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My Laser Eye Surgery, Part II: The PRK Operation

May 2, 2014 |  by  |  Science

In July of 2011, I had PRK laser eye surgery done. Shortly before, I wrote up a Primer on PRK vs Lasik that the reader may find interesting (TL;DR: Lasik is a dodgy quick-fix, avoid it, stick with PRK). Since then I expanded on the differences between PRK and Lasik, which hopefully provides the reader with all the questions they should be asking their laser eye surgeon: Lasik vs PRK: What the Lasik Doctor Doesn’t Tell You.

Before I went into the surgery, I did a great deal of research and found a dizzying array of variables that the prospective patient should take into account before choosing whether to have the surgery and where to have it performed. Resulting from this research I detailed the critically important questions that need to be asked before going under the laser: My Laser Eye Surgery, Part I: PRK Pre-Op Preparation. In this article, I describe the PRK procedure itself and the subsequent recovery period. Edit: Here is the third part, detailing my post-op recovery: My Laser Eye Surgery, Part III: PRK Post-Op Recovery.

Summary First

It has been about three years since my PRK surgery, and I still couldn’t be happier. I reached better than 20/20 vision three weeks after surgery, and have had practically no side-effects with my 20/15 vision since around the four-week mark. I have not tested my vision for quite a while, but I don’t feel as if I’ve had much if any fall-off (your eyes will naturally get worse whether you have surgery or not). I still have better vision than I ever had before, and regularly am able to ‘show-off’ when discussing my PRK by reading things at distances others cannot. Before the surgery, I was about -4 in each eye with an astigmatism of around 1.00. I see much better now than I did with glasses or contacts before and my eyes are actually less dry and less red than they were before surgery. I have had zero regrets about the procedure.

While I have been on the ‘best case you can hope for’ end of the bell-curve of results. *knock wood*, I think perhaps that my efforts to assist in my healing provided at least some benefit to that experience. Along with my account of surgery and recovery, this article will also detail the steps I took to give myself the best possible chance to recover optimally, in the hopes that readers may benefit by it.

Day 0: Operation Scorched Orbs

Pre-Op: Peak Anticipation

The procedure was crazy fast. The time between arrival at the clinic and departure for home was about 45 min, and that’s including filling out the necessary paperwork, waiting 5-10 min for the pre-operative anesthetic drops to take effect, post-operative exam, etc. The actual procedure took about 5 to 10 minutes, maximum.

After I was signed in and waivered, I was brought into an examination room for one last look at my eyes, to ensure that nothing had changed and that I was still Go for Surgery. With the green-light, I was led to a bed in a quiet pre-op prep room and given some anesthetic drops for my eyes. I was then left alone for ten minutes, just outside the operating room, so that I could obsess once more over the risks of the coming procedure the anesthetic drops could take effect.

At length I was ready. A nurse fetched me and brought me into a medium-sized room that was dominated by the sight and sound of a large, droning machine. The machine itself was a desk-sized cabinet with a manhole-sized robotic surgery on an arm overhanging an attached bed. The contraption, made for a single purpose, sprouted a host of digital and optical display instrumentation, control knobs, and ventilation tubes. The sound it emitted was somewhat lower on the tonal register and decibel scale than a vacuum cleaner, but above in volume and pitch the buzzing of a wasp nest. It was a blanketing white noise, loud enough to soothe jangled nerves, and loud enough to isolate the room from sounds coming from without (coming from within too, for that matter). The machine would not have looked out of place on a Star Trek sickbay set. Come to think of it, it would not have looked out of place on the set of a Borg Cube assimilation chamber.

My heart-rate was at its highest at this point of Peak Anticipation.

The surgeon introduced himself and laid me on the bed. He proceeded to give a quick overview of the procedure, what I would experience, what it would feel like, and what was needed of me. The surgeon’s description of the process had no surprises for me, I knew the procedure fairly well, even having gone so far as to watch videos of the surgery online, and when he asked if I had any questions, I replied that I hadn’t.

