Lasik vs PRK Surgery

[Texasbuckeye]

Okay this is something I am also considering but I have a bad eye phobia. I can barely get eye drops in with a lot of effort. Open eyes under water, no freakin way. Can’t even look at a close up image of an eye. I’ve almost passed out eye dr office before from anxiety.

But how can one get through the procedure itself. Can they put you out to the point where you’re awake but have no idea what is going on? What about the recovery process itself. Just drops?

Not sure how to get past the phobia though and if this would ever be an option.

lasik and prk are what I call a participation sport, you have to focus on a blinking light so you can ensure the laser treatment hits the centers of your vision on the cornea. So no, they can’t put you out to the point you don’t know what’s going on...you need to know what’s going on.
We will give a low dose Valium, but in some patients all that does is disinhibition kind of like a couple of beers makes some people more irritated. I am not a fan of the Valium but that process was in place before I even showed up, so it stays.
tbh, if you have that much phobia about eyes, you either need a really good doctor to do your lasik or you just don’t need it done. You can mess things up if you are jerking around and not able to be cooperative under the laser. I have never had someone I couldn’t talk through the surgery, but there is always that one person out there. Feel free to pm if you want

 

[Clarkdale17]

Thanks for all the responses folks. Seems like the general consensus is it will be the best money I'll ever spend regardless if I go with Lasik or PRK.

 

[pirogue]

I had refractive lens replacement done. One advantage of this, after this is done, you won’t need cataract surgery down the road. LASIK doesn’t remove that possibility.

 

[sandhillhunter]

I had refractive lens replacement done. One advantage of this, after this is done, you won’t need cataract surgery down the road. LASIK doesn’t remove that possibility.

Interesting and something I’ve wondered about.

How old were you when you got your new lenses?

Do you have to use long term medication postop?

How long do they estimate the lenses will last?


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[Vandal 44]

I had PRK surgery a little over a year ago. If you want to know how you will do with the recovery; get some bear spray and give yourself a good blast to your eyes, that burning feeling last for about 48 hours after a week it a lot better. I would do it again if I had to, I am 20/20 but its nit real crisp vision

 

[pirogue]

Interesting and something I’ve wondered about.

How old were you when you got your new lenses?

Do you have to use long term medication postop?

How long do they estimate the lenses will last?


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I was in my fifties, and has been 9 years since done. No medication needed. Don’t think there is a lifespan on them. One benefit I was unaware of, was that I was always rubbing my eyes before surgery(probably since childhood). No more after surgery.

 

[ridgefire]

I had PRK done probably 15 years ago and it was the best money I have ever spent. They wanted $4800 and I talked them down to $1000 an eye out the door so $2000 total. Recovery took a few weeks but I have not had any problems since. You will love not having contacts or glasses.

 

[sandhillhunter]

I was in my fifties, and has been 9 years since done. No medication needed. Don’t think there is a lifespan on them. One benefit I was unaware of, was that I was always rubbing my eyes before surgery(probably since childhood). No more after surgery.

I may have to consult with my ophthalmologist about that option. I have borderline dry eye and didn’t think PRK or LASIK would be good for me.

I would have had to have punctual plugs and possibly Restasis long term (which was $400-500 out of pocket with my high deductible insurance plan.


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[Texasbuckeye]

So refractive lens exchange is an option we usually reserve for those around 50+, because the risk of going inside the eye vs just doing a surface treatment (lasik and prk) is higher, increased risk for infection, inflammation, retinal detachment and such things. Also, it will absolutely take away your ability to focus on things up close (you lose your accommodation) unless you spend more and get a multi focal lens. Those lenses have some side effects of rings around lights at night and slight decrease in low light vision so I am not a huge fan of them in hunters/outdoorsmen. The cost is a also higher for lens exchange than lasik/prk.
It does negate the development of cataracts in the future, and should last a lifetime. If you have lasik at a younger age and are out of glasses for a coupe decades, it does not preclude your ability to have a lens exchange later in life.
just giving some info on that procedure since it was brought up.

 

[sandhillhunter]

Thank you for the info Dr. Texasbuckeye! That is all very helpful.

My optometrist has always discouraged me from corrective surgery since I’m nearsighted and would lose my up close vision that I use daily at work.

I even discussed with my ophthalmologist about a different procedure for each eye- one up close and one distance, but thought that was too risky.

At the end of the day, my ophthalmologist wears eyeglasses and said he never considered elective surgery on his own eyes, so I thought that was telling.


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[Clarkdale17]

First off I wanted to thank everyone for their input and especially Texasbuckeye for answering the questions I had. I recently had the PRK surgery done on 7/10. I'm sure there are plenty of other people on Rokslide that have contemplated getting PRK either due to inability to get Lasik or just a personal choice so I though I'd give an update.

