PRK and me

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PRK and me

Postby Pappy » Wed Feb 27, 2008 10:43 pm

Hopefully those reading sharing similar experience will have another story to relate to. I had PRK on 1/24/08 my stats were -5.25 in each eye with no astigmatism. Corneal depth of about 480 each eye, pupil size 7mm. 37 years of age.

Could have been a candidate for either Lasik or PRK. Chose PRK over Lasik due to flap considerations and corneal depth concerns. This decision was about 6 years in the making and I had informed my self as well as I could on complications, lasers, doctors and healing times. I thought I was well prepared and yet reading and living it are two different things.

No pre-op requirements (I've been wearing glasses for the past 10 odd years) and I wont bore you with operation details, suffice it to say, standard with add 20 seconds per eye of MMC. Took a whoping 15 minutes total and had contact lenses in.

Day 1-4, experience excruciating pain (I'm a wuss maybe). Which ranged from acid in the eyes feeling to a large pebble in my right eye. I think the major thing for me here was that I know what sand in the eye feels like but I didn't know what sand in the eye that wont go away feels like. I wish I could say I saw well after surgery but I had intense light sensitivity and my eyes just wanted to stay shut. Standard meds (4x flarex(sterois), 3x acular(anti inflamatory), 4x Vigamox (anti-biotic), Systane SUVs as needed. I added v1codin to this regiment just to sleep and I did.

Day 5, Bandage eye day (yay!). By this day my left eye felt pretty good and my right eye still felt like a piece of sand in it (I'll explain why later). Vision? I could see pretty clearly except eveything felt like it had a haze over it. My contacts were filthy vision. Removing them made both eyes feel much much better. Vision immediately went south, blurry, ghosting.

At this point reading anything was an impossible task. Blurriness added with severe ghosting + double vision meant it was semi impossible to see a screen or read fine print. Distance vision? What distance vision I would say everything looked like I just needed to find my glasses to see. I found 3+ reading glasses they helped a bit to read things although it took great concentration. Pain much better with the contacts out and meds no more acular but keep up vigamox on my right (2x per hour). Possible infection there and doc wants to make sure to nuke it before it even begins. Appointments every day for the next 3 days and infection worries behind us (old corneal scar which was irritated by the badange lense) but keep putting in antibiotics until the bottle runs out.

Vision from day 5-15, to say PRK healing for me was slow is an understatement. I kept up my systane drops once every our and reduced my steroids to 3x per day. Small improvements almost imperceivable from day to day. Reading still a huge chore so I turned up my fonts and used the +3 reading glasses. It helps. Distance vision everything is a blurr and as this two week period progressed I saw sharpening of my vision, not day to day but day to 2 days ago. I'd say by day 15 I could see ok and the +3 readers actually gave me headaches. Now what do I mean by see ok? Well I could see bark on a tree 40 feet away (yay progress) it's just that there were multiple images. I think I made three visual checks for my self. Digital clock, tree, and a house across the street which had a number on it. By day 12 digical clock at 12:00 appeared to be 1212::0000 and overlap those but I could see across the room by day 15 I could see the house numbers but the same effect. While functional I would call this iffy vision to drive.

I drove my self to my next docs appointment, the ghosting and blurriness is there but see well enough to at least know if people are slamming on their brakes 30 cars in front of me. At this point steroids are dropped to 2x per day.

Not much changed over the next week, really small changes in how I saw things but the ghosting images are starting to overlap much more. I find that cloring one eye and concentrating on an image sharpens it up and almost completely removes the ghosting. At this point is not so much blurriness but this ghosting and both eyes having to strain to focus which is making my vision sub par.

At about day 21 or so post op is when I finally started to see close to a human again. While the ghosting is still there it's much further away. An example streetlight close by looks normal, the next blocks streetlight is doubled. Over the next week this diminishes more and more. Digital clock looks like 12:00 small blurriness when in low light (I'll call this a pseudo halo). Both eyes starting to learn to see together again, reading is no longer a hasle (fonts back to normal, no readers). Some initial dryness symptoms when waking up but a few blinks does this away.

So today I went in for my monthly appointment (it's more like 5 weeks but who's counting, not me not siree it hasn't been 34 days and 18 hours or so since my surgery). Vision wise I can read 4 out of 5 on the 20/15 line. Low contrast lighting still makes things a bit hard to see and my low light vision (star light) is not so good. My ghosting is almost non existant and if it's there it's more like double vision than ghosting. My eyes are adjusting the normal resting state is a different focal point which means that when scanning across a variety of distances your eyes do that digital camera zoom effect (which you normally do instantly).

Night vision wise, starburst (but I've always seen them) they are a bit more pronounced but actually disappear if I focus on the light source. No real halos but I see difused light from non direct light (think of looking at a lit window with the shades drawn and a small splash zone of light). Low low light vision I'd say is night blindness (think of shutting off all the lights in the house and walking upstairs with only star light coming through windows). In those conditions I cannot see a thing.

So this last visit, everything is good (cornea wise) dropping to 1x steroid for the next two weeks and then no more. I should expect to see contrast sensitivity increase once the steroids are stopped and my eyes are on the +side still (good thing, there is more healing occuring). So they'll work their way back to plano. This should help with the digital camera zoom effect and as the contrast sensitivity comes back so should much / some of the night vision as well as decrease the starburst intensity. The night vision is something that is going to take a year (if not more) to see how it finally ends up.

That's my story so far, a novel almost! Any ways I have a good understanding for each of the process steps that are occuring so my "stress" level has been real low (the corneal scar inflamation though, that one came out of left field!). I'll update this in a month or so (next appointment). You'll also notice I don't actually really talk about 20/what ever. To me and my doc agrees it's pointless, I didn't do this to read an eye chart well I did it to see well and remove my dependency on eye wear. Shockingly enough I can't tell you what my current script is but I'll know when I'll be happy with the outcome. At the moment I am pleased with how it's gone, would I recommend PRK to any one? Not unless you have about 3 weeks vacation saved up and a loving family member to drive you around to doctor appointments. That and lots and lots of patience coupled with lots and lots of knowledge with some reasonable expectation levels throw in for good fun.

Peace, hope you enjoyed reading it any typos and misspellings you can blame on netculture and the failings of the US education system :)
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Postby padlom » Thu Feb 28, 2008 10:01 pm

thank you so much for sharing your journey.. as you always give good advice and opinions to the board community.. having read your story and having thin corneas myself, now i know that i should expect.. :)
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Joined: Tue Feb 12, 2008 10:32 pm

Postby Pappy » Thu Mar 27, 2008 8:22 pm

This is my 9 week update.

Alright daytime vision (or just pure good light vison) is now 20/awesome. My current prescription is +.5 in each eye with no astigmastism.

No longer using any drops although it feels like I have excesive tearing from time to time.

Night vision wise I'd say under low lights (moonless night) I see 20/40? Not sure this is kind of hard to discern but it's shifting slowly and I should expect it to change over the next year as my prescription nears plano. There is subtle difference between my two eyes though under these conditions and it makes my right eye tear when it happens, nothing major but enough to feel like I have much in the corner of my eye.

Starburst are pretty prominent but I always saw them prior just not as large or as many. This is what I'll be hoping improves over the next year of healing. I would say at the moment on the 20/what ever scale my night vision is 20/meh lets see how this turns out.
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