Prior to this, I had been prepped by both technicians and ophthalmologists, they had given me the necessary information on the procedure, it’s risks, and it’s post-operative care, but this was the first time I’d been told the ‘nuts and bolts’ of using a high-powered laser to burn a new shape into my cornea. Based on my prior research, I was likely more informed than the vast majority who had laid on the bed before me. As I’ve mentioned previously, my one criticism of all the laser eye surgery providers is that they are not overly forthcoming with details on risk, complication, and actual procedure. They were all quite helpful when I asked for greater detail, or had specific questions (if they’re not, run the other way!), but none were forthcoming with more than the minimum required. I suppose this is necessary, as most truly don’t want to know more than the very high-level picture of risk and reward. The reader would be forewarned to do their own research before going under the laser, though I suppose that message is preaching to the choir in this account.

After the run-down of the surgery, and after one last chance to ask questions or back out, we began the assimilation surgery.

PRK Surgery: Blink and You’ll Miss It

A nurse inserted Clockwork Orange eye-priers, and dabbed a few drops of lubricant drops. Then, the bed I was on was swung under and into the machine. From above, the large, round robotic surgeon looked mostly benign, but from beneath, the beast’s many-eyed, many-fanged face felt uncomfortably close. That said, as a lover of all things novel, technological, and physiological, the dozen different lights and probes and nozzles of this technological terror were at once intimidating and fascinating. My heart-rate was at its highest at this point of Peak Anticipation.

I had an unparalleled view of the operation, best seats in the house.

As the procedure commenced, I was a little surprised when the very first part of the purportedly “no-touch” procedure was the doctor placing a ring-like device on my eye (to be filled with an alcohol solution for effectively ‘delaminating’ my epithelial from the cornea), then using a scalpel to score the epithelial around it. I’d known that some procedures use laser, others scalpel for removal of the skin-layer. This isn’t a critical part of the procedure (unlike the cutting of the Lasik cornea-flap, in which the laser is much safer than the scalpel, but you shouldn’t even consider Lasik and its cornea-flap anyway, so never mind). I wasn’t overly concerned about this, but I did have a brief, wry thought involving “no-touch” and “my ass”.

I wasn’t too nervous once things got started. I’d imagine it’s like bungie-jumping or sky-diving, the nerves peak, then fall away when you step into oblivion. I suppose there’s no evolutionary advantage in nervousness past the point of no return, instead the body goes into a “let’s do this” mode, though the message is probably less verbal and more atavistic.

The surgery was quick, and fascinating. I had an unparalleled view of the operation, best seats in the house. While fully manageable sober (I declined the happy-pill), the procedure was a bit unpleasant for a few different reasons. Readers will have to decide for themselves whether they’d rather have the sedative.

For three days, every time I disturbed my beard I’d get a fresh waft of Charnel No. 5.

The first unpleasantness was that, despite the knowledge that they had milisecond 3D tracking of the outside of my iris (the best available at the time, see Part I), I was more than a little nervous that I’d screw myself up by losing track of the orange target light that I had to stare at. In practice, this isn’t really an issue, the laser is supposed to detect any movement off-axis and halt the procedure within a millisecond or so. Even armed with that knowledge, I was still apprehensive before starting. And this worry raised itself during the procedure itself, as I kept wondering, “Hey did I just move my eye?” It was difficult to tell with all the activity, water, implements, and flashing lights going on in your eye, and it left room for groundless doubt to creep in. In the end, there were no issues of course.

The second less-than-pleasant aspect of the surgery was the smell. Awful. Ever had your tooth drilled at the dentist? That’s the smell. Worse for me, I have a beard. And because you can’t wash your face for a while (don’t want to risk bacteria getting flushed into your eyes), for three days, every time I disturbed my beard I’d get a fresh waft of Charnel No. 5.

The third, and most unpleasant aspect of the surgery is the fact that there is an awful lot going on to your poor eye. While the eye itself is completely numbed, three parts of the procedure were uncomfortable: the Clockwork Orange eyelid clamp; the epithelial removal ring, which had to press fairly hard onto your eye (stick your knuckle into your eye pretty good for an idea); and the ice-cold water bath immediately after the laser had done its work (instant, terrible ice-cream headache, centred in your eye, thankfully lasting only a few moments).

Once it was all over (I’d say in a blink of an eye, it was so quick, but of course blinking was prevented by surgical clamp), I took a breath, gave a brave thumbs-up to the surgery team, and we started all over again on eye two. The second go-round was easier, as I knew what was coming, but I found myself dreading the ice-water bath more than all the other ocular indignities. It wasn’t that bad, but like licking a nine-volt, your body remembers its first time jangling raw nerves and is naturally hesitant the subsequent times.

