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My Laser Eye Surgery, Part III: PRK Post-Op Recovery

March 1, 2017 |  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 a subsequent article, I described the PRK procedure itself: My Laser Eye Surgery, Part II: The PRK Operation.

Here, at long last is my account of my Post-PRK recovery. I’d written some of this in the months following my surgery for a friend who was considering the procedure, but for unknown reasons never posted it here. Well, here it is, some six-plus years later. And yes, I’m still extremely happy with my PRK experience. I would do it again in a heartbeat (though I’d look into the new epithelial-flap (not corneal-flap like Lasik!) methods like Lasek (note the e) or Epi-Lasik.

Day 1

No pain, just a little dryness. Feels like you’ve had non-breathable contacts in overnight (which you have). Overall, the eyes were scritchy, but I was happy playing Ray Charles in the blacked-out apartment. I listened to a few audio books, took lots of drops constantly (never did the pain ones as I mentioned), and chewed gum to try to get rid of the awful taste of the antibiotic drops as they drip down the back of your throat (you’ll love that bit!). Got driven by my friend to my 1-day follow up and everything was looking good. It was a very bright trip, but not as bad as immediately post-op. I took another half sleeping pill that night, not so much because I was uncomfortable, but because I didn’t do anything all day and wasn’t really tired. I wanted to make sure I got a ton of sleep though, as that helps the healing process.

Day 2

No pain but slightly more discomfort, you’re now at 48h wearing the same non-breathable bandage contact lens. I didn’t take any drugs (not even ibuprofen). Boredom was the worst part, but I entertained myself with frequent trips to the bathroom to pee from all the water I was drinking, by eating, with more audiobooks, and by listening to a couple DVDs with my eyes closed. I used my computer a tiny bit, but it was really bright, I couldn’t see very well (huge magnification required), and the strain wasn’t super good for me. That night I took another half of a sleeping pill for the same reasons.

Day 3

This is the only day that was bad. My eyes were very dry, I’d now been wearing the same non-breathable contacts for 72h and my eyes were really dry and really scratchy, even with the constant lubrication of the eye drops. This is where the nickel really dropped on the preservatives in the eye drops, as my eyes were really dry and scratchy and they were no longer providing much relief at all, almost making it worse. I took a T3 in the morning and it was a lot better. I went to my 3-day follow-up. I took the skytrain and bus over there. My light sensitivity was not crazy bad, but I did have two pair of sunglasses on and a hat. My progress was going well, they lowered the frequency of the steroid drops on one eye, and kept the other at the same level. Best thing was that they replaced the bandage contact lenses with a new pair. Hallelujah! That felt a hundred times better. With the new pair, the pain and discomfort didn’t make its way past the T3s. I kept on the T3s every 4h or so, when the pain would come back (ever had super dry eyes? It’s like that), and then my wife came home with the new preservative free drops. That made a huge difference, and I was finally over the worst of it that evening. I took another half of a sleeping pill that night, just to make sure I got a good night’s sleep through the discomfort, but I did sleep well.

refresh-celluvisc-hero-packaging

Preservative-free drops are absolutely essential.

Day 4

This day was easy. You’re back to boredom though. Your eyes are a bit dried out and scratchy (mostly due to the new bandage contact), but the new drops do the trick. I may or may not have taken a T3 that morning, but I don’t think I did. I started to get pretty stir-crazy this day, but I kept entertained by going from couch to bathroom all day for water, urination, and drops. I snuck a few minutes on my computer to see how the world was doing and post something pithy and only mildly self-pitying on my social media, but I still couldn’t really bear it much. To deal with the boredom, my wife and I went for a walk that night when it got dark, and it was glorious to get out of the house. I did without the sleeping pill.

Day 5

By now, your eyes are back to drier than a nun’s… well, they’re dry, and scratchy. I couldn’t really detect any traces of the ‘healing pain’ and ‘rawness’ I’d felt over the past few days, so I was pretty sure all the discomfort was from the 48h of wearing the bloody contact lens. I went to my 5-day post op appointment (again by myself on Skytrain and bus), and man did it feel great to get out of the house again. The first part of the checkup was the removal of the accursed bandage lenses, and immediately, I felt like a million bucks. All the pain and discomfort vanished. The checkup went well and the doc stopped the drops in one eye, and told me to do once a day on the other eye for two more days. The photosensitivity was pretty much under control by that point, and I took the tinfoil down either that afternoon or the next morning.

Week 2

No pain, no discomfort. I used the no-preservative eye drops when I’d feel a bit of dryness, but this was pretty infrequent. I kept a little 1ml blister drop back in my pocket at all times, but only really used them when I was staring unblinking at my computer or walking around outside. By the end of week two, I was still carrying them, but rarely used them.

