on the other) be temporary?. Would getting PRK in the other eye help?

At 10 days the epithelium has just covered the treatment area, is still thickening, and has not even started to smooth. You won't experience the crisp vision you are seeking until 6-10 weeks postop, and dry eyes will delay that healing process.

[MN_PRK]

With your right eye dominant you are forcing monovision in reverse. This may lead to a change of eye dominance, which can result it odd convergence, accommodation, and depth perception issues. People deliberately have plano and -1.50, but commonly it is the non-dominant eye that is -1.50.

How long does it take, typically, for people to adjust to monovision? I think along with the eyestrain, I'm feeling a little nausea.

[LasikExpert]

It totally depends upon the person. Some have an immediate switch without any problems whatsoever. Some never get it quite right. You should probably hold off any final opinions about your monovision for at least three months. Truthfully, at age 27 you should probably not have this kind of imbalance between the eyes. Monovision is a good workaround for presbyopia for people over about age 40, but at your young age your eye is trying to focus around the refractive error.