PRK - Friday Oct 12

Research your concerns in this forum or post your questions if you have had Lasik, IntraLasik, PRK, LASEK, Epi-Lasik, RLE, or P-IOL within the past three months.

PRK - Friday Oct 12

Postby MarkD » Sun Oct 14, 2007 2:02 am

Finally I get to post to the "Just Had It" section of this site, instead of "Thinking About It"!! Sorry for the long post, but here is my story so far:

Had PRK on my right eye (dominant) down in the Boston area yesterday (Friday Oct 12 2007)

- Prep Work: Started taking Vigamox 1 drop 4-times per day on Tuesday the 9th. My doctor provided the Vigamox as well as well as all other eye drops I need.

- Procedure: Arrived at the center about 1 hour before the scheduled start time. My wife and I first went into room number 1. I was given a single X-n-x pill, they collected my consent forms, and we went over the post-op instructions. We then moved over to room #2 where I received anesthesia drops and they cleaned around my right eye. The nurse then drew a large purple X over my right eye brow. The surgeon came in said hi and off to the surgery room I went; my wife to the viewing area to watch.

After getting seated in the chair, they first began by taping my eyelids up/down. Just like the tape used to dress IV sites, they used this to get my eyelashes out of the way. In the end they actually completely taped over my eye, and then the surgeon cut a hole in the tape to expose my eye. My left eye was then loosely bandaged and I was instructed to keep it open. Lots of anesthesia drops were added in - basically the nurse kept putting drops in my eye until I said they didn't sting anymore.

Next was really the only uncomfortable part. The doctor placed some type of ring around my eye and told me I would feel some pressure. He applied a bit of pressure and then immediately released it - and said "thats what its going to feel like and it will last 25 seconds." I said okay, and this ring then applied a lot of pressure on my eye. My vision essentially disappeared at this point and the nurse started counting out loud backwards from 25. Absolutely no pain whatsoever, just a bit weird to have someone pushing on your eye (in some strange way, I think I'm okay with pushing versus the suction of LASIK...). At the end of the 25 seconds, the doctor said okay your vision should come back now, and it did. I believe this pressure was the alcohol bath used to loosen up the cell layers.

Next came some more drops and what appeared to be sponges wiping my eye. From a vision perspective, it simply looked like someone was cleaning a window in front of me. There was no feeling at all, so you can't really tell they're touching your eye at all. Next comes the laser, and that lasted a very short time - your told to just look at the red dot, but its real straight forward.

Next step was the Mitomycin-C application. This was some type of disc applied to the eye, and again the nurse counted backwards from 25. Compared to the initial pressure ring, this was a non-event other than you can't see while they're doing it. Following the Mitomycin-C they then put in a bunch of VERY cold drops. Not sure if this is simply to wash away the Mitomycin or if its an early application of ice to aid the healing. Regardless, for me there was no "brain freeze" involved. It just felt like cold liquid on my eyes.

For the home stretch, the doctor said he was cleaning up the edges to help out my healing, put some punctal plugs in to keep my eye hydrated, and then dropped the bandage contact lense in. To give you an idea of how little you can see during the procedure, I never even saw the contact get put on. I can assure you my eye was open the whole time, I just never saw it!

From there they pulled the tape off my eye, removed the bandage from my left eye, placed an eye shield over my right eye, and told me I was half way there.

I stood up, and my wife and I left the office maybe 10 minutes later. I took 2 aleves to get some pain meds on board right away but I was in no pain at this point. All in all I was in the office a total of 1.5 hours, and I was sitting in the chair maybe 8 minutes.

- Post Op: Once at home, I went to bed and slept about 2 hours. After that I got up and basically did normal stuff around the house for the rest of the day. Vision out of the right eye was better than before the surgery but certainly not 20/20. Next day, saw the doc, said things looked good, and I go back on Tuesday for the contact lense removal. Vision has some what gotten worse over the course of the day - but everyone tells you this will happen.

At this point, I'm about 30 hours out from the surgery and I have had really no pain at all. I'm sticking with the Aleve every 12 hours, but thats more of a just in case. The doctor told me to expect pain and that it will show up - but it hasn't yet.

As for drops, I'm now doing Vigamox and EconoPred 1 drop 4 times a day. I also did 4 doses of Nevanac in the first 24 hours following surgery.

I'll post again as my recovery continues. Left eye is scheduled for October 25th.

Thanks,
Mark
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Postby MarkD » Wed Oct 17, 2007 6:20 pm

Quick Update -

Day 4 - Went to get the contact removed but there was still 1 pesky spot that was healing. So we decided to wait 24 hours and try again on Wednesday.

Day 5 - Same pesky spot was still trying to heal. Unfortunately this spot was dead center of my eye which means it has a pretty negative impact on my vision. My doctor removed the contact lens, used the tweezers a bit to help the healing out, and then put a new lens back in. I know that sounds horrible, but he used numbing drops and you just can't focus on anything that close to your eye so you really don't see anything. I'm suppose to go back tomorrow and hopefully get the contact removed. Second eye is still scheduled for next week, but if my healing gets delayed anymore, then I'll postpone just in case.