During all this time though, actually right from Day 0, my eyesight wasn’t very good. It was much better than I was without my contacts, but it was still not good enough to pick out really any details on anything, no matter how close or how far. The vision wasn’t near-sighted, it was as if you were trying to look through a slightly blurred lens. It’s hard to describe, but it’s as if your focus capability is great, but your resolving detail wasn’t there. I could see things equally poorly at 1m and at 10km.

Over this first two weeks, as I’d anticipated through my reading, the vision ‘cured’ up gradually. After about a week and a half, the detail was coming along pretty well, but by then I was experiencing slight double-vision, “ghosts” as they’re called. This is where, due to the swelling and healing of the epithelium, there is a slight, faded double image that is slightly offset from the main image. What made it challenging was that the ghost would be offset in different directions for each eye. So, there’d be a faint double image at 2 o’clock on one eye, and another faint double-image at, say 6′oclock on the other eye. The result: treble-vision.

Again, this was expected, but it made the detail in the world all but impossible to see. I could walk around fine, see shapes, signs, etc, way better than I could before surgery without glasses, but it was hard to make out details. As a result, I was walking around in a bubble of awareness that was just large enough to keep me from bumping into people and tripping over things. My world felt small, so the cabin-fever effect was still there from the 5 days of being a shut-in. I actually played a game of ultimate on Day 7 post op. (cleared with the doc and wearing safety sunglasses of course). I couldn’t really see the disc and was pretty ineffective, so I stayed on the sideline mostly. Still, I got out of the house.

Generally the vision and ghosting would be pretty good in the morning, and as the eyes would dry out more through the course of the day, it would get worse. From day to day, it would improve, usually better in the morning than it had been the day before, but some days it would slide backwards. Each eye was on its own schedule. I expected this, complete with setbacks, but there was some frustration involved as you’d wake up and think you’re done with the visual artifacts, only for them to come back by the end of the day.

Throughout this week, I was on the computer a fair bit, but it was a bit of a pain, it still required giant font sizes, but less and less so over the course of the first 2 weeks. I probably could have, but I didn’t feel comfortable driving by the end of Week 2.

Week 3

I played another game of ultimate at the start of Week 3 on Day 14. By now I could see quite well, but still had the ghosting fairly noticeable. I had optimistically hoped I’d be back to normal 2.5 weeks after the surgery, for a big ultimate tournament, but I still had the ghosting fairly strong. I could mitigate this somewhat with the eye-drops, but not entirely and only for a little bit. I took a couple discs off the face that weekend, but I had fun. I had optimistically hoped that I’d be back on my ice-skates playing goal by then, but that would not have worked.

Right around the three week mark, as if a switch was thrown, my ghosting disappeared. My vision felt super-human. Whether it was three weeks of not being able to see or whether it was actually better than with my contacts previously, I felt like I could see details that I could never see before. I had set up a few benchmarks before the surgery, little eye tests I could give my self, and it looked like I was indeed better than my pre-op correction ever was. I could see detail on the trees at the top of the North Shore mountains from Downtown, license plates and road signs at greater distances, and the registration marks on the cargo containers at the rail yard across the street.

By now, my computer screen was back to normal size, and I had been driving since the 2.5 week mark. At the end of Week 3, I was forgetting at times that I’d had the surgery done. I wasn’t using any drops any longer, as for the past week or so, they were just to keep the ghosting under control.

Aside: A cure for eye dryness?

Also of note was that my eyes, even when I wouldn’t wear my contacts for a week or so, would always be relatively dry and red. I’d often wake up with little crystalline ‘eye crusties’ and have to rub them away when waking up. Surprisingly, since the surgery, this has disappeared altogether. After the first week, once I stopped wearing my sunglasses all the time, my wife was really surprised at how much whiter my eyes were. The redness that was always there previously was gone. I wondered if this was due to all the drops I was taking as part of the regimen, but it’s held out all this time. The dryness of my eyes is improved across the board. I woke up maybe twice with dry eyes in the first few weeks, but that was a more acute, painful dryness (soothed by the lubricating drops) than the general dry-tiredness that I’d usually wake up to. Other than those two occasions, I haven’t really noticed my eyes being dry at all in the 6+ years since the surgery. Only if I’m being very bad to them, staying up late staring at a computer screen, but even then, much less severe than pre-surgery. I had heard that this isn’t altogether uncommon in PRK surgeries, for it to help cure dry eyes, but I simply hadn’t really thought of myself as somebody who even had dry eyes before surgery. There you go.