Recovery: Into the Heart of Darkness

Immediately post-op, I could see fairly well. But hazy. 100x better than not wearing contacts. I could tell my vision was corrected significantly, but it was like looking through dense fog. Within about 10 minutes, on the way home, the light sensitivity kicked in. Even with eyes shut tightly, sunglasses on, my head down low in the car, and a hat pulled low over, it still felt super bright. And I mean painfully bright. I just wanted to go home and get in the darkness, fast.

Once home, my wife commenced Operation Grow Op, by tinfoiling all the windows. I’d heard some found this necessary, and I figured I’d hold off. I regret the decision, especially in eye-scorching sunny mid-July. My advice is to do this in advance, you won’t regret it. It was bad until it got dark inside. Even the tiniest slit in the corner of the window was crazy bright to me, even while wearing sunglasses. Be prepared to be a mushroom for 5 days.

Overall, aside from the light sensitivity, there was almost no pain. My eyes were definitely sensitive, they were abused pretty good, but the pain drops they give you pre-op lasted a while, and I was thinking I’d take a T3 that night, but didn’t have to. I took half of one of the sleeping pills they gave me and slept well all night. I didn’t use an eye-shield at all, just to help avoid bacteria. I’ve slept with one before and my face was a sweaty steamy mess.

Note: My surgery clinic gave me a little green bag that had all my drops (antibiotic, steroid, pain, lubrication) each well labeled with giant numbers on them listing their dosage intervals. Also in the bag were enough sleeping pills to last a week, and a load of T3s. You’ll be dipping into the bag for drops at least every 4h for the next 5 days, so you will grow to love/hate your Little Green Bag.

This is an important one to ask about too, check to make sure how much of the above your clinic will give you on the day, and how much you’ll have to get yourself. If they don’t provide it, I strongly recommend you getting all of your drops and drugs in advance. You literally will not be making any trips to the store for the next few days.

Extra Important Note: Standard eye drops that come in the medium size (30ml) bottle *all* have preservatives in them. The non-preservative ones don’t come in sizes that are greater than 1ml (to avoid infection). You’ll be using a ton of these drops to keep your eyes lubricated, and I realized way too late that using the standard drops that much just dries your eyes more. On Day 2 I started to notice that my eyes felt drier shortly *after* using the drops than they had been before, and on Day 3 I confirmed it. That’s the preservatives. Late on day three I had my wife pick up some of the non-preservative ones (available at your local drug store) and it helped immensely. Check with your doc first, but if I had to do it over again, I’d only have used them. The best ones I found after researching online were Refresh brand, specifically the “Celluvisic” variety (they’re about $0.50 per three dosages). They’re fairly thick and goopy, but they actually have less in them than the standard drops, and they were miraculously more comforting.

Continued Reading

Here are my posts on PRK and laser eye surgery, continue reading or, feel free to join the discussion in the comments below!

Laser Eye Surgery Primer: Lasik vs PRK
Lasik vs PRK: What the Lasik Doctor Doesn’t Tell You
My Laser Eye Surgery, Part I: PRK Pre-Op Preparation
My Laser Eye Surgery, Part II: The PRK Operation (You are Here)
My Laser Eye Surgery, Part III: PRK Post-Op Recovery
Halos: A Likely Complication of PRK or Lasik
    

More Information


23 Comments


  1. Hello again :)

    My operation is due on the 29th of May and I just had one quick question. I have already been twice to the eye doctor to double check my vision and my worries that they have the correct vision although they have ensured me numerous times that the machines double check that the vision they have is correct but I also believe that manually it is also good to check when reading those letters. They will yet another eye test before the surgery so should I double check my worries then again or do the machines really know better than myself? Thanks and can I truly trust the machines without being worried of an undercorrection…

  2. Your blog posts have been super helpful! Can you email me the clinic where you had your surgery done?

  3. Which centre did you get this PRK surgery at? I’m leaning towards Coal Harbour over Pacific.

  4. @Sid: I believe he got his done at London.

    My PRK date is coming up soon at Pacific. I chose the particular doc because he is the person to whom the other guys in the Lower Mainland send their post-PRK patients to when they mess up. I got this info not from the doc or the clinic, but from a close relative who is an Ophthalmologist in town.