Overall at this point, my vision is relatively crappy - and thats a technical term. Very blurry - I can see big things, but details are very much lost. I can still function (driving, working, etc..) as I still have 1 good eye - but I'd be freaking out if I'd done both eyes at once right now.

As for recovery, as everyone predicted, days 1+2 after surgery were basically uneventful - no pain, vision was somewhat good. Days 3&4 my eye became very achy and I had difficulty keeping it open. Vision also took a big down turn with the blurriness showing up. Now at day 5, no more achy feeling, no overwhelming pressure to keep my eye closed, but just this general blurriness.
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Postby LasikExpert » Wed Oct 17, 2007 11:55 pm

Please keep us updated! You sound like a textbook PRK case and I'm sure many will appreciate reading your observations.
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Postby houstonman » Wed Oct 31, 2007 10:21 pm

MarkD wrote:Quick Update -

Day 4 - Went to get the contact removed but there was still 1 pesky spot that was healing. So we decided to wait 24 hours and try again on Wednesday.

Day 5 - Same pesky spot was still trying to heal. Unfortunately this spot was dead center of my eye which means it has a pretty negative impact on my vision. My doctor removed the contact lens, used the tweezers a bit to help the healing out, and then put a new lens back in. I know that sounds horrible, but he used numbing drops and you just can't focus on anything that close to your eye so you really don't see anything. I'm suppose to go back tomorrow and hopefully get the contact removed. Second eye is still scheduled for next week, but if my healing gets delayed anymore, then I'll postpone just in case.

Overall at this point, my vision is relatively crappy - and thats a technical term. Very blurry - I can see big things, but details are very much lost. I can still function (driving, working, etc..) as I still have 1 good eye - but I'd be freaking out if I'd done both eyes at once right now.

As for recovery, as everyone predicted, days 1+2 after surgery were basically uneventful - no pain, vision was somewhat good. Days 3&4 my eye became very achy and I had difficulty keeping it open. Vision also took a big down turn with the blurriness showing up. Now at day 5, no more achy feeling, no overwhelming pressure to keep my eye closed, but just this general blurriness.


how about another update Mark!!!! Thanks!
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Postby lvziggy » Thu Nov 01, 2007 5:36 pm

Mark, did you have your second eye done yet? I experienced the same thing with the pesky little spot that took forever to heal, but that was on my second eye. My first eye healed so fast the dr. was concerned enough to consider doing something to slow it down. After my first eye healed as fast as it did I was a little disappointed that my second eye took so long. The dr. left the bandage contact in for almost 2 weeks. Well, he did change it a couple of times, but I was getting tired of having to go back every couple of days to see if it was healed enough to remove the bandage contact completely.

Hope everything is going well and you've had your second eye done and are on your way to seeing everything clearly!

~Alison
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Postby MarkD » Mon Nov 19, 2007 5:01 am

Sorry for the delay - I was waiting for some good news to post. As long as I'm apologizing, let me also apologize for the novel I've written below.

My recovery actually went south for a while. I wasn't all that worried - but my Doctor was clearly very concerned. Anyway, here's the story:

As I mentioned before, I showed up day 4 for the lens removal, and I wasn't ready. Day 5, he took the lens off, roughed up the surface a bit, and then popped another lens on. I showed up day 6 - and I still was not ready.

Finally day 7 - vision was spectacular! Drove to work without glasses (I still have 1 uncorrected eye but my brain does an amazing job of dropping the fuzzy image from the bad eye.) That afternoon, I head to the Doctor and get the lens removed. Blurriness returns. Bummer. Everyone said this happens, but even when your prepared for it, it still stinks. My vision in the morning was incredible and now it was gone. Key thing was the doctor indicated I had improved since the day before, but the pesky spot had still not healed completely. He put me on an antibiotic gel at night.

Next appt was scheduled for Monday (day 10), however the doctor actually called me over the weekend just to discuss how I was doing. He expressed concern that being 7+ days out from surgery and still having surface defects was not typical at all. I believe his main concern was scarring. He also requested that I discontinue the Psoriasis med I was taking (Enbrel). Anyway, I checked in on Monday with him - vision still blurry and somewhat unusable. We canceled the 2nd surgery and set up a normal follow up appt for day 20 (Nov 1).

Between day 7 after the contact was removed and day 20 of the next appt, I really didn't see any change in my vision at all. Probably the most disconcerting part was being able to look in the mirror and see a "divot" on my eye - right in the center. So even if I thought I was having a good vision day, one look in the mirror would confirm my eye wasn't right. (Note: at no point could I ever feel this divot - no pain whatsoever) The one encouraging thing that was happening was that my vision was somewhat good in the morning - probably for about 1 hour after wake up - and then it would return to unusable blurriness.

At the day 20 appt, the pesky spot was still not healed. The doctor wanted to do a "SuperK" procedure on my eye - essentially taking a sponge to rough up the area and let it try healing again (this procedure had a real name, but this was the nickname that the nurses used). I refused because I had some plans the next day, and this sounded like it could derail them. The doctor also placed some punctal plugs in based on my observation that mornings were much better than the rest of the day.

