PRK on August 9, and feeling pretty good

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PRK on August 9, and feeling pretty good

Postby kschueleraugsburg » Mon Aug 20, 2007 4:04 pm

Hello readers of this bulleting board:

I've been in hiding for quite some time already, and there is a simple reason for this. I've had surgery on Augsut 9. Now I want to share some of my experience.

First I want to mention that I had PRK done and not Lasik. Initially, I was leaning towards Lasik, three doctors said I would be a great candidate for Lasik, read so much hype about it. But the more research I did, my conclusion was that even though all the numbers appeared to make me a great candidate, I did not want to live with a flap that never truly heals.

At this point in time, I am very pleased with my decision to do PRK. The day of the surgery was uneventful. The surgeon checked all kinds of numbers again (he said "in this practice, we measure five times and cut once"). He then discussed Mytomicin treatment with me (we jointly decided to go without it because of low prescription). Then he praised his laser system and the great experience he has with it, how the engineers from the German manufacturer came to his location a few times and how the thing is calibrated/maintained,...

Then preparation, got eye drops and valium (I asked if necessary, the assistant said yes). Then walked to laser room, laid down, got adjusted for right position etc. Surgeon talked all the way through the procedure, explained every step along the way. It was totally painless, even the portion where they put the thing under your eyelids to hold them open. The surgeon worked really carefully. Then he talked about an alcoholic solution (therefore thing it was not pure PRK, even though they called it PRK).
The laser did it's work, smelled a little bit, was not so easy to see the red blinking light (was blurry). The laser was in operation for about 1 minute per eye (this is my guess). Then contact lense was applied, and same thing with the other eye (first right eye, then left eye).
Then after a total of about 5 minutes in the laser room, everything was done, I got up, looked at the wall clock, and was able to see it. A bit blurry, but I could see that it was 12:15 PM.

The biggest thing I noticed was light sensitivity. My wife and kids were there and picked me up. We went home, only few minute drive. I more or less immediately went to bed and spend the rest of day in dimmed room. My eyes felt slightly irritated, but no pain. Turned out that I slept (with interruptions) until about 11 PM, got up, washed, brushed teeth and went to bed again. Because I had slept for so long already, I had a hard time sleeping. However, I chose not to take a sleeping pill. In hindsight I'd say: do what works for you, but I did not need a sleeping pill.

Next day (Friday), woke up, could see well, NO pain, eyes were itching but I managed not to rub. Not too much luck with the plastic eye covers they gave me (came of during the night multiple time, then I tossed them).
Went to surgeon for eye exam, he was happy, vision was much better then I had expected (not positive, but believe somewhere of 20/25 and 20/35, combined a blurry 20/30). I expected worse, so I was happy. Doctor was happy to hear that I was not in pain, but told me to expect pain later or next day.

Second day after (Saturday), eyes HURT, a lot! But not a painful pain, but more a strong itch, I would call it healing pain. The eye feels like the epidermis got scraped off and need to grow back again. The Saturday was tough, but if you can afford to do nothing, stay inside with window shutters closed, listen to audiobooks, and keep your eyes closed as much a possible, then (in hindsight) it's a piece of cake.

Third day after (Sunday), morning, woke up and there was no pain and very little itching. Could see pretty well (I would guess between 20/30, and 20/60, depending on with/without drops etc). Very light sensitive, the sunglasses I got from the eye doctor are cheap junk, fit well but quality of the lenses was very poor. Stayed inside for most of the day, had to jump into action because kids spotted a mouse in the basement, and I was able to catch it and bring outside. Kids and wife went to the pool, I spend most of the day inside and on the bed. Then, in sunset, we took a walk downtown to get some ice-cream. Was able to see o.k. without the sunglasses. Overall, started to gain a lot of confidence in my decision.

Fourth day after (Monday), went to eye doctor, they told me the epithelium had healed, there was a horizontal seam. With contacts still in, I could see very well (around 20/20 to 20/25, with some adjusting, a little blurriness). Then we floodded the eyes with artifical tears, and contacts were taken out. What a disappointment, vision was significantly worse without contacts, blurry. Eyes felt a little dry, a little sore, with eye drops I could see crystal clear for a moment, then went blurry again. I went to work (had to), had a staff meeting (good thing I didn't have to work on the computer for long that day).