I decided to do a little timeline write up on the recovery as there doesn't seem to be a ton of good information online. My biggest concerns before the surgery were the amount of vacation time I'd have to take, and how soon I could start driving again. Do yourself a favor and don't go digging through every PRK recovery thread you can find online like i did. Every damn post I read went something along the lines of this "The recovery has been the worst experience of my life. Excruciating pain 36 hours a day 9 days a week for the first two weeks.... Still can't drive two months after the surgery." I understand that people will recover at different paces and that some have unfortunate long term side effects from the surgery, but I could probably count on one hand the amount of people who posted a good review about it. I figured they have been doing the surgery for over 30 years and it's still being offered so no use letting people online make me second guess my choice to proceed with the surgery.

Day 1- Friday 7/10 Went in for surgery around 1. Declined the valium they offered before getting in the chair. Surgery probably took less than 10 minutes. No pain at all during the surgery however I will say it wasn't comfortable. Got up out of the chair being able to see better than i have my whole life. Got a ride home and took a nap. Woke up ate and watched a movie and went to bed. No pain after the surgery but vision began to deteriorate throughout the day.

Day 2- Woke up with no pain or uncomfortableness and had none throughout the day. Eyes were a bit watery and had some light sensitivity Vision was about the same as the day before but did deteriorate throughout the day more. Had a few friends over for a buddies master graduation party so just hung out with them all day. Was able to play lawn games with no problem. I declined to partake in the alcoholic libations as I felt being dehydrated wasn't conducive to growing back the epithelial layer.

Day 3- Woke up with extremely blurry vision which maintained all day. Day was essentially wasted sitting around and sleeping all day as I couldn't see very much. No pain throughout the day, however did have an uncomfortable feeling now and then. Just threw an ice pack on them when this happened and they felt fine.

Day 4- I teed my boss up to take a few vacation days if needed. Today was the first day I was supposed to be back at work. Woke up with decent vision and no pain. Was able to work at a computer all day bidding a project without any issues. Turned the display to nighttime and upped the font. Had some ghosting of words and had to take some breaks but it was bearable.

Day 5- Woke up with no pain and much improved vision. Eyes were no longer tearing up constantly and were comfortable. Worked all day at a computer again without any issues. Eyes were significantly less sensitive to light. Felt comfortable enough to drive today so I did.

Day 6- No pain and vision improved again. Short distance vision was pretty close to where it was with contacts, however it lacked crispness and still had ghosting at times. Long distance vision was still struggling, however i was able to shoot my bow at 30 yards no problem.

Days 8-11- No pain and vision was significantly improved. Long distance vision was coming in nicely and everything was starting to become more crisp. At this point it really sucked not being able to work out due to the contact bandages still being in.

Day 12- Contact bandage came out. Long distance vision crispness and clarity took a pretty big hit when the bandages came out. Vision was slightly blurry throughout the day, but much improved over days 1-4. Lifestyle went completely back to normal and was able to work out again.

Days 13-15- Short distance vision has maintained at very good. Long distance vision still lacks the crispness and clarity I had before contacts, but can see small improvements most days.


I'll provide another update in a week or so if anyone is interested. Overall I'm very happy with the results I've gotten so far and hope I don't have any long term side effects from the surgery. I haven't really noticed a difference in light sensitivity before and after the surgery, but I do have a slight halo around lights at night. Hopefully this is eliminated once the epithelial layer fully heals and smooths out.

 

[Texasbuckeye]

Just so everybody understands what is going on with clarkdale’s eye, his skin layer of the cornea was scraped off and last done to reshape the cornea, and the skin layer needs to heal back together. The body/eye does a quick job of closing the wound, but this is a rough layer that is not smooth and needs time to smooth out. The skin heals in between day 3-5, and takes a few more months to smooth out completely. This is where the vision will have some loss of crispness, halos, ghosting, etc and those will slowly go say over the first couple weeks to month or so.
Clarkdale is doing great and I appreciate hearing his side of things and how his vision is affected. Reaffirms what I tell folks when counseling them on this procedure.

 

[njdoxie]

I had PRK done about 10 years ago. My vision is still great since the procedure. Recovery was brutal. Immense pain for a few days that transition to moderate pain for probably another week. It’s the kind of pain that you can’t get comfortable with. Brutal. Took awhile for my vision to return fully as well. Didn’t drive for awhile. I ended up hunting deer a month or so after and it was questionable. Still glad I had a procedure. If I had to do it again I’d consider going lasik.

Wow...there's a wide range of reactions...but....makes most sense to do what is in your best interest long term, short term cost/pain be damned.
I had lasik done 25 years ago, some of the best money I've spent, I still have 20/20, but I know others who's vision has deteriorated...if that happens to me, I'm having it touched up, no question, using whatever method gives me the best long term results.

 

[Tahoe1305]

Thanks for sharing. My experience with PRK was closer to yours than many of the “horror stories”. A couple days of discomfort then great. I’ve been able to see everything on a eye chart ever since (6 years now).

I see a ton more game hunting with naked eyes. They pick up movement like crazy. It’s awesome.

Enjoy!