  5. What a brilliant write-up. Thanks for putting in the effort. This certainly helped my navigate my options. I am scheduled for my PRK surgery on May 28 at the Gimbel Eye Center in Calgary. I was 50/50 until I digested your blog.

    Thanks again.

  6. thanks for this write up man. Really detailed and well written. Definitely the best on the web regarding eye surgery from a client perspective. Thanks! :D

  7. Great summary thank you very much! I feel much more prepared and have better questions to ask. I’m deathly afraid of halos and the description on them in the pre-op write up was great. My surgery is on Wednesday

  8. Senior Temple,
    I too would greatly appreciate being privately emailed the name of the Eye Centre in Vancouver that performed your operation.
    The post-op sun light / brightness glare issue sounds the most painful and long winded inconvenience, which has made me determined to get this procedure done during the winter months!
    Question: How soon were you able to use a computer / cell phone screen?
    Great wealth of very useful information. Kudos to you Sir! :)

  9. Do you think it would have been better to have silicone plugs placed in your eyes rather than such frequent application of drops? You mentioned having to do it every 4 hrs. , but the center I consulted with said it could be as frequent as every 15 min. They recommended the plugs to keep natural moisture in.

    • I don’t know. I don’t have any experience with the plugs.

      I can offer my experience, which was that the adding of the drops was not a chore at all (it was a relief). If the plugs would make it so that they wouldn’t get aggravated before needing that relief, then that would be better. However, I’m not sure I’ve read that that would be the case. Maybe just make the drops required less frequently? Not sure. My gut tells me that moisture evaporates from your eyes fairly well (don’t blink for half a minute for an example), so preventing drainage with a plug would only be a partial solution to dryness after surgery. Again, not sure.

      If it was a zero risk procedure to install/keep/remove the plugs, and there was a chance they’d help, then I’d definitely go for it. However, I’d still want to answer a few questions about that risk. I’d want to know if it increases the chance of infection having the plugs in. Does that more frequent flushing of the eye with sterile eye drops actually help keep bugs at bay? I could see it as plausible that it does, but I could equally see it plausible that it wouldn’t make much of a difference.

      One note, if you do get the surgery, make sure to buy the drops without the preservatives. And have them on-hand before the surgery. The no-preservative drops are a few dollars more for the amount you’ll use, but I found them to be night and day better. The preservative-based drops actually started making my eyes *more* irritated (after a brief relief). I switched to the no-preservatives, and it was like a cool spa for my eyes. Plus the no-preservatives come in packs of tiny individual 1ml blister drop-packs, which were handy to have a few in my pocket in the week or two post surgery when I’d get infrequent dryness.

  10. Thanks for the wicked blog post! I’m going to Coal Harbour Eye Centre with Dr Kirzner on the recommendation of my cousin. Flying all the way from Calgary for it because it’s half the cost and I’m sure he’s got all the experience! Your blog has definitely helped me prepare mentally and I’ve gone out to get those specific eye drops.

  11. Thanks so much for the fabulous information! I’m scheduled for a consultation in a couple of weeks and have been debating about LASIK and PRK for almost 20 years. One question I do have for you is how long did you have to wait before you could drive again? I ask because I’m concerned about being off work for a long time. Obviously that’s where LASIK is an advantage, but the issues you mention in your first post are making me lean toward PRK now. How did you find the actual healing process afterwards other than the brightness?

    Thanks again for the excellent information!

  12. Hi, Your articles on PRK are great. Like Jen above, I’ve happened upon your website several years later. I don’t know if you’re still checking in here at all. I was just wondering if you ever did that Post Op report mentioned in this article?

    I have been considering LASIK over PRK because of the shorter recovery period. I’ve read so much online about long, awful PRK recoveries, but even for those it seems most people are happy in the end. I will have to give PRK a serious consideration over LASIK after reading through your site.

    Thanks!

    • I haven’t posted my recovery story. It’s pretty brief (and I think fairly optimal).

      The first three days were painful and light-sensitive.

      Days 4 and 5 were very uncomfortable (felt like I’d had my contacts in for way too long, which is exactly what was happening), but I was able to commute on transit to the clinic on Day 5, where the bandage contact lens was removed, the discomfort subsided immensely. I’d wished I’d known about the preservative-free drops, as that would have helped a fair bit.