Fifth day after (Tuesday), had a 6:30 AM flight to give presentation to customer (our CEO took me, therefore I could not cancel), good thing I know this stuff by heart, and presenations like this are more like improv/stand-up type. Came back at night, in the plane I could see remarkably well. Eye drops momentarily provided crystal clear vision but not for long.

Sixth day after (Wednesday), full day in the office, worked out o.k., still blurry vision, had my sunglasses on me for whole day, temporarily wore it even in office. No pain, just the sensation of the epithelium seam, mainly in right eye.

Seventh day after (Thursday), another 6:30 AM flight, went to customer, meeting, talked to our technicians, overall worked well (but I was happy that I had someone drive me). Eyes tired at night, but felt fine.

Eigth day after (Friday), like Thursday, not changes, only office, felt o.k.

Nineth day after (Saturday), felt GREAT, could see very well, less dependent on artifical tears, no much light sensitivity, did not feel the epithelium seam any more (nice), overall still significant difference right after putting eye drops in.

Sunday, August 19, ten days after, felt really well, still a little bit like Saturday, but getting better day by day.


A few observations, and maybe you guys have some comments:

The Zymar was not a problem, eye doctor told me to stop after 7 or 8 days post-OP. Is this usual?

The Acular was a non-issue, used it for 6 days or so, and eye doctor told me to not continue. Is this usual?

The Pred-Forte seemed to be a BIG problem initially, I felt like it completely dried up my eyes, they felt sore, itchy. Stopped using them for a day or two, then eyes felt better. Eye doctor told me I should continue to use for 4 times per day up to 10 days post-OP, then switch to Lotemax (less potent), and use for 3 times daily for a week, then 2 times daily for a week, and then 1 time daily for a week. THIS seems to be a very long time. I have the impression that my eyes feel better without the steroid eyedrop. What do you guys think IS this really necessary, or would it be o.k. to use the Lotemax for maybe once or twice daily for a while and just be very alert if something changes?

Except for the steroid eyedrops, the whole process was a success. I feel very confident, and I'm especially happy that I chose the PRK and not the Lasik. I was a little worried, but the most important thing is: I was well educated and I was prepared to expect a lot - then it was much less than what I had expected, and therefore was able to manage without any issues.

Would appreciate your feedback regarding the Pred-Forte / Lotemax steroid eyedrops, and I will provide an update down the road.

Glenn, can I in one way or another recommend the laser center that I chose, in personal email or similar? I understand that you don't want any form of advertising on the bulletin board, however if someone asks I would be willing to share my experiences.


Cheers,
Kai

P.S.: By the way, Glenn, this site is great, thank you so much. It helps people to gather information, interact with other individuals, and I feel this is the most unbiased site on the net on the subject of laser eye surgery.
kschueleraugsburg
 
Posts: 17
Joined: Tue Jun 12, 2007 7:16 pm

Re: PRK on August 9, and feeling pretty good

Postby LasikExpert » Thu Aug 23, 2007 3:54 am

The steroids eye drops are a necessary and important part of of safe and controlled healing. Do not stop using your steroid eye drops without your doctor's approval! This can cause a severe reaction for some people. If there are allergic reactions such as you describe, a change to a different formula or type of steroid may be appropriate, but that is for the doctor to decide.

kschueleraugsburg wrote:Glenn, can I in one way or another recommend the laser center that I chose, in personal email or similar?


You may, of course, publish your email in this forum for others to contact you directly about your doctor. You may want to include the community where the doctor is located and write out the email to reduce the probability of automated spam (ie: glenn dot hagele at usaeyes dot org).

kschueleraugsburg wrote:P.S.: By the way, Glenn, this site is great, thank you so much. It helps people to gather information, interact with other individuals, and I feel this is the most unbiased site on the net on the subject of laser eye surgery.


