Just got PRK after RK

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Just got PRK after RK

Postby Indept » Sat Feb 14, 2009 2:05 am

I had Radial keratotomy in 1983 and was good until about 10 years ago when I noticed my right eye getting weaker. After that RK my left eye was 20/25 and my right 20/35 but now the difference was annoying me

Well, after a consultation with the surgeon, I went ahead & got the PRK.
I had the PRK yesterday 2/12/09. I had asked the surgeon about his experience doing PRK on RK patients. He said he has done quite a few former RK patients and said the RK adds another variable. He said I know your measurements and what to do to correct it but the RK will have an effect on how they heal. He said all of his myopic former RK patients improved after PRK surgery, some were good & others didn’t achieve the result they had hoped for although they did improve, he said none were worse. I'm sure it has a lot to do with the severity of their myopia & astigmatism. My eyes tend to be slightly myopic when I wake up only to get more myopic as the day goes on with the right eye (the non dominantone) being the worse of the two. They only did 1 eye (the right) to see how it healed before doing the left.
Day1: After my PRK yesterday I was told to go home & sleep for at least 3 hrs. I took a Lunesta, which they had given me a prescription for, to help me sleep. My eye felt like I had a hair in it and it teared a little. I slept for about 5 hrs, then got up & put my antbiotic & steroid drops in. I had a headache, probably from the Lunesta. Still felt like a hair in it. I can see an improvement, actually pretty good out of the PRK’d eye although there is some blurriness that changes when I blink, which is to be expected. I watched TV for a few hours then went to bed for the night.

Day 2: I woke up at 7:30 am. The hair now felt like a wig in my eye. I put both the antibiotic drops & the steroid drops in. That felt better. My wife drove me to my 1 day followup. I could see pretty well again with some intermittent blurriness, after all, my eye is slightly swollen any I have the bandage contact in. It felt good enough that I could have driven myself (of course I didn’t) but that probably had a lot to do with the help of the PRK gods, it is cloudy here today, I’m sure it would have been a little more difficult had it been a sunny day.The doctor said all looked good, my right eye measured 20/25 today. Very little discomfort today so far, just the irritation when I first got up. Overall, so far, so good. I know things will fluctuate as my eye heals, but so far in the 1 day I am very pleased. I haven't noticed any dry eye but I am using the moisturizing drops 4 - 6 times a day as instructed.
They gave me Optive drops in my "kit" at the doctors office, but it only had 5 one use vials, so my wife picked up Refresh Plus drops. They said to get the one use instead of a bottle because even though it says preservative free, there is a chance they're not if in a multi use vial. The assistant there said that is what she is told & I forgot to ask the surgeon about that but I'll just get the one use pack since there is less chance of contamination anyways. Just curious, has anybody else heard this about the drops?
Also, they said any preservative free drops are ok to use so does anyone have a recommendation as to what they've found to be the most refreshing drops?


Oh yeah, I forgot, the doctor said to take 1000 mg vitamin C / day. Also the surgeon applied Myomicin C after the surgery to help with halo effect.
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Re: Just got PRK after RK

Postby LasikExpert » Sat Feb 14, 2009 8:53 am

Indept wrote:The hair now felt like a wig in my eye.


Just about anyone who has had PRK knows that feeling.


Indept wrote:They gave me Optive drops ...has anybody else heard this about the drops?


They are 'preservative free on contact' eye drops. In theory, the preservative immediately neutralizes on contact with the eye. Unfortunately, nothing screws up a perfectly good theory faster than reality. The reality is that all preservatives are a mild toxin and after surgery you don't want any toxins in your eyes. Perhaps later these types of drops would be okay, but not so soon after surgery.

The thicker drops will be nicer in the early days when you are not expecting much in the way of crisp vision anyway. Look for the "extra dry eyes" type. As vision gets better, you will want to switch to drops that are more like natural tears. Everyone is different. Try a few and see what you like (pun intended).

Indept wrote:Oh yeah, I forgot, the doctor said to take 1000 mg vitamin C / day. Also the surgeon applied Myomicin C after the surgery to help with halo effect.


Not so much for the halo effect, but for hazing. Taking 500mg of vitamin C twice a day for a few weeks before and for a few weeks after surgery can reduce the probability of corneal haze. Mitomycin C makes haze virtually impossible and is almost always required with PRK after RK. It stunts the wound response, which would likely be pretty strong after RK.
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Postby Indept » Sat Feb 14, 2009 7:16 pm

Thanks for the reply LasikExpert.
Here is my update:

Day 3: Today feels like somethings in my eye, a little annoying but tolerable. I can't imagine getting both eyes done & having this, at least I can function. I can watch tv & write this which would be impossible if both eyes were like this. Surprisingly it's not very light sensitive. So far I'm pleased with how things are going.
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Postby Indept » Sun Feb 15, 2009 9:11 pm

