Dec 9, 2007
08:06 PM

Notes on PRK eye surgery.

So, about 5 weeks ago, I went in for PRK eye surgery, and now that there has been some time to heal and see the results, I thought I'd write a blog post about it to let people know how it went. There seems to be a lot of interest about the procedure out there on the internet, so I'm hoping someone finds this useful, if not at least an interesting read.

First off, I have been wearing glasses since the fifth grade, contacts since seventh, and hard contacts since 9th grade (which was in 1990). My last eye glasses prescription was rated -5.25 in the right eye and -6.00 in the left, so I had a pretty high prescription. Anything farther than 5 inches away from my face was pretty blurry. I was switched to hard lenses because my eyes were very sensitive and put out a lot of protein when I had contacts in, and my soft lenses got deposits on them too fast. Hard lenses are way easier to keep clean. If disposable lenses had been cheaper back then, I probably could have switched to dailys, but they has just been introduced and were still pretty expensive. But, my eyesight was very good with the hard lenses in, about 20/15, so was mostly happy with them.

What prompted my decision to look into eye surgery was that I was just tired of dealing with the downsides of contact wear. Mostly things like that they made my eyes very sensitive to any kind of debris in the air, and even a stiff breeze has been known to knock the hard lenses out of my eyes if they hit me just right. And I work on a computer all day at work and spend a lot of my free time in front of a screen too, so the dryness and fatigue of wearing hard lenses were factors as well. I considered switching to soft disposable lenses again, but I figured I might as well check into the eye surgery just to see what my situation was first.

I chose Pacific Vision Institute here in San Francisco, mostly due to Dr. Faktorovich's reputation and the fact that they had all the most modern equipment available. As much as a good doctor is important, having the right equipment is almost as important (some people will tell you that it is more so), since the procedures themselves are mostly automated. That said, a good doctor is one who will give you an honest and thorough evaluation as well as proper pre and post operative care. I have been mostly satisfied with PVI so far.

After my evaluation was done, I was told that my retinas were too thin for lasik, and that PRK was my best option. After reading up more on it, I actually felt that I would prefer to get PRK anyway, since the chance of complications is less than with lasik, due to the lack of a flap being cut. That said, I was pretty concerned of the extended healing time. When I asked my doctors about how much time I should really expect the healing to take, they gave some good answers, some bad. They were always clear that my final result wouldn't known for months after the surgery, since your eyes take some time to fully heal. I understood that the surface of the eye needs to smooth out and that the membrane covering the eye needs to grow back, and that takes time. What I felt like I wasn't given a straight answer on was how long after the procedure I could expect to have reasonably good vision again, meaning that I could take care of myself and go back to work and such. Than answer I always got was "it depends on your comfort level", which I now understand to mean "it's different for everyone so you just need to wait and see".

I actually had a friend go in to PVI for the same procedure exactly a week before me, and being able to gauge his experience against mine, I would say that healing time is pretty different between people. He took almost twice as long as I did to get back to functional (good enough to get around) vision after the procedure.

So, let's skip ahead to the day of the procedure. I was very (very) nervous going in, since I was uncertain if I had taken enough time off of work and of course I was hoping that nothing went wrong and that I could fixate on the target well enough. They gave my a dosage of ativan to help calm me down beforehand (I never felt it kick in, to tell you the truth), and then I waited for my turn in. I was surprised at how busy the place was, there were about four other people in the pre-op waiting room, and I could tell they were being taken in one right after the other. It was very strange to see one person go in, spend about 10 minutes in the operating room, and then see them come out with the dark shades and protectors over their eyes. It seemed too fast. Soon enough, my time came and in I went.

They had me lie down and they started on the prep work (sanitize face, tape back eye lids). We waited for a bit while they set up the machine, and finally DR Faktorovich came in and they began. First thing they did was they push down on my eye with a metal ring and remove the epithelium. At this point, I kind of freaked out, since they didn't bother to tell me what they were doing. In all the prep work and pre-op briefing, they always mentioned that there would be no flap to cut, but they never mentioned having to remove this membrane layer manually. I figured it burned off with the laser, I didn't know to expect to have my eye scraped. If I could fault PVI for anything, it would be the lack of information given about this in particular. If you are interested and are not squeamish, you can watch this video on youtube to see what the procedure is like (note: that is not me in the video, just some random patient). I kind of wished I had looked it up before going in just so I could have known.

