PRK surgery recovery “what to expect”

I read a BLOG prior to having Ulnar Nerve Surgery two years ago to try and gain some understanding of what I was facing from a recovery perspective.  Not just what my doctor was telling me.  It was very helpful, many of the posts that others added were of negative effects they ended up with so I want to give a good news story approach.   I may talk about that surgery later but wanted to touch base with a very common procedure, PRK or its full name Photorefractive Keratectomy. Most people chose to go with LAISK which is a much quicker recovery procedure.

I was screened for LASIK and the morning of the operation when the doctor was applying the stabilizing equipment it was discovered that my eye shape would not support the equipments use.  This happens rarely but it happens.  Since I was eligible for both procedures I went with the PRK.  If you are thinking about have refractive surgery the doctors will explain the differences and benefits of each option.  I will try and cover what was explained to me.  Again not an expert just passing on my experience.

Primary difference as I see it was that in LASIK they cut a flap in the eye’s outer layer, fold the flap out of the way, bring the laser in make the cut as needed then return the flap over the newly shaped eye.  This means that what has to heal outwardly is only the area around the flap (the 75% or so of the edge of the flap).  In PRK the doctors remove the area that was the flap in LASIK and then make the cuts.  Afterwards a temporary contact is put in place over the wound area for protection.  That contact is removed about 72 hours later.  What makes PRK less desirable to most, myself included was the pain from recovery. The healing of the outer layer that was removed during PRK is what people avoid by having LASIK.  Most of the terrible stories of extreme pain from PRK was due to practices that did not include the outer contact for protection (this was an early method).

The meds package that I was given for LASIK was pretty basic.  Some drops to prevent scaring, some numbing drops, and drops to help with dry eyes.   Nothing more than over the counter stuff for pain management.  For PRK I was given the same but added a Narcotic for pain.

I had to return for follow ups on the next day, on the 3rd or 4th day (to remove the temp contact), one week, one month, and 3 months after the procedure.  This seemed like a lot but it created a sense of comfort for me by the high level of aftercare.  I am sure different insurance plans and medical options could create some variance in this schedule.

Other than the pain of recovery the real difference between the two procedures is the flap vs no flap aspect.  I was cautioned that very active people may have issues with the flap being torn later and requiring attention.  Folks with very active sports lifestyles for example.  Contact sports being the highest risk. I was 48 when I had this procedure done so my contact sports days were behind me.

In my pre-op appointment most of the information I have was presented to me along with some very impressive stats.  Very small percentages of people had dry eye issues long term (small like less than 1%), that made me feel better about having it done.  Also the vision post surgery was truly impressive the stat that stuck out was that at 6 months 85% were 20/16 and 45% were 20/12.5.  That was incredible I thought.

As I said I was 48, wore bifocals, and had a stigmatism.  None the less, I was done with not being able to see when I went for a run (contacts proved too much effort for the return), or looking like I was 20 years older with glasses hanging halfway down my face all the time.

On the day of the procedure as I stated I was all set for my LASIK operation.  An assistant sat me down in a waiting area and put numbing drops in my eyes at least 4 maybe 5 times in the 10 minutes we spoke.  He kept going over post op information which help me to focus on something other than a laser cutting into my eyes.  I think the drops were excessive, as one or two may have done the trick but I was in trust the professionals mode at this point.

In the chair I had the issue with the stabilizing piece I spoke of so they had me step out from under the laser, asked if I was ok with changing to the PRK process?  They gave me a moment to think about it as they did another LASIK patient, arranged the equipment for PRK, added more numbing drops and brought me back in.

Scary having something that close to the eye but I kept thinking about how many people had done this so I stayed calm.  I had to look into a bright light that didn’t hurt really to look at.  The team had given me two small toy footballs to hold so my hands had something to do, which reenforced for me that it was not their first time.  They went over my eye once to remove the outer layer, then went in and made the corrections to the eye itself. Then repeated on the other eye.  My actual laser time was 18 seconds for one eye and 12 for the other.  Of course I felt nothing, and afterward thought myself a little silly for being concerned at all.

When I came out I looked a bit worse than most because of the attempts to get the LASIK gear to work.  My right eye was pretty red and swollen at the start.  I had seen two other patients who were ahead of me that day and their eyes were red but not terribly.  I was not in pain and was given temp glasses to wear to keep light away.  On the ride home I took the meds to get a jump start on the pain.  My wife drove of course, they would not perform the operation without a driver present.  My eyes felt heavy but not painful.

When I got home I took a nap still felt no real pain.  I had to avoid TV which was not a problem that day.  What was the toughest thing to do that night and so far in the recovery phase was to NOT SCRATCH MY EYES!  This was very important and i was told that often.  It would hinder the recovery.  My eyes didn’t truly hurt as much as they felt irritated.  I was given steps to follow if the contact fell out but I had no issues with that.  I used the pain meds for 3 days which is the longest I felt comfortable taking narcotics.  It was long enough.

I stayed home form work for 5 days because of this operation as I could not drive that week (surgery was on a Monday).  On the Friday we went to our high school’s football game to watch my daughter cheer.  I had to leave at halftime as the halo effect from all the lights was creating allot of problems for me.  I could not see much on the field.  I was able to see the sidelines ok but the lights were troublesome.  The ride home was crazy as street lights looked like they were 6 or 9 lights vice 3.  That was the worst day of the halo effect and by Monday I was ok.  It was still present but not enough to effect what I was doing.

The drops I had to install were designed to tapper off as weeks past and that was pretty much how it worked.  The issue I had with the drops that I did not expect was that the anti-scaring drops left a sort of jell like paste on my eye lashes which would harden and make my sight less effective.  It also looked a little gross.  I would have to use a mustache comb (very fine) and warm water to literally comb out the material.  It made opening my eyelids a little tough on two different mornings.  I was not briefed on this before surgery so I am not sure if it was a common thing or it just happened to me.

The more I used the refreshing drops the better my eyesight would be.  I was and still am able to attach my hydration overall to the quality of my eyesight.  In bright lighting and properly hydrated I do not require reading glasses.  I do need them in less than ideal light and when dehydrated.  But this is better than I expected considering my age.  I do not use prescription reading glasses rather those cheap over the counter “cheaters” that are common.  I am ok with this reality.  At about the 60 day mark we made a 850 mile road trip that I drove.  It was during December and I was forced to drive in the dark much of the time.  I cannot recall in my entire life being able to see as well at night as I did on that trip.  It really supported my decision to have the operation done.

Overall, I would recommend the surgery to anyone and I feel the 5-7 days of adjustment are well worth it.  I will update this post as i pass milestone dates to report on how my eyes have performed.

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3 Comments

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  1. Hi there! Do u think it was still worth it? I am getting PRK done in May and am terrified from the reviews! My blog is here that I’ve started https://prksurgeryreview.wordpress.com/2015/01/22/prk-surgery-review/

    • Tammie Freels July 4, 2015 — 4:32 pm

      Did you get your surgery? How did it turn out. I am supposed to have it done Tuesday and am also terrified by everything I am reading. I am 56 years old and I really don’t care if I have to wear glasses or contacts, have worn them since I was 17. I am not doing this for cosmetic reasons, so do you think it would be better to just go with glasses/contacts?
      Thanks

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