The LASIK and PRK Adventure

Because just one of those isn't fun enough, right? Hell, let's do both!

 

It'll be fun, they said.

 

Not at all shocking to hear, but my body is stubborn right down to my eyes. Actually, that's not true. Here's what actually went down on the laser table in that very chilly room.

 

LASIK: very cool procedure. I opted to go through Hollingshead Eye Center because, despite his widespread reputation, the dude is flat-out the best in the state. And when it comes to your eyesight, let's just not mess around with any other option. I'm sure the other people are good. Hell, I'm sure even the other doctors at Hollingshead are good, and most likely trained by the man himself. Still, I'm not messing around with my eyes.

 

The first thing that happens is they bring you in for a consult to establish if you are a good candidate for LASIK. There are several disqualifying factors, such as too thin of a cornea, too dry of eyes, unstable vision, etc. They run you through a battery of eye tests (all non-invasive) and, if you are a good candidate, walk you through what's next, the financial situation (mine was $3,806 after a VSP discount, and this includes all pre-op and post-op care), and ultimately schedule the date of your procedure. 

 

Leading up to the procedure, they will call in two prescription drops so you have those in-hand prior to the big day. You will also need to grab a ton of preservative-free eye drops. You will also have a pre-op exam, most likely by your regular eye doctor. Mine did a double dilation of my eyes, and holy hell that was about as fun as it gets! I had to be completely free of my contacts for a week and a half leading up to the procedure date, which included many headaches from my glasses.

 

The day of the procedure, there's a lot going on. You arrive and they immediately whisk you off to a pre-op room. They do a fresh set of eye exams to dial in the specifications for the laser. They also completely clean/sterilize around your eyes, and put in some numbing eye drops. They offer a Valium - take it. And take the candy "chaser" they offer as well because that Valium tastes AWFUL. The main dude came in to go over any last minute questions and walk through every step of the procedure. And then you are cleared and they walk you into the LASIK room.

 

The room is very dim, and quite chilly. There are numerous people in there, doing their own specific jobs. You are instructed to lie down on the table and shimmy up so your head is under the laser.

 

 

[Obviously this isn't me, but the set-up is similar, though it was quite a bit darker.]

 

Once you are on the table, they get your head situated just how they want it. They tape one eye closed, and then put some plastic guards above and below they eye they are doing first. Then they pry those eyelids open.....probably could have used a less intimidating word there, huh? Anyway, I had a lady holding my hand the entire time, and another one up near my head who was very calmly explaining each step, telling me I was doing great, and probably the one in charge of keeping drops in my eye. Your eyes are numb, so you truly don't feel any of this, or any sensation to blink.

 

[not my eye]

 

Once they have everything in place, they put in a corneal suction ring, which holds your eye in place while the flap is created.

 

[also not my eye]

 

Once the flap is created, the laser part begins. You are instructed to maintain focus on a blinking red light the entire time. (The laser is set up so that if your eye moves out of the designated field, the machine stops.) The laser then begins its process, and they are explaining how many seconds each "round" is, counting down for you. I have to say, their calm assurance is 100% appreciated. Once the laser is done doing its thing, you are done. They put in some more drops, take out the clamps, and move on to the other eye.

 

Only in my case, we didn't get very far. My left eye is anatomically smaller than my right. Small enough that they kept losing suction on the suction ring, meaning we couldn't get the LASIK done on the left eye. He tried three times, and finally said "we just can't get this one done". I was really upset as he walked me through what happened, and what we can do going forward. PRK, the "original" procedure before LASIK was developed, was the next plan. PRK does not require the use of the suction ring, and therefore, a better procedure for my left eye. We needed to give my left eye a little break and some time to heal from the trauma of that suction ring, so we scheduled the PRK three weeks out.

 

Here are some pictures of my eyes in the days and weeks following LASIK. Obviously the "hickeys" from the suction ring were very pronounced in my eyes for quite some time!

 

[week 1]

 

[week 2]

 

[week 3]

 

The healing process was really easy with LASIK. I went home and slept for a couple of hours. It's really important to rest those eyes (or eye, in my case) for a couple days. You can drive the next day to the follow-up appt. There was very mild irritation - for those who wear contacts, it's like getting a piece of dirt/sand in your eye. It's annoying, but it never hurt. At my follow-up the next day, my eye was testing at 20/20. The vision fluctuates quite a bit. Even now, at four weeks out, I have good days, and better days. I know it's going to take some time for it to ultimately level out. I just lack that thing called patience. :)

 

PRK is a little different than LASIK, in some very key ways. First, there is no flap created, hence no need for that suction ring. Instead of creating a flap, they remove the entire epithelium (top layer).

 

 

 You are on the same table, and they still clamp open your eye (the other is taped shut). Then they use a solution to break down and dissolve, so to speak, that top layer. Once the solution sets in, they use a scrubber tool (almost like the scrubber thing used at the dentist) to remove that top later. Once the top layer is gone, the laser does the same buffering process (27 seconds for my left eye). Once the buffering process is over, they place a sponge on your eye with some drops that reduce/eliminate the haze commonly associated with PRK. This sponge remains in place for 30 seconds, then they remove the sponge and totally flood your eye with drops. As in, my hair was soaked by the time they were done flooding the eye. The last thing they do is place a non-prescription contact in your eye, to protect the epithelium as it regenerates over the next few days.

 

And that's it. Probably two minutes, max, on the table, and they send you on your way.

 

 

The first day getting home after PRK is pretty much the same as LASIK. You sleep and rest. And then the well-known PRK issues set in. First, the light sensitivity. Holy crap. Worse than when your eyes are dilated at the eye doc. Much worse. The irritation in the eye - much worse than LASIK. Day two was ok for me, but by the evening of day two, things went straight off a cliff. My eye started weeping constantly, and the burning sensation was pretty extreme. And that irritation just went through the roof. I wanted to rub my eye so bad! I ended up going in to the doctor on day three, as my eye was fairly swollen and the weeping just wouldn't stop. I was assured that this was totally normal, and unfortunately a byproduct of PRK.

 

Great.

 

Fortunately, day 2.5 and 3 were my bad days. Once day 4 rolled around, my eye was feeling a lot more normal, though I still very much needed sunglasses inside my house, with all the blinds closed.

 

 

 I navigated in the dark as much as possible. Driving wasn't even an option - too bright!

 

[here are some more recent pictures of my eyes]

 

 My post-op nurse was a total slacker!

 

Day 6 post-op was when they determined the epithelium had totally grown back, and they removed the bandaid contact. With tweezers. As if my poor eyes hadn't been through enough?! Fortunately, they used numbing drops prior and I didn't even feel the contact being removed.

 

So I'm now one week out. My PRK eye tested at 20/40, which is great for one week. The healing process and stabilization of vision takes much longer in PRK than LASIK, potentially six months.

 

Overall, it's awesome to not have to deal with contacts every single day. The night vision is still a little dicey at times, so I avoid that when possible. I'm hoping that part levels out as well in the coming months. I know it might not be 100% crisp like my vision was with contacts - or maybe it will. Only time will tell.

 

I'll continue with updates over the next several months to track the LASIK and PRK processes.