      For the next two weeks my vision was good, but ‘blurred over’. It seemed like I was wearing glasses where somebody had smeared a tiny bit of oil over the lenses. Clear vision, with a bit of blur overlaid as the epithelium was growing back. Whether looking 10 feet away or 10 miles away, the vision was the same quality. Not great to begin with, but improved over time. The first week post bandage contact removal the world felt small, as I couldn’t see well (though well enough to function. It’s hard to describe because it was unlike pre-surgery myopia where details get worse the further away. Details were universally poor from tip of nose to infinity. This improved each day. By two weeks, I could see well, but I still had ‘ghosting’.

      Ghosting is a faint double-image which occurs because the epithelium is swollen as it grows back and heals fully. It’s offset a tiny bit from the actual main image. Problem is, each eye had its ghosts offset in a different direction, so you’re really seeing triple. The main image crystal clear, but two a faint, slightly-blurry double images offset half a degree from the main. My ghosting got worse as my eyes got dryer (those no-preservative drops were a godsend). Typically later in the day, they’d be worse than in the morning. Never was it so bad that I couldn’t function easily. But it was highly distracting at first.

      Immediately after gettitng the bandage lens out, I could use the computer, but I had to crank the zoom to max. I’d say it was about 12-14 days before I felt like I was using my monitor at normal levels, and probably three weeks before I set it back to Max-Resolution Tiny Type.

      17 days after my surgery, I played in an all-day all-weekend frisbee tournament. My world still seemed a bit small, but I was able to see well enough to throw and catch a fast moving frisbee coming/going downfield. I took two frisbees off the face, which is very atypical for me. Little hard to catch the middle of the three discs, but those conditions were very tough (keeping eyes open without blinking on a long throw, etc). I’d say I was at 95% capacity, even if my vision still had noticeable ghosting that would come and go (sometimes there’d be none at all, other times it would be bad).

      By three, three-and-a-half weeks I was pretty much fine. Every so often I’d see ghosting, but only when I was tired and my eyes were dried out. By my 5 week follow-up, I hadn’t had any visual artifacts in ages and I was extremely happy with my vision. I was tested at 20/15 (I saw at 20′ what others saw at 15′), but I felt my visual acuity even improved a bit over the next month or so.

      Eye Dryness

      As for eye-dryness. I’d largely stopped wearing my contacts, because my eyes were getting sensitive to them. I used to wear them all day and night, taking them out only for bed. In the couple years previous, I wore glasses when I was home, and only put contacts in to go out and play sports. Even when I’d not worn glasses in a day, I’d wake with my eyes a bit dried out (eye-crunchies). I didn’t think I had any dry eye issues, I thought that was normal.

      After the surgery, (and after the bandage contact lenses were removed), my eyes already felt less dry. This is rare but not uncommon. Some people get SEVERE dry eye from laser surgery. This is much more frequent with Lasik, as it cuts much deeper into the cornea and has greater chance of severing the nerve which transmits the signal to the tear ducts. It is not unheard of with PRK though. I didn’t know what was meant by ‘dry eye’ as a side-effect to laser surgery until that first five days when I was recovering. It is incredibly painful. Unlike any symptom that I’d have called dry eyes previous. It felt like my eyes were dessicated and could not be rehydrated. The drops helped (but the preservative-filled ones started to make it more frequent). When I switched to the preservative-free drops (which are nice and gloopy), this problem went away (it also coincided with the day 3-4 recovery of the epithelium, so it was a combination of both).

      Halos

      The only other side effect I’ve suffered (and still ‘suffer’) is haloing. I knew going in that my absolute widest pupil diameter was about 8-8.5mm. I measured my own in a *completely* dark room using a camera with a flash that would bounce off the ceiling and capture the pupils at the instant before they reacted to the flash. The laser doc measured my pupils in a semi-dark room and got about 6.5mm.

      I knew that the system’s true correction zone (ignore any taper zone, that’s worthless) was about 6-6.5mm, so I knew that I was going to be susceptible to haloing under very dark conditions. And I am, and will be unless I get my eyes done again in later years after my vision naturally deteriorates (and assuming these future machines have wider treatment zones).

      Haloing is an effect where your pupil opens wider than your corrected zone on your cornea (effectively carving a lens into the cornea itself). In such a case, I have say 6-6.5mm of great corrected vision, but a donut-shape of another 2mm of uncorrected vision. So–and only in *very* dark situations–I will get 70-80% of the light entering my eye and hitting my retina being corrected perfectly, but overlapping that, 20-30% of the light will be blurry, virtually the same blurriness as it was before my surgery.