Anyway, they held me down and went to work fast, giving me directions on when to focus and how much longer it was going to take. They constantly irrigated my eye with a cold liquid, which was actually quite refreshing, and before I knew it, it was done. Each eye took less than two minutes a piece. They then toweled off my face, taped on the eye guards, handed me a pair of the coolest shades ever and a vicodin prescription and lead me to the waiting room. My brother came and picked me up and took me to his place where I would ride out the first few days of healing.

At this point, my vision was pretty blurry still, but I could definitely see better than I ever could without glasses or contacts. I was very light sensitive, and kind of in shock about how fast and seemingly rough the surgery itself was. I had my brother drive by a pharmacy first thing so I could fill the prescription for the vicodin, because even though they said that I should fill it only if I felt I needed it, I knew from the research I did that I was definitely going to need it. Actually, come to think of it, that is another thing that the doctors could have been clearer about. I'd hate to think that someone would come out of that surgery and not immediately fill that prescription, because although it only mildly stings at first, it grows to be a serious throbbing pain soon enough. If you didn't have pain killers on hand to help out with it quickly, you'd be very sorry.

So, the first 24 hours were actually mild. I could kind of see well, despite the light sensitivity. I could actually watch TV. I was doing my artificial tears and steroid drops every two hours and felt ok. I went in for my check up appointment the next morning feeling great. They just did a quick check up to see that everything looked ok and then made me another appointment for Monday (it was Friday then). I ate lunch and went back to my brother's place. That was when I started to get VERY light sensitive, and my eyes started stinging a lot. I hit the vicodin and waited. That 45 minutes of waiting for the pain killers seemed like forever, as my eyes were tearing up something fierce. The next two days I was pretty much immobile. My vision got very blurry and I couldn't stand any kind of direct light. I stayed doped up and found that I needed to take my next dose about an hour before my last dose would wear off (four hour effectiveness, so every three hours I'd take a pill), because any gap between would be miserable. All I could really do was lay in a dark room and listen to the radio. I got very bored. Saturday night was the worst of it, as I had to double up on the paid medication just to fall asleep.

The following morning, things started to get better. The stinging was less, and I could stand a little bit of light. As the day went on, it got better. My nightfall I was good enough so that I could actually hop on a bus and ride it home, but still with my shades on at night. I could see well enough to move around on my own, and the pain was gone. My eyesight was such that things didn't get blurrier the farther away they were, everything was just blurry to an extent. But, I could at least function.

So, as I said before, the doctors at PVI had said that I could go back to work whenever I felt I was comfortable enough, giving a minimum of four days of healing. Having the procedure done Thursday morning, I was definitely not ready to go back to work the following Monday. I took two additional days off and went back in the following Wednesday, a day after I had my contact bandages taken out. At that point, my eyes started to heal a little faster. I could sit in front of my monitor and do work, but I had the font size on my web browser and text editor turned way up. I would take breaks every couple of hours to let my eyes rest, but my eyes were showing good progress daily.

At my follow up appointment approximately 11 days after the procedure, my right eye was doing very well, at about 20/20. Left eye was taking longer to heal, and still had some blurriness. Still doing the artificial tears hourly and on slightly more dilute steroid drops four times a day at this point.

After my most recent one month checkup, my right eye now tests at 20/15, and my left is 20/20. I am using steorid drops twice a day and artificial tears as I feel I need them. My eye are dry, but I consider them to be about as dry as they used to be when I wore hard contacts all day, and I still have the hope of them getting better as time goes along. I've been taking omega-3, 6 and 9 supplements as well as multi-vitamins containing vitamin C and lutien to help healing and tear production. My night vision seems to be fine, no halos around lights.

All in all, my vision is fantastic and I still look around on occasion and remark at how clear things are. I am still not used to waking up in the morning and being able to see right away, and sometimes I still automatically reach for my glasses on the night stand. Am I glad I did it? Absolutely. Would I recommend it to everyone automatically? Not really. I suggest you go get evaluated and have a good long talk with your doctor first, maybe with several doctors in order to find the right one and to see if you are comfortable with everything that is involved. I personally am very happy, despite my fears and apprehensions about it beforehand. If you have any questions, please feel free to ask away in the comments.

41 Comments

Comments

  1. Perfect indication as to what a person should feel from the PRK sergurgy. I am feeling the same feelings as you did. In fact, I returned to work too fast and I am now sitting home just trying to feel better. I never take pain pills and Vicotin was a definite 'must' for me. Thank you for your feed back... I was wondering how the tear drops work as far as healing... I think I should be using them more often - I was not aware it would be so helpful after the procedure. It seems that you use them often. Thanks for your help.