 

[MTCruisin']

Yep, my experiences were very similar to Clarksdale and Tahoe's. Have to figure the portion of patients who had issues with pain tolerance and other things tend to be the ones you see posting elsewhere online.

 

[TexasAg86]

I did lasik and would agree with others that it was some of the best money I've ever spent. A hunting experience is actually what made me finally pull the trigger. Had tons of money and months of preparation put into a mule deer hunt when I thought i lost my glasses, and realized my hunt was effectively over not being able to see. Luckily I found them. Had the procedure a week or two after returning home.

 

[targetpanic]

In people's experience, how was the no wearing contacts for weeks before the surgery? I'm -6.50 with Toric correction contacts. I put them in first thing in the morning and take them out when going to bed. If I have to wear my glasses for any amount of time I get headaches and my vision sucks (esp peripheral) with them.

 

[Charlotte99]

I had my LASIK eye surgery six months ago, and it was perfect for me.
The surgery does NOT hurt me much. For about a week, I wore IIRC protective goggles and is asked to put in eye drops for a year (lots at first, then little bits after that).
For me, the most significant change was not to rub my eyes for the first year in the morning; even though the corneal flap seals almost immediately if you are not vigilant, you can move it.

 

[Clearedhot1]

I’m bringing this one back from the dead.

I had PRK one month ago. I am almost 41 and relatively healthy. I had a vasectomy two weeks prior to this procedure and healed up like a stallion (or gelding?). I was not a candidate for Lasik because of dry eye. Because of the dry eye and before the surgery, the doctor recommended some procedure where suction cups were placed on my eyeballs and essentially milked my glands to help me tear better. It was the biggest waste of money Ive spent besides a Chevy Silverado I bought new in 2013.

Moving on. The PRK surgery was quite easy with the help of prescribed Valium before and after. The next couple days were not easy. I spent at least two nights on the couch wondering what the hell I had done to myself. Joe Rogan podcasts got me through it because I could not see television or my phone really. I wore metal shields over my eyeballs and my children called me”Fly Dad.”

About a week after the surgery the doctor put punctal plugs in me to help with tearing. I never had to pay for them so maybe they were included with the surgery? No clue, I didn’t ask. I took the prescribed steroid drops and I’m still on them and now down to one a day.

It is very interesting process. One day the vision in my left eye will be better, the next the vision in my right eye will be better. Two days before I went back to work the office staff put my right eyeball in a contact lens to correct it. It helped. On days like today, the vision in both eyes is blurry.

I was out of work for one month using a mix of vacation and sick time. I just went back to work three nights ago and realized I should not have been there. By trade, I work night shift. I quickly realized I couldnt see clearly past 100 feet. The blurry halos and light sensitivity are not good. I could not read the odometer of the work car at the end of my work shift. This was 28 days post surgery. If I worked in an office and on dayshift I likely would’ve returned a couple weeks ago.

On day 29, yesterday—a Friday afternoon, the doctor called me and told me he has a life-threatening medical condition and will not be returning to practice. I explained that my vision was not right, and he referred me to another doctor he had partnered with some 40 miles away to treat his post surgical patients. So on top of the anxiety of healing correctly, there is that…And the grief of losing my doctor, who I actually really liked. He had been in practice for 40+ years.

Current symptoms: blurry distance vision (varies by day/by eye), extreme light sensitivity, halos, double vision (left eye), blurry close vision (both eyes), minor sinus headache, minor pain (behind right eye), and a deep regret for having done this so close to season.

Monday morning when I wake up I will have hopefully heard back from two new ophthalmologists I reached out to. I will likely be taking more time off of work to get this under control. Now I have yellow lens glasses for night driving and blue light lenses for computer work. Makes me think, “what was the point?”

I applaud the patients here who are better in a couple days or weeks. There have been brief moments during the past month where my vision has been great and I have not had to wear any glasses or contacts. It was bliss, but short-lived. There are horror stories. Believe them.

I will try to provide an update when this situation is resolved.


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[Texasbuckeye]

When i do prk, i always tell the patients it is a couple month process to get best vision. The healing phase is impossible to predict and there can he some refractive error the eye tries to heal back that wont be rhere long term. In short term, its a crap shoot as to what you will get. In the ling run, the results are as good as with lasik. Just takes some time.
truth is most patients are very good at one month. Sounds like you have some issues. Could be related to dryness, and aince you had dryness before hand i would guess that is the main culprit of your visual dis-satisfaction. Tears, tears, and more tears. If your vision is good for moments and then blurs out, thay is tear film and your eyes are drying too much. Use preservative free tears as much as needed to keep your vision clear (at one month you should be using them at least four to fice times daily still). Yes it sucks short term, just as rehab does for knee or shoulder surgery, but you did have surgery.
If you want to PM me i can answer questions you may have.

i agree the eyelid heat treatment to help suck the oil out of the glands is a waste, i dont do that because its a waste of money. Some docs believe in it, most do it as a revenue source. The ugly of medicine there. Sorry about that.