      This results in excellent vision of objects, with a faint after-image. In practice, I only notice it when there is a very bright object in a very dark setting. When setting is dark (driving at night in the country), but the object is not bright enough (pretty much everything except headlights and retroreflector cat-eyes on signs/road/etc), the halo is below my visual acuity. And when the setting is bright enough (driving in the city), the ambient light from orange streetlights is more than enough to contract my pupil to 6-6.5mm (still quite wide!), and all the light hitting my retina is corrected, so there are no halos.

      I really only notice it in the countryside. Very bright stars have halos, but fainter ones do not (their halo is too faint). Cat-eyes on the side of the road and reflective signs in the distance (small size) have halos, but large size signs or the moon do not. And I can make all the halos go away if I turn the map-light in my car on. That’s just enough ambient light to contract my pupils. I can actually play with it. A distant road sign will have a halo, and when I increase/decrease the brightness in the car just enough, I can watch the halo shrink/increase as my pupil contracts/dilates.

      Anyway, it’s interesting. But not really disturbing. I’d prefer not to have it, but I haven’t actually changed my behaviour any way. I don’t drive with any lights on in the car cabin (even though the light is still quite faint, just enough to have my pupils go from Extremely Wide to Very Wide). It simply never bothers me enough to bother about it. It’s kind of interesting though.

      Of course, if you think about it, how your pupils react will have a big effect on your haloing. If your pupils go Extremely Wide (beyond the treatment zone, ignoring taper, etc) under relatively lighter ambient lighting situations (say driving at night in the city), then you’re going to experience haloing much more frequently. If I saw halos on every bright object (remember only the bright objects have enough light for their 20-30% halo to even register) in the city, then I may not be happy about that.

      That’s one of the reasons I think they measure my pupil in a ‘mostly dark’ room. That more closely simulates the environments you’d be most annoyed if you had haloing. It’s not often that we are in extremely dark settings that have very bright lights. Driving at night in the dark countryside is one of them.

      Summary (at long last)

      I know this is a lot to process, but hopefully the straight dope helps you make your decision. I think the ‘you only need a week off work’ for PRK is a bit optimistic (depending on the work you do). I also know (and it’s good to reiterate) that my PRK experience was pretty much optimal. I had a decently thick cornea, not a huge correction, and tried to do *everything* I could to maximize my body’s healing capacity (lots of rest, lots to drink, vitamins, keep bacteria out, use as few of the medicated drops as possible, etc). That said, one might do the same thing and have a different result. Though, as I understand, that’s fairly rare with PRK.

      And above all, I’d never, ever consider Lasik. That’s just stupidity in my opinion. Save two weeks of discomfort/inconvenience by sacrificing your long-term eye-health. No thanks.

      For me, if the choice was down to Lasik or no surgery, I’d STRONGLY urge all to go with no surgery.

      Of course, since I’ve done my surgery in 2011, there have been advances in Lasek (note the e) and Epi-Lasik. Both involve an epithelial (eye skin) flap, but no cornea flap (which makes Lasik so dodgy), but both seem to quicken the recovery process. Each have slight complications (though not the corneal flap complications that Lasik has), but as I understand (I’m not super-well informed here), when there is a complication with the epithelial flap in Lasek (that e again) or Epi-Lasik, that epithelial flap is simply removed, turning the process into a de-facto PRK.

      If I was going under the laser again, I’d definitely look into either Lasek (always going to point out that e) or Epi-Lasik. Seems the *only* nice aspect of Lasik, but without the dodgy-as-hell aspect of cutting a cornea flap.

      Oh look, it turns out I made that post after all! :) Good luck, and keep me posted!

      • Wow, thank you so much for all of the information. It is so very helpful! I appreciate all the details. Your description of your contact situation before surgery is exactly where I am at now. I can barely stand to wear them anymore because my eyes get so dry and tired (almost immediately), but I used to wear them whenever I left the house. That is really interesting about the halos. I will have to ask about that regarding my pupil size; I hadn’t heard about that elsewhere, just about halos in general.