Day 4: today is better than yesterday, basically no discomfort since I put the first drops in this morning. Vision in my PRK eye is decent, with a little haziness which looks to be a blurry haze on the bandage contact which moves around when I blink. I'm surprised at the "lack" of light sensitivity, I was expecting more than I have. It seems to be worse when I first got up today, I closed the curtains when I had my morning coffee & watched TV. But now it's not a problem, I watched hockey all afternoon (Go Flyers ). It's very sunny today and the room is very bright and that's not bothering it. So far so good. It's back to work tomorrow. I was able to drive yesterday, no problem so tomorrow should be fine going to work and being presidents day traffic with be lighter than normal.
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Postby LasikExpert » Sun Feb 15, 2009 10:16 pm

Do keep your report coming. This is so very helpful to others who have had PRK and especially those considering PRK after RK.
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Postby Indept » Tue Feb 17, 2009 12:51 am

--------------------------------------------------------------------------------

Day 5: Eye feeling fine today, a little dry but distance vision is very good & sharp. Back to work today, driving wasn't a problem and I'm surprised that I have no light sensitivity. I do have a slight ghosting when looking at my computer close up. I get the bandage contact out tomorrow. I will be glad to get it out but remember others saying their vision got worse for about a day after getting it out. Guess I'll have to suffer for a day. very pleased with the results so far.
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Postby Indept » Wed Feb 18, 2009 12:49 am

Day 6: got the bandage contact out today. Vision was 20/20 just before it came out. My eye is blurry as expected after taking it out. Most say it gets better in a day or so. I'll let you know how it progresses. So far everything has been a "textbook" result.
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Postby Indept » Thu Feb 19, 2009 1:29 am

Day 7: vision was good today when I got up. My eye was dry so I put some wetting drops in which helped but felt like something was in my eye. I put the Pred Forte drops in and then the Zymar drops as directed. I notice afterwards that my vision was somewhat fuzzy but still better than yestarday just after I got the contact out. my eye was dry today so I kept using wetting drops. My vision improved slightly throughout the morning but got a little fuzzy again after I put the 2nd dose of Pred Forte. I am glad today is my last day for those drops.
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Postby Indept » Thu Feb 19, 2009 7:09 pm

Day 8: Well the eye is progressing slowly but surely. It is still weak since the bandage contact was removed and also a little cloudy. Distance is getting a little better everyday. I look forward to the clear sharp distance vision that I had just before they removed the contact, I hope my final results don't disappoint. I started the Lotemax drops today, I'll see if I get the improvement others have stated since stopping the Pred Forte drops over the next few days.
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Postby Indept » Sat Feb 21, 2009 6:27 pm

Day 10: It,s now 4 days since the bandage contact came out and this is the 3rd day since I stopped the Pred Forte drops & started Lotemax 3x/day. Vision in my right eye (the one that got PRK) is improving every day. Distance focus continues to improve to the point that by mid day my previously dominant eye (the left that hasn't had PRK yet and was originally the better of my eyes) takes the day off as far as distance vision & my right eye takes over. I do have ghosting & halos at night but, with the exception of the distraction of the halos, I can see very well at night, evidentally no loss of night vision. Also I still have hazyness which will hopefully clear in the coming weeks. Overall I'm pleased with the progress. Watching TV is decent although the ghosting is noticable, mostly with reading print, not so much during scenes. Getting 1 eye at at time was definitely the way to go. My left eye does the reading. My right eye can focus at reading distance but the haze makes it more difficult.
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Postby Indept » Sun Feb 22, 2009 7:35 pm

Day 11: I notice watch the Sunday morning talk shows that the ghosting I've had up til now is much better, the words on TV and also the channel readout on the cable box were much sharper today. Maybe it's just day to day fluctuations, so I guess I'll find out in the coming days.
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Postby TeacherAmy » Mon Feb 23, 2009 2:35 pm

I don't mean to hijack your thread, but Glenn's comment about Mitomycin-C had me concerned. I asked my surgeon about that, expecting it was a given, and he said he wasn't going to do it due to my relatively mild prescription. I found that puzzling and wondered if there was some possible risk of using it that would make the surgeon forego it?
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Postby Indept » Mon Feb 23, 2009 7:22 pm

My doctor said just after the procedure was over and he rinsed my eye that "this drop is the Mitomycin-Cwe discussed before the surgery". It was just a drop or 2 at that time to help reduce the halo effect. I still have halos at night but I'm still less than 2 weeks so I'll give it time. I've read that some docs don't give that for very light corrections.
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Postby LasikExpert » Tue Feb 24, 2009 6:49 pm

TeacherAmy wrote:I don't mean to hijack your thread, but Glenn's comment about Mitomycin-C had me concerned. I asked my surgeon about that, expecting it was a given, and he said he wasn't going to do it due to my relatively mild prescription. I found that puzzling and wondered if there was some possible risk of using it that would make the surgeon forego it?


Mitomycin C is strong medicine that should probably be avoided when possible, but is appropriate when necessary. MMC changes the wound healing response of the corneal cells. This pretty much eliminates the probability of corneal haze, but most doctors (and patients) would prefer to avoid medications that are not required.

Corneal haze does not normally occur with prescriptions under around 6.00 diopters. Indept's surgery was PRK after RK, so the probability of corneal haze was elevated even though it was a smaller prescription. Using MMC was undoubtedly required.
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Postby TeacherAmy » Tue Feb 24, 2009 11:34 pm

Thank you, Glenn! I appreciate your insight. :)
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