Within 48 hours of the plugs going in, my vision arrived! All of a sudden I could see, just like I did the morning of day 7. Also, when I looked in the mirror the divot was gone. Hmm, maybe I did have dry eye and never knew it! I had been using artificial tears, but maybe not enough.

Anyway, saw the doctor this past Friday (day 35). He indicated while the healing is significantly better, it does look like I have some hazing where the spot had been. My vision is probably 20/30 maybe 20/25 out of that eye. He believes the eye will continue to heal, but he indicated that my slow healing response was very unusual and added that I dodged a bullet to get where I am right now. He flat out said he absolutely does not recommend I do PRK on my other eye given my healing response. While it may have been caused by Enbrel, its not worth finding out. Essentially the problem is that the healing for PRK happens directly within your field of vision. So if you don't heal well, you don't see well.

The doctor indicated he is okay with doing LASIK on the other eye. The healing that occurs with LASIK is outside the field of vision, and therefore my slow healing will in no way impact my vision. He is very much against me doing PRK again. (I was the one that originally selected PRK - I was a candidate for LASIK but just decided against that procedure)

So here's the dilemma: Do I even risk another surgery? My right eye at 20/30 is good enough that I only need glasses at night right now. I really like the concept of PRK and not sure I want a flap. And finally, I'm a bit weirded out that I still have plastic plugs somewhere on my eye. I can't feel them, but when the heck are they coming out? Right now I have intralase LASIK scheduled for Nov 30. Haven't fully decided if I'll do it yet.

Thanks for reading my story!

Mark
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Postby houstonman » Mon Nov 19, 2007 5:39 am

wow sounds crazy. I would go with Lasik on the eye if I were you. I would deff not do prk again because of your healing situation and what your doc says.


I had it done this past thursday (PRK) and my vision is really blurry. im scared that I wont have reg vision again. Tomorrow the contacts will come out at 9am. I just want things to go back to normal asap.
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Postby MarkD » Sun Dec 02, 2007 6:32 pm

Another update: Had LASIK on Friday, Nov 30th on my left eye (intralase - custom view). From a patient perspective, the surgery is similar to PRK. Same feeling of pressure, absolutely no pain whatsoever. Surgery might be a bit longer, but in the grand scheme we're just talking minutes. I was in the surgical suite no more than 12-15 minutes total.

Instructions after this procedure included waiting 30 minutes in the office to be rechecked/discharged (PRK went home immediately), keeping both eyes closed for 3 hours (weight of the eye lid helps the flap reseal), and keeping an eye shield on until the follow up appt the next morning.

After the surgery was over, the vision from my left eye was dark and blurry. Not what I expected. After PRK my right eye could see great (unfortunately its temporary with PRK). With Lasik it seems to have taken a few hours for the vision to kick in. However, once it kicked in, WOW is all I can say. My left at the follow up apt on Saturday morning (18 hours post-op) was seeing the 20/15 line of the chart clear as day. My right eye, now about 10+ weeks out from PRK can read some of the letters on the 20/20 line. It was 20/30 just about 2 weeks ago, so it keeps improving. No reason it shouldn't get all the way to 20/15 like the left eye, but only time will tell.

Needless to say, I'm very impressed with LASIK. My PRK recovery was delayed more than usual - over 3 weeks before the vision was usable. And that was a VERY LONG 3 weeks. There's certainly something to be said for instant. Regardless of which procedure you pick, I would recommend doing 1 eye at a time. I can't tell you how comforting the fact was that I always had 1 eye to fall back on in case something went wrong. Now maybe with LASIK this isn't as important, but just the piece of mind that I still had 1 untouched eye that was 100% correctable with glasses was great.

Thanks,
Mark
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Postby slim » Wed Jan 09, 2008 7:31 pm

I'm looking at a place in Boston as well for PRK and the surgery days and op procedure sounds the same as yours... you didn't by any chance go to a Dr "R." for your work?

Jim-
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Postby MarkD » Thu Jan 24, 2008 7:28 am

Had another follow up with my surgeon this past week:

- Left eye (Lasik on 11/30/07) comes in at 20/15

- Right eye (PRK on 10/12/07) is 20/25 but I can still read a letter or two from the 20/20 line

- Still on Econopred once a day for my right eye.

- No dry eye problems with either eye - occasionally I use some preservative free drops, but not every day.

Overall, I'm thrilled with the results. The PRK eye gave me a scare, but even that turned around. The Lasik eye just went perfectly.

Jim - If you want more detailed info, post your email and I'll send you the info.

Thanks,
Mark
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Postby LasikExpert » Thu Jan 24, 2008 8:26 am

MarkD wrote:Jim - If you want more detailed info, post your email and I'll send you the info.


You can both email me and I'll forward the messages. Send to glenn dot hagele at usaeyes dot org.
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Postby slim » Sat Jan 26, 2008 4:59 am

Thanks, I forwarded my email address to Glenn.. After much research I'm scheduled for PRK on the Feb 15th, the research continues though!
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