Considering PRK

[MissP]

I am seriously considering PRK. I have had trouble with allergies since August and have had dry eye since 1996. I recently got a Schirmer's test over 20mm (good), but did have staining with Rose Bengal. I know there is NO WAY for me to get lasik, but I am miserable in glasses. Has anyone out there had a bad dry eye outcome with PRK? Or mostly lasik? Thoughts? I am going to the Cleveland Clinic. so I've done my homewo rk. Still nervous.....

Miss P

[Rebecca Petris]

MissP,

Irrespective of your Schirmer and staining, if your symptoms are not under excellent control on a consistent basis for a considerable period (i.e. if you dry eye discomfort is posing any real challenge to your quality of life) personally I think that any laser surgery poses a great risk of pushing you over the edge again.

Not to get personal but didn't you say something recently about wanting to conceive? With chronic dry eye I'm not sure how many of these additional risk factors one can take.

Sorry not to be more encouraging, but I know many women with serious post PRK dry eye, who did not have a pre-existing condition. I just hate to see people go through that who could avoid it.

[neil0502]

What about contact lenses?

[MissP]

Was going to conceive, thought I might try this first

No contacts for me contact lens intolerant now.

I did ask the doctor about punctal plugs prior to the surgery, but thet said they wanted to keep that as an option AFTER surgery. For me, it is hard to tell where dry eye stops and allergy begins. I have been very pushy/ aggressive about the dry eye. The response has been: "That is why we are giving you PRK." So I am torn between trustung them, but am doing everything I can to try and figure out what other people have gon through, too so I am making the most informed decision.

Thank you for your responses. I am also going to post on d'Eyelogues - a new site I just found.

MissP,

Irrespective of your Schirmer and staining, if your symptoms are not under excellent control on a consistent basis for a considerable period (i.e. if you dry eye discomfort is posing any real challenge to your quality of life) personally I think that any laser surgery poses a great risk of pushing you over the edge again.

Not to get personal but didn't you say something recently about wanting to conceive? With chronic dry eye I'm not sure how many of these additional risk factors one can take.

Sorry not to be more encouraging, but I know many women with serious post PRK dry eye, who did not have a pre-existing condition. I just hate to see people go through that who could avoid it.

[indrep]

Theoretically PRK should not have the severity of postop dry eye that LASIK causes. The reason being you don not severe nerves with the PRK. However the epitheium is removed which will cause a reaction by the nerves.
PRK does have good long term stabilty vs other types of refractive surgery techniques. Personally if I had dry eyes I wouldn't have any eye surgery unless it was necessary to save my sight.

[desertcry]

hi

Hi MissP,

What has made you contact lens intolerant? Is it the dry eyes? I really would not advise PRK.

I had LASEK (A close relative to PRK) about a year ago and regret every bit of it. Before the operations I has no dry eye symptoms. About three months after the operation, as I was gradually reducing my eye drops usage the problems started: painfull, irritated eyes. waking up with my eye lids stuck together.

It remains a personal decision. Glasses or the risk of a chronic eye problem? I'm afraid there's no doctor or clininc in the world that can remove this inherent risk. What is your eye strength?

Is wearing glasses that bad? I recently read a thesis that stated that glasses give the best "corrected contrast sensitivity" when compared to other correction methods (http://dissertations.ub.rug.nl/FILES...y.k.nio/c6.pdf).

Please think very hard before jumping,

Desert Cry

[mflores22]

Irrespective of your Schirmer and staining, if your symptoms are not under excellent control on a consistent basis for a considerable period (i.e. if you dry eye discomfort is posing any real challenge to your quality of life) personally I think that any laser surgery poses a great risk of pushing you over the edge again.

I couldn't put it any better myself. If you can't tolerate contacts, and have other symptoms of dry eye, you shouldn't consider refractive surgery. I too am having a hard time tolerating contacts (some days are better than others), and I have a really high prescription ( -7.00 in both eyes). I know how much glasses suck when you feel like you are walking through a fun house 24 hours a day. I have mulled the option of PRK myself, but I have come to the conclusion that it is better to struggle with my dry eye and hope to get it better, rather than run the risk of permanent dry eyes. Scroll around this forum and you'll see some people admitting that they have considered suicide because of dry eye. I'm not willing to take that chance.

If you do go ahead with the surgery, get opinions from doctors who know they have no chance of performing the procedure, that way you get an objective diagnosis. My dry eye doctor is also a lasik surgeon, and while he has never put any pressure on me or even suggested lasik, his staff has. And the things they have told me are outright lies. Consider the source.
And even if you do get second opinions, you are still taking your chances.

[MyDryEyes]

Don't do it!!

MissP:

I had PRK last summer and my life has been really difficult ever since because of severe, chronic dry eyes. I suspect, like you, I had a mild to moderate case of dry eyes going into the surgery. However, unlike you, I did not know that I had a condition that needed to be treated. I just thought that my contact lenses being uncomfortable was the way it was. It had been that way for quite some time. This issue never came up from my refractive surgeon or other doctors treating me prior to surgery. Before I has the surgery I was functioning normally. I could go outside without protective eyewear. I could sleep at night without foam goggles. I was not in constant pain all day long. This is the reality of my life now. I struggle to get through the day. I struggle to get outside.

Please, do not have this surgery.

I was a -12 prior to my surgery and I would give anything to be able to go back to my thick, clunky glasses.

I am a different person than I was 10 months ago. And it is really, really hard.

MDE

[liz56]

That's a powerful story, MDE! I'm sorry that you are suffering so. I'm glad that you are here at this site, though.

When I was at Healthboards.com, which is kinds of a hit-and-miss discussion board with rude moderators, I read many posts encouraging people with my problem EBMD made minifest with RCE's to get PRK as a way to resolve the problem. I was enlightened to read over at D'Eyealogues that PRK removes the bowman's layer, which is in between the epithelium and the stroma. (It also causes UV sensitivity to the point where patients are told to wear sunglasses outside for at least two years!) That is the corneal layer where my dystrophy is located, but rather than try to heal it up, this surgery removes it. That scares me.

Miss P, you came to the right place to check out all angles before making your decision. You are getting good advice and good information.

Good luck to you,
Liz

[woodart]

Prk

I hsd this done in one eye to resolve scarring problems which hindered my sight. Next, I am a long time sufferer of dry eye and I can say for sure now that the eye I had the pkr done is is the worse one for dry eye now. I wish I had not done it but that is behind me now. I am thankful I did not do both of them. This was at lesat 10 years ago. That's my experience with pkr.

[Lucy]

Not to seem like a smarty pants or anything, but did any of you realize the poster (MissP) made this post 2 years ago? Easy mistake. Lucy

[liz56]

Not to seem like a smarty pants or anything, but did any of you realize the poster (MissP) made this post 2 years ago? Easy mistake. Lucy

That's so funny!No, I obviously did not notice! I guess some people really do use the "search" feature!

[MyDryEyes]

I didn't notice either. Ha!! I wonder what her outcome was.

[dianat]

Miss P could be Mrs. P by now.

[Guest]

Miss P could be Mrs. P by now.

Or worse still, her post PRK dry eyes now prohibit her from sitting in front of a computer reading bulletin boards advising her not to do it by people who have walked the road before her.

If she decided on the surgery I hope it went well, if she didn't I congratulate her on her decision.

Ian