Help me prepare for PRK recovery
December 11, 2008 10:15 PM   Subscribe

Have you had PRK eye surgery? Please tell me about your recovery experience.

I'm scheduled for PRK surgery next friday (my corneas are too thin for me to be eligible for Lasik), and I've managed to freak myself out based on the following two things:
1) A few years ago, I had a corneal ulcer where the entire top layer of my cornea was essentially gone, and it was the most intensely painful and traumatic thing I've ever experienced.
2) I've somehow only read blog posts about PRK recoveries that take weeks or months or somehow go otherwise awry.

So, what i want to know, other than general expectations, are:
a) How long did it take for you to be, well, a functioning human being, in that you were comfortable going out, meeting friends, etc
b) How long before you could stare at a computer monitor for extended periods of time? (I'm concerned about going back to work.)
C) How long did it take for your vision to completely heal, and for you to have 20/20 vision? (Or enough to function at work.)
d) Do you have any tips to conquer pain, discomfort, the urge to rub your eyes, and the boredom of not actually being sick or tired, but needing to keep your eyes closed for the first few days?

posted by Kololo to Health & Fitness (11 answers total) 3 users marked this as a favorite
i had it done right around christmas last year. i was doped up on percoset for 2 weeks around the holidays, apparently cranky as all fuck (i don't recall too well, wouldn't say i was in pain exactly , but pretty out of it. mostly holed up in the bedroom listening to this american life)

trying to remember, i think it was a few weeks more before everything came back to normal. when you first go back to work your vision is still a little weird.

that was beginning of the year. at this point i'm 20/15 and hardly a day goes by that i don't marvel at how fucking awesome it is. when i'm driving i always see stuff before anyone else. never have to deal with contacts, any of it. it's pretty great. you will be happy you did it.
posted by jcruelty at 10:56 PM on December 11, 2008

my wife had PRK this summer. one eye at a time. for each surgery, it was done on a friday afternoon, and she was back at work on monday. there was some moderate pain/discomfort initially...the weekend was spent hopped up on vicodin, sleeping and chilling out. the vicodin helped her nap and audiobooks passed the time. she was functional after 2 days, but her vision was a little fuzzy for 4 or 5 days. then she was fine. she went to the doc this week and her vision tested 20/20.
posted by gnutron at 12:24 AM on December 12, 2008

Have you considered an intraocular lens instead? I have that, and one of the real appeals for me was that it's reversible.
posted by miss tea at 5:53 AM on December 12, 2008

Kololo, I know I'm not really answering your question... But I'm concerned by the fact that you are having PRK at all. PRK as I understand is now a redundant procedure - it has been supplanted by the more modern LASEK or epi-LASIK, neither of which involve cutting into the cornea and so should both be suitable for you. Both of these newer procedures have much improved outcomes over old style PRK, as well as much shorter and less painful recovery periods.

Is there a particular reason why you are having PRK rather than one of these other procedures? It may be a little late now, but I would honestly advise you not to go through with the PRK if you can still back out, especially if you are concerned about pain and recovery times!

I agree with jcruelty - it is totally awesome being able to see properly, but I honestly can't understand why PRK is still being performed when such superior procedures exist. Well, whatever you choose, good luck - and get hold of some valium if you can!

PS I have had both LASIK and LASEK - both times I was back to work the next day!
posted by ruperto at 5:55 AM on December 12, 2008

This came up in an earlier question... here's my response from there:
My boyfriend just had this done about 2 months ago, and I was the lucky person there to see the recovery... He had the surgery done courtesy of the US Army, which prefers Photorefractive Keratectomy (same thing as ASA, from what I understand) because its more time-tested and "rugged" in the long term. Even though LASIK is popular in the civilian world, the army does a ton of PRK surgeries everyday.

The results were fantastic, but what infinitewidow said about the pain is true... its no joke. BF was given 1 week of leave for recovery and he spent over half of it popping the narcotic pain meds and sleeping (and this is a guy who doesn't even like taking tylenol). He also was *super* sensitive to light for the first few days, he kept things as dark as he could - the light from my laptop 10ft away was painful.