        I’ve already been for a pre-evaluation (assuming Lasik but knowing PRK was also a possibility), but I have to go back because one eye was too borderline dry on one of the tests. If he doesn’t already recommend PRK for me, I’m definitely going to suggest it rather than Lasik, unless he suggests Lasek or Epi-Lasik for me.

        Thanks again, so much!

        • I just realized, I’d completed most of a PRK post-op description years ago! It’s been sitting in my unpublished drafts folder. I just posted it (links above).

          I’m also going to post my comments about haloing in their own post, because I’m sure others would like to know.

          Also… Consider your doctor’s bias. There is good money in Lasik. I wouldn’t touch Lasik with a ten foot pole. That said, I’ve seen some clinics advertise Lasik, but never perform it (doing Lasek or Epi-Lasik or PRK instead). Lasik is a powerful brand that gets people in the door. Though a lot of docs recently are eschewing its (in my opinion) wholly unnecessary risks for the safer no-cornea-flap alternatives.

          • Thanks so much for the information! I had an appointment with my optometrist today, and he recommended either LASIK or PRK, but said the surgeon would tell me whether LASIK could be performed on me due to my prescription and whether I have the appropriate corneal thickness (my eyes are -7.5). As for my job, I’m a librarian and spend a lot of time in front of the computer. I’m very ambivalent about both procedures, to be honest, and admit the length of healing time required for PRK makes it difficult for me to choose as I need to drive to work. Do you remember when you were able to start driving again? Of course, I hesitate with LASIK for the reasons you’ve mentioned. Such a dilemma. Thanks again for all of the information, and I’m glad it worked out for you!

            • I just dug this post out of the depths of my drafts folder. It was mostly written about four years ago:

              http://www.isthisyourhomework.com/my-laser-eye-surgery-part-iii-prk-post-op-recovery/

              In it I describe how I probably could have driven at the two-week mark (perhaps even earlier), but wasn’t fully comfortable even then.

              I started driving after 2.5 weeks.

              If recovery time is a factor, I would choose no-surgery over PRK. Lasik is not worth the permanent long-term risks.

              Investigate Lasek (note the e) and Epi-Lasik. I understand that both do an epithelial/skin-layer flap (NOT the dangerous corneal flap that Lasik features), and both have significantly reduced recovery times (at slight added risk of relatively non-serious side effects. Very much unlike Lasik).

              Many clinics today are advertising Lasik, but performing Lasek (that e again), Epi-Lasik, or PRK due to the significant reduction in risks of the no-corneal-flap procedures.

              Don’t do lasik. Certainly not to trade two weeks of hassle for a lifetime of serious risk to your eyesight.

              • Hi Mr. Temple,

                I finally had my consultation and have decided to go with PRK. I am a candidate for LASIK, but when I asked about my corneal thickness after the surgery and ecstasia, even the doctor said that he would recommend PRK over LASIK to alleviate any concerns I had. I still have to check if I can get the appropriate time off work as it’ll be difficult for me to get there without driving.

                Two last questions for you: I’m over 40 and will likely have to wear readers after the surgery (I don’t right now). If you wear readers, do you have to wear them while using a computer and/or using your cell phone? I’m trying to determine if it’s worth swapping one kind of prescription for another. Finally, would you say your vision is crisp now? Would you do it all over again? Thanks again for all the info! It’s been hugely useful!

  13. Jen, this is the same big decisions I’m wrestling with (regarding readers). I’m turning 45 this year. My doctor has given me a mini-monovision contact sample to try to see if I can tolerate it (since I’m on the verge of needing readers for most near, detailed tasks in my regular prescription contacts). My left eye is at my normal full strength distance prescription and my right eye is -.75 below my normal distance prescription. It’s a little weird (mainly for distance) but I think I could used to it. It definitely helps a lot for seeing close up versus my regular contacts. For distance I can really see quite well; it’s just in wide open spaces that the edges seem just a bit fuzzy. I’ve requested also to try -.50 off my prescription to see if that helps perfect the distance to the point that I won’t notice it at all, without sacrificing the near vision too much. I have a feeling that the prescription I’ve already been trying will end up being the best compromise.

    I am curious also to hear Mr. Temple’s input if he has had any experience with this.

    • Hi Chelsea, yes monovision was mentioned to me, too, but when they found out I’m a chronic migraine sufferer, they advised against monovision. So, I’ll be dealing readers if I decide to go ahead with things. Decisions, decisions.

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