                         Sincerely, 
                     Kristine A. Hansen
    Kristine A. Hansen on

  2. Thanks for writing this and with such detail. I'm having PRK at PVI next month and am starting to chicken out. I want to take a couple of Valium before the procedure ...=)

    Melissa on

  3. Wonderful anecdote on PRK. I was looking at getting a similar procedure done, but costs and fear being two primary reasons I have avoided it. Maybe now cost is the only thing stopping me... :)

    Jarrett on

  4. and thank you all for commenting! I'm glad I could be of help.

    Tom on

  5. howdy!! I'm on maui! don't your parents have a flower farm? Can I buy some for my gf? best to you, old friend!

    dan shankin on

  6. hi dan! my parents no longer own the store, unfortunately. they sold it off and retired a few years ago. but, you can still buy flowers from the current owners, who are great people, at sunriseprotea.com. Hope you enjoy your trip!

    Tom on

  7. Did you notice any major vision reduction? About a week post-op my right eye felt 20/20, the, over the weekend, it regressed to being as bad, if not worse, than before the surgery. my doctor keeps saying a little vision reduction is normal, but this seems a bit much.

    jesse on

  8. Hmm, I personally did not see any vision reduction post-op, except for during the immediate healing period (1-4 days afterwards). My doctor did say that my eyes healed quite a bit faster than usual (he said my right eye in particular was as good a 10 days out as most people's were a month out), though. Keep in mind, PRK usually does have quite a long healing period in order to get a full assessment of how successful it was, so I wouldn't freak out just yet. I hope things work out for you!

    Tom on

  9. I had PRK and was not informed properly of the postop discomfort. The band aid lens that they put over my eye fell out the first night and I ended up with a corneal abration. This has been the worse experience I have ever had. In the end I ended up with a corneal transplant. Please do your reseaech on this procedure. I was never instructed to have one eye done at a time because with PRK the recovery time is so much longer. I am healthy 54 year old female and at this point we do not kno what went wrong. I ended up with mrsa behind the abration and the pain was worse than words could explain.

    sandra on

  10. Thanks for this info. I'm getting PRK in two weeks. Sandra, where did you have the procedure done?

    Lisa on

  11. Had PRK on both eyes Mar 26th2008 Great Experience!!! In and out quickly. No Pain during procedure. Had worse experiences at a health spa. Went shopping immediately after with my dark shades on. Vision pretty good. A little blurry but better than before. Next day had my post op check and all was good. Never had any pain or discomfort. Little light sensitive but not unbearable. 5 days later had the protective lenses removed and was healing right on schedule. Distance vision became more blurry but could read and use computer no problem. Since then vision is improving every day. Following the drop schedule and looking forward to complete recovery with better vision.
    Only had a couple of days of not being able to drive comfortably after the protective lenses came out. Night driving is a different story. Every light has a cool halo around it but it is immpossible for me to drive at night when there is oncoming traffic. Hopefully this will end. It seems to be getting better

    hawk eye on

  12. My daugther just got PRK last Friday. Although we reserached everything we still weren't totally prepared for it. She had major pain the night of the prk and the next day and night. It's only been 3 days. She has seen her post doctor twice and has had to call him Sunday because he was concerned about her. We'll let you know how things progress for anyone interested.

    lisa on

  13. I had PRK 2 months ago on my right eye and my vision is no better than it was before surgery. After my surgery, my eye stayed swollen for about 3 weeks, and my eye pressure became very high. The doctor gave me eye drops to reduce the pressure and MURO eye drops to reduce the swelling and informed me that my eye was healing very slow. At my checkup yesterday, the swelling and pressure were both normal. However, my vision is still blurry. This is actually the third surgery I've had on my right eye. I had LASIK in 1998 on both eyes, RK in 1999 on my right eye and now PRK. After the first two surgeries, my vision stayed at 20/20 for several years. After the birth of my second child, I noticed my vision changing and to make a long story short, my vision regressed to 20/80 in my right eye and 20/200 in my left. The doctor wanted to correct my right eye with PRK first, since it is my dominant eye. I'm very discouraged at this point, because it doesn't appear to have worked. I used all the drops prescribed, I use the tears as needed and still no improvements. I've also experienced some pain during the night that I've read others have experienced as well. It seems that my eye dries out and "sticks" to my eyelid which causes abrations. Using my "tears" eye drops seems to help this pain. At this point, I'm really regretting having the surgery, because I'm afraid that having three surgeries on one eye cannot be good even though my doctor assures me that he cannot find anything wrong with my eye. Also, I've had MRI's to rule out any tumors that might be causing the vision problems. Has anyone had numerous laser surgeries that didn't work, or just PRK that didn't work?