Glad to be of service, and you feeling that we are unbiased is the highest praise we seek. We try very hard to be neither cheerleaders nor naysayers. Our policy is to just provide the information and let everyone come to their own conclusions.
Glenn Hagele
Volunteer Executive Director
USAEyes

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I am not a doctor.
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Postby kschueleraugsburg » Fri Aug 24, 2007 10:03 pm

Update on my progress:

Today is day 14 after the operation, just came back from the eye doctor.
Vision is 20/15 with both eyes, just a little bit slow with reading, because slightly blurry. This is mainly because I have a small amount of "central haze" as the doctor called it. She explained this would go away by using the Lotemax for another few weeks (tapered off 4x daily for a week, 3x daily for following week, 2x daily for third week, 1x daily for fourth week).
She wants to see me back in the office in about three weeks.

So far I'm feeling pretty confident that things will work out. Vision is a little fluctuating. This seems to be normal with PRK, and it has only been 2 weeks since I had the procedure. Therefore, I'm very happy.

Proper set of sunglasses in the sun helps a lot. The sunglasses I got form the surgeon were really not good, I bought a pair of Miami Jim glasses, they are anti-glare coated and polarized.

Light sensitivity is almost back to normal now.

If anybody wants to know the name of the surgeon, just post a reply with your email address. He is in the western suburbs of Chicago.


Have a nice weekend,
K
kschueleraugsburg
 
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Postby LasikExpert » Sat Aug 25, 2007 12:15 am

It is good to hear of continued improvement!
Glenn Hagele
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I am not a doctor.
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Postby kschueleraugsburg » Sun Sep 02, 2007 12:10 am

I'm a little more than 3 weeks post OP (PRK/Lasek). My vison is constantly getting better, when all is well I'm 20/15. My right eye is just a tiny little bit weaker than the left eye, still a little bit of haze but I notice it only very rarely, less than compare to a week ago. What I notice is that when I am really worn out from work, I notice it with my vision, too. Eyes get tired, too, and then you don't see as good.
Dry eye was never a real problem, and by now I really take the lubricant eye drops (Refresh plus, vials, no preservatives) for comfort, and because my doctor said so. She did a tear break-down tests last week, with the yellow eye drops and blue light (not the Schirmer), and said something about a "15" which was supposed to be good.

When I look at the trees outside, I am amazed at how well I see, how much detail, how crisp I can see individual leafs, not only see a rabbit in the far distance, but can see his eyes, how is nose is moving while he detects a scent in the air, this is magic for me. I've been moderately myopic (around -2, -2.5), with significant astigmatism (2.75), and honestly, I am convinced I was never before able to see as clearly as I can today. If this small amount of haze goes away in the right epithelium, it must be like x-ray vision. Also, I expected the prespyopia (I'm 38, but still). But it is really not bad. I was able to focus as close as 5 inches before the operation, and now I can focus probably as close to 7 or 8 inches. I can read books, the computer screen, everything.
Only thing is that I feel a little bit more sensitive to sunlight (however, it might be subjective, because I really was very careful not to ever be in the sunlight without sun-glasses after the operation - I've read somewhere that UV can cause haze post-OP, therefore, I am VERY carful to protect my eyes from UV. How long do you guys think I need to do that?

Best regards,
K
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Postby LasikExpert » Sun Sep 02, 2007 4:38 am

kschueleraugsburg wrote:Only thing is that I feel a little bit more sensitive to sunlight (however, it might be subjective, because I really was very careful not to ever be in the sunlight without sun-glasses after the operation - I've read somewhere that UV can cause haze post-OP, therefore, I am VERY carful to protect my eyes from UV. How long do you guys think I need to do that?


You should always be very careful about wearing 100% UV-A and UV-B protection when in the sun. It is very critical in the first 3-6 months after surgery, but there really is no time when being in the sunlight without good protection is okay.

Congrats on what appears to be an excellent outcome.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
Site Admin
 