Of course, Lasik can have serious complications with Dry Eye (to be fair there are very rare cases with PRK too). This isn’t your typical eye dryness that I experienced before surgery when I’d wear non-breahtable contacts overnight. I experienced this painful dry-eye in the days following the surgery. It’s extremely painful. It’s a lot more frequent with Lasik (PRK too in some extremely rare cases), because Lasik cuts that flap into the cornea, and when doing so, there’s a chance of cutting a nerve that helps keep your eyes hydrated. One so-called ‘solution’ to this with Lasik is surgically implanting plugs into your tear drainage ducts. This helps keep your eyes flooded more. I don’t know about you, but to me that doesn’t seem like much of a fix!

Weeks 4-5

My vision didn’t have any more artifacts, but kept improving slowly and steadily over this time. When I went in for my 5-week follow-up, I was measured in my left eye at a little better than 20/20, and the right eye was at 20/15 (better than 20/20).

5 Month Checkup

I had noticed my eyes had kept improving over the first few months and when I went in for my 5-month both eyes were at 20/15 (actually the right was a little better). I really felt like I had super-human vision. I still do. Whenever I talk to people about my surgery, we test our vision against each other, and I’ve always been a lot better. It’s pretty nice especially being able to make out street signs a half-block earlier.

Summary

I really feel fortunate that everything went just about perfectly for me. Other people take a lot longer to heal up and for their vision to settle. It’s often related to how much they have to correct, but not completely.

I have a friend who had to go back for a touch-up at the 1 year mark (it wasn’t the full procedure, didn’t require the 5 days of healing). During the year she had adequate vision, but not great, she wore light prescription glasses for that period. The worst part for her was the perpetual frustration of not knowing whether or not it was going to get there, when, and if it would take a touch up. She was at about -9 in both eyes before the surgery, and even without the perfect vision she was very glad to have had the correction (-.75 to -1 is a lot better than -9). As of a few months past her touch-up procedure, she said she was just about perfect, quite happy. She did spend an awful lot of time going back and forth for after-care checkups and of course the follow-up procedure, all of which was of course with the docs who did her surgery (and that different touch-up procedure). All for no additional cost of course.

So, part of your potential outcome is down to your prescription, but I also tried my very hardest to make sure that I picked the right surgery, by the right doctor, with the right equipment, with the right follow-up, and sticking to the pre- and post-op regime that gave me the best opportunity to heal. I tried to do everything I could to maximize my healing process. I ate well, and drank lots. I took vitamins. I slept as much as I could. I avoided the use of an eye-shield for the light, as I always got sweaty and that just seemed like an invitation for bacteria. I also avoided the use of the pain-drops in the eye, as I was told that can affect the healing process. Of course, I was told that feeling pain stresses the body which affects the healing process quite a bit as well. For me, the T3s were enough to handle the worst of the pain, and I avoided use of the pain-drops all together. Overall, I tried to maximize my self care.

I am certain that luck played a factor in my results, but I’m also certain that some amount of my over-preparation contributed to the great results.

Anyway, this is a magnum-opus, but hopefully it gives you an idea of what you’re in for. Let me know if you have specific questions, and I’ll get you a (shorter!) reply.

Good luck, and keep me posted on your journey!

PS: No guarantees on a shorter reply.

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
My Laser Eye Surgery, Part III: PRK Post-Op Recovery (You are Here)
Halos: A Likely Complication of PRK or Lasik    

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6 Comments


  1. Priyanka Parijat

    hello there,

    This is my Week 2 and even though the doctor had briefed me earlier, I has started to panick because I see what you have mentioned as “ghosts” and due to some reasons I need to use the computer and was wondering if using the computer is affecting my vision. thanks to your vivid descrition I feel mentally relaxed now…

  2. PRK for me here, and I’m 4 weeks post op. I haven’t tested since week 1, but I was already 20/20, and 20/15 at that point. Still, there wasn’t great clarity, even though I was acing vision tests. Some of that bubbling you mentioned. That’s pretty much disappeared by now. The only things I’m noticing are some residual halos, some dry eyes, and that my eyes take longer to focus, especially at night. I’m still taking steroid drops, for the next 3 months actually. I guess every place is a little bit different in what they recommend for healing.

    • Sending good, healing vibes your way!

      “I’m still taking steroid drops, for the next 3 months actually. I guess every place is a little bit different in what they recommend for healing.”

      Totally true. This is why I think the after-care being performed by the surgery clinic is so important. They see thousands and thousands of patients in recovery, while the clinics that don’t do after-care in-house see very few patients through the recovery phase and the individual patients’ ophthalmologists likely have seen even fewer and are just following a generalized post-op treatment plan.

  3. I really like your site. Very informative!

    I may have missed it in an earlier post, but what was your prescription and visual acuity pre-op? Just want to compare with mine. Thanks.

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