You will probably need to have a good week off of work to recover, this isn't LASIK where you can go right back. Also, like any of the eye surgeries, make sure you're religious about all the drops they prescribe you. If you have any more questions, I'd be happy to forward them along... email's in my profile
As a followup, as this was posted almost 2 years ago, he loves the results and thinks its one of the best decisions he ever made. Physically, since the surgery he's jumped out of airplanes, survived ranger school and been overseas with nary a problem, and I think part of it was that he followed the post-op instructions religiously.
posted by dicaxpuella at 7:03 AM on December 12, 2008

Well I had RK, not PRK, done about a dozen years ago and would agree with dicaxpuella's boyfriends assessment. I only took a few days, but I did the same with three cracked ribs a couple years back, so I'd figure up to a week of recovery for someone who's not an idiot.
posted by JaredSeth at 7:22 AM on December 12, 2008

PRK as I understand is now a redundant procedure

This is incorrect. There are a number of reasons why a particular patient should undergo PRK rather than LASIK. Commonly, thin corneas make PRK a better option for some candidates. Also, PRK has a considerably longer safety record and does not pose the future risk of flap displacement. For these reasons, some professions with vision requirement will accept vision correct via PRK, but not via LASIK, including the astronaut and fighter pilot programs in the US. LASIK is a good, safe procedure, but it's not appropriate for everyone.

Anyway, to answer the original question, I had PRK several years ago, for a number of reasons. The post-op pain was not that terrible, but since it's your eyes, it's hard to ignore. I was pretty laid up for about two days, during which I used cool compresses and oral demerol for the pain, and mainly slept. After that, I had pretty mild pain and some blurry vision, but was generally functional, for about five days to a week. After that, my vision was 20/15 in both eyes and I was totally back to normal, except that I could see. Awesome. I would do it again in a heart beat.
posted by LittleMissCranky at 7:36 AM on December 12, 2008

Hmm LittleMissCranky maybe I should have made myself clearer.... I was not suggesting that PRK is redundant to LASIK, you are certainly right in suggesting that LASIK is not appropriate for all cases, including thin corneas which the OP mentions.

What I am saying is that PRK is redundant to epi-LASIK and LASEK. epi-LASIK and LASEK are evolutionary developments of PRK, and neither of these treatments involve cutting a flap, as does LASIK. PRK, LASEK and epi-LASIK are in fact all known as "surface ablation techniques"

With PRK the excimer laser burns straight through the epithelium covering the cornea, before removing the corneal tissue. The problem with this is that the cornea is then extremely sensitive and painful until the epithelium that normally covers it grows back. With LASEK and epi-LASIK, either an alcohol solution or a blunt instrument respectively is used the remove the epithelium, the cornea is then lasered, and the epithelium replaced, where it naturally reattaches to the eye, resulting in greatly reduced pain and recovery time, without the complications of a flap (LASIK) or the cornea being without an epithelium (PRK).

If you ask me, the military is probably still conducting PRK over LASEK / epi-LASIK only due to cost issues and institutional inertia. It is no longer considered a treatment of choice for private clients, and certainly the UK at least you would be hard pushed to find anywhere still willing to carry out PRK at all.
posted by ruperto at 8:20 AM on December 12, 2008

I had PRK three or four (?!) years ago, both eyes at once, and did not take any pain meds at all. I did not feel like I needed them. And I had a contact lens fold over in one of my eyes (they use that as sort of a band aid for your cornea). That hurt. I did use the numbing drops once or twice when I had to go do something important, but other than that, I was on the couch and listening to the TV for a few days. You also get what seems to be an absurd list of drops to use a seven times a day or so. Use them like clockwork. Take your vitamins. Drink more water than you thought possible. It all matters.

You feel like you are looking at the world from under water when you can open your eyes during those first three days. After that you are very photosensitive. After that you can see. I am still religious about wearing sunglasses outside, and my eyes can get a little dry at times, but I would do it all again tomorrow if I had to.
posted by oflinkey at 11:11 AM on December 12, 2008

Interesting, I hadn't realized that PRK had been superseded by epi-LASIK and LASEK. Good to know, though too late for me!
posted by jcruelty at 11:43 AM on December 16, 2008

Response by poster: Thanks for all the advice, everyone! I'm now two weeks post-surgery. Here's how it went for me:

I spent the first two days pretty much just conked out on Tylenol 3. I would have been in a lot of pain otherwise. I had my eyes closed for about 23.5 hours a day, (opening them was uncomfortable/painful and therefore unappealing) and I'm pretty sure that helped my rate of healing. At my 'morning after' and 'day 3' post-op appointments, my doctor told me my vision was better than expected! After those first couple of days, each day was drastically better than the last, and by wednesday I was pretty functional (although focusing on reading for an hour exhausted me - i had to nap to recover from the exertion of focusing!) By friday (one week after my surgery), i felt good enough to actually go to a movie! (Although my eyes got really dry and I had to close my eyes a few times.)

At this point, my eyes feel pretty normal, other than a bit of dryness. However, my vision seems to go 'in and out' still, as far as clarity is concerned. Reading a computer screen still requires some concentration to deal with blurriness/double vision. I'm hoping that my vision settles in soon,
posted by Kololo at 8:55 AM on January 2, 2009

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