Posts: 3309
Joined: Fri May 12, 2006 6:43 am
Location: California

Postby kschueleraugsburg » Mon Sep 24, 2007 8:03 pm

Back again, I'm now 6 1/2 weeks post PRK procedure. Things have not changed much after my previous post. I would venture to guess I'm still 20/20, possibly a little better under good conditions. I've reduced the Lotemax now to about twice per day (almost every day...). Do not really need artificial tears, use them probably once or twice per day (because doctor told me to).
Eyes feel very good, if I look in the mirror I would even guess that my eyes aren't as red as they used to be before the procedure. Have to ask my eye doctor about that on Friday, almost seems that my eyes are now more relaxed (maybe the glasses didn't correct me as well).
I have minimal starbursts around certain lights at night (LEDs mostly), but compared with my wife (no glasses ever), and she said she would also see a certain starburst around them at nights.
Overall I would summarize:
Vision has improved dramatically
the aspects of my vision that have not improved are at least at good as before (light night-vision)
No dry eye, redness, discomfort, ...
Focus extremely close objects is a little more difficult (as a nearsighted person, I could focus extremely narrow, this has changed a little, now I can focus up to about 6 to 8 inches, before was 4 to 6 inches).

Unless something changes drastically (my doctor initially said regression was a potential since I had substantial astigmatism), I am extremely happy with the result.

Also, may I say that in my personal opinion PRK is the way to go (or Lasek, ... and other PRK derivatives).
Pain was a non-issue
Healing for me was quick
I don't have to worry about a flap (ever)
I've saved about 100+ micron of cornea (relative to stability)!

Do the research, get second and third opinions, find a surgeon you trust, then you have potential for a great outcome.
BUT don't rush into it! If I had made my decision earlier in the process, I may have opted for Lasik, and from todays perspective this would have been a mistake.
Your conclusions may vary!

One last thing: Buy a GOOD set of sunglasses, and toss the glasses you get from the surgeon! Polarized, anti-glare coated, 100% UV-protection with good wrap around fit (Maui Jim's worked for me).

I'll write another post after 3 months.

Best regads,
K
kschueleraugsburg
 
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Postby kschueleraugsburg » Mon Nov 05, 2007 11:19 pm

Wow, it has been 3 months already. Time for an update. However, folks, it's going to be pretty boring. Reason?
Well, things have stabilized pretty much at where they were one month ago.
My vision is 20/15 for both eyes together. The left eye is slightly stronger than the right eye. My eye doctor predicted that this may improve when the epithel layer becomes a little thicker. So far, I can confirm this. My vision on both eyes is more or less identical (one month ago it was a little stronger on the left). Astigmatism is completely gone. My vision is better today than it ever was with glasses.

The steroid eyedrop were tapered off approximately 7 to 8 weeks post-OP. Initially, the drops were the most annoying thing in the whole procedure, but after about 4 weeks I got really used to them. Today, the only thing I need to do is approx 1 to 4 time per day Refresh Plus, vials, no preservatives.

Couple of observations, and maybe Glenn can comment if this is true or just my twisted view of things:

You can apply "too much" of the refresh-plus eye drops. They are mostly water, and they seem to wash away the lubricating part of your tear film if you overdo it. (Glenn?)

A mild eye infection (pink eye) can reverse the healing process. After about 11 weeks post-OP, I had a little eye infection. After the infection, vision appeared to be where I was 6 weeks post-OP. May be that the pink eye reduces the thickness of the epithel layer. Right before the pink eye (10 weeks post-OP) my vision appeared to be perfect. (Glenn?)


Best of luck for everybody on this board.

Kai
kschueleraugsburg
 
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Postby LasikExpert » Tue Nov 06, 2007 3:30 am

Congratulations on your excellent outcome and thanks for coming back to let us know how you are doing!

kschueleraugsburg wrote:You can apply "too much" of the refresh-plus eye drops. They are mostly water, and they seem to wash away the lubricating part of your tear film if you overdo it. (Glenn?)


Yes, you can apply too much artifical tear lubricant, but fortunately it will wash away and the tears will stabilize after a short time.

kschueleraugsburg wrote:A mild eye infection (pink eye) can reverse the healing process. After about 11 weeks post-OP, I had a little eye infection. After the infection, vision appeared to be where I was 6 weeks post-OP. May be that the pink eye reduces the thickness of the epithel layer. Right before the pink eye (10 weeks post-OP) my vision appeared to be perfect. (Glenn?)


An eye infection will commonly respond with inflammation, which can change your refractive error. The antibiotics and antiinflammatory medications commonly prescribed to treat pink eye can also cause changes in vision quality.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
Site Admin
 
Posts: 3309
Joined: Fri May 12, 2006 6:43 am
Location: California


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