    Hope on

  14. I'm on day 4 of PRK recovery and still blurry and hanging out to have my contacts out....I'm sure they are causing most of my discomfort and was told that as time went on they would become more uncomfortable. Lost one of my plastic shields that you have to wear to bed last night, so had to use my sons pirate eye patch! He was a bit surprised to find me in bed asleep with his eye patch on LOL. Anything to not disrupt the new cells on my eyes from doing their things. Although I'm a little worried I may have unconsciously bumped my eye while watching tv tonight. Hoping I havent moved anything I shouldnt have. I get my contacts removed tomorrow! I was at 1.5mm to go 2 days ago, so I should be all healed over now and just waiting for the new cells to fill out. If you can tolerate a few days of terrible discomfort and misery (sleep as much as you can) then have prk. 20 years of wearing glasses all day averyday, not being able relax and play with my kids, go out in the rain and many other things is over. Hurray!

    Yvette on

  15. I had PRK done a week ago....first and second day after was extremely painful, mainly due to extreme light sensitivity. My vision is still very blurry for lil things..computer, etc...only way Im online now is that I have my computer hooked up to my LCD TV. Vision is better than before though when I had my glasses off...but nowhere near what it was when I had my glasses on.....I think that it's still a bit too soon to expect full vision....I'll try and let you know how it goes in a few days from now. Thanks

    Barry on

  16. I am doing research on cosmetic surgery in Ireland and also thinging of having Lasik or PRK so it was really useful to read about your experience. I can see that it makes sense to just get someone to get your prescription immediately. I had never thought about a kick in period for the medication.

    Niamh on

  17. I am having PRK surgery this morning, and still reading up about it last minute when I found your story. I hope my experience goes as well as yours did. I'm not afraid of the surgery itself, my only concern is the longer recovery time. Thanks for sharing your experience!

    Debra on

  18. Thanks for posting this and all the great responses. I'm having PRK in 3 days and quite nervous but looking forward to the end result. It's good to hear the different reactions folks have had with pain and no pain. I've talked to several other folks that have had this done - one recommended Benadryl for the scratchy eyes - said it helped tremendously so I have my supplies ready (really hate the thought of taking oxycodone for the pain). Thanks for the info!

    Lisa on

  19. Great blog. I am currently experiencing what you went through. Thus far, your writing is very accurate. I had it done on 9/26/08. Later this afternoon (10/2/2008), I will have my protective contact lens removed. My friends who may be cosidering PRK, I will point them to this entry.

    Kelly on

  20. Great blog. Thanks for doing this. My fiancee is going in for this surgery tomorrow morning, and reading your blog and the responses has helped to inform her and set her mind at ease a bit. She's been wearing glasses since she was 3 years old, so she's really looking forward to not needing them for things like driving and going to the movies. She's especially looking forward to walking down the aisle next June without having to wear glasses just to be able to see my expression when her dad gives her to be my wife!

    Art on

  21. PRK SUCKS! I did it and regret it///

    Mike on

  22. Hey Tom, It's so nice to hear from someone who had PRK, I just had surgery on Thurs. afternoon; I had Lasik done in my right eye and PRK in the left because of the Cornea. I was not prepared at all for the PRK, the Doctor sprung it on me the day of the surgery. Not that I blame him, he has had much more sucess with PRK in eyes that were similar with mine and didn't want to take the chance with Lasik. The pain has gone, just some sensitivity and of course everything is still blurry in my left eye. My problem is I work in sales and drive ALL THE TIME! I have no idea when I'll be okay to go back to wotk. In your experience were you comfortable with driving on your 6th day after surgery? Also, I would like to know what to expect after the bandage comes out, will I feel better or will more discomfort and more time off from work follow?? Thanks for your input! Kim

    KImberly on

  23. I'm so glad to have seen this blog. I had PRK about 2 weeks ago and kept looking for information to ensure everything is going ok. My surgery was PRK because they said my perscription was high and a large astigmatism. They discussed it with my husband and I before and discussed how it damages less corneal tissue-so it seemed better. They said recovery takes a little longer but that I could return to work after a couple of days. I had it on a Saturday and went back to work on Monday. NO- I do not recommend it but I couldn't afford not to work. i work at an elementary school but mainly stay in front of a computer so I could turn a light off and sit closer to the computer but driving was bad that first day! It was hard to keep my eyes open even with the shades. I kept waiting for the day when i could take out the contact bandages because for some reason i thought my vision would be great then..ahhahh I called them first because we live 45 minutes away from civilization and since i was used to contacts they said i could remove the bandages myself. Did it no problem, still seeing through a layer of vaseline it seemed. One thing they did at my dr. that perhaps they shoudl fix was that they gave us a care paper that said i could use waterproof mascara and eyeliner after a week. DONT DO IT!! I did and soon after my left eye started hurting more and scraping. I had people look at it and they said it was kinda yellow. so i went to the dr and he said it was irritated and off color in that eye and I realized that after i took the contact out i got clumsy about making sure i didnt bump or rub my eye etc. so now, my left eye is worse than my right. EVERYTHING is blurry have to sit ON the tv but i am encouraged that it will get better by reading these posts. Thanks! The only other posts i found were from some seemingly hypochondriacal lady. immediately afterward, they gave me a scrip for vicodin but i didnt need it. I just took the drops. they perscribed-one was for pain and discomfort - didnt have much pain. i like some of you wish they would be more honest about the recovery time. in a way i am glad i didnt know it would take this long or i would have been too chicken to do it. i am still glad i did. I have faith it will have been worth it.

    Laura on

  24. I had prk on 10/17. Everything was typical. Pain late the first day and light was unbearable. I couldn't keep my eyes open. I had both done the same day. so I was pretty much locked in a drk room for 3 days. Then the sensitivity lessened. On the 5th day I took the contacts out and had a problem with them. They stuck to the eyes. They were both extremely painful as soon as the contacts came out. A burning sensation and watering. Each time I put the drops in it was fire all over again. That got better as the day went on and in a couple of days they really improved. My vision is good in my left eye but is lagging in the right. It is blurry and it seems like I have a little double vision. The Dr said there is a suture line on the eyes. On my left the line is off center which gives better vision that the right which is dead center. I didn't expect the pain or the light sensitivity. I didn't expect the now 3 weeks and still not great in one eye. But I am free from wearing contacts. I see better now than I did even with contacts and I expect to see much better when the right eye catches up. I would do it again! Be prepared for some healing time if you are about to get prk. But it is basically painless,with the help of medication,unless there are complications like mine.

    Dens on

  25. I appreciated your blog while searching for information on PRK and I wanted to add my own experience to this wealth of information.

    I had PRK 2 weeks ago, on 10/30/08, and am doing very well. I had very poor vision prior to the surgery, dry eyes, astigmatism and quite a bit of scarring on my eyes since I had been wearing contacts nearly 17 years (I'm 29). Currently, I'm still a bit blurry but am looking forward to getting better every week. I have trouble watching TV because my vision isn't sharp but that's not a problem for me - but I do wish I could see the computer with a little more sharpness. It will come with time. 1 caveat - I still don't feel great about driving although I can if I have to (day 14). It's not a problem for me because I take the metro but I can see how it would be difficult for people who drive a lot.

    I think I was most worried about pain before my procedure but I shouldn't have been. Pain medication is started 24 hours before surgery and make sure to put your drops in the fridge.

    If people are considering PRK, for me there was stinging and dryness but mostly it's the BCL bandage that you wear in your eye which is uncomfortable. And by uncomfortable, I mean, if you wear contacts think of when you take a nap with your contacts and wake up and they are kinda stuck to your eyes. It's like that, just for a few days. Use plenty of drops, take at least 5 days to chill out, always wear the sunglasses and you'll be fine.

    I did not get a prescription for Vicodin but I didn't need it either. The surgery itself is no big deal at all, they gave me a Xanex for relaxation and 15 minutes later I walked out. Probably the strangest/annoying part is when they squirt your eyeball with ice cold liquid for about 10 seconds.

    I had no major pain although I tried my best to sleep most of the day of the surgery, through the night and then much of the next day. I woke up to take the drops and all the medication on schedule but otherwise just did my best to relax. Of course there is light sensitivity and the medical sunglasses are a must. I used the drops for pain about once a day, but the staff was adament that the pain drops slow down the healing process and I took that seriously. I would definitly not describe myself as immobile - I took my dog for a walk, helped my friends who were moving in, but tried to take it easy and take frequent naps.

    A book-on-ipod is crucial and so is taking enough time off to heal. I would recommend 5-7 days. I took 5 off and wished I had taken more because I do so much computer work, but didn't really have that luxury.

    Also, I did have some regression in my left eye. It healed really quickly and I was frustrated that my right eye was lagging. Then all of a sudden they switched. My left eye was blurry and my right eye is better. I've seen the Dr. 1 day, 3 days and 8 days post-op and they are confident that I'm completely on schedule to getting to 20/20.

    It's so great to wake up and just see everything around me, I'm so glad I did it. I went to TLC Vision in Tyson's Corner, VA and follow ups in the DC office.

    Kris on
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