PRK Advanced Surface Ablation

[Judy]

Hi all,

First, please forgive me if this subject has been discussed in detail elsewhere here. My husband has just decided to go ahead with PRK Advanced Surface Ablation and is very excited. When he initially went to the Dr., he was tested and they determined he had 'slight dry eyes" already. Thus, they will be doing the PRK ASA as this "does not result in long-term dry eye syndrome". They also spoke to him about starting on Restasis which they will stop once he has completed the surgery and is healed. OOOOYYYY. This is so scary to me as I have severe dry eyes (not from LASIK or PRK surgery) and he sees me leave a trail of Refresh Plus vials, using Restasis, having red eyes constantly, and all the other routine things I need to do continuously for Blepharitis, etc. He knows the wind and fans and bright lights are all painful for me. I have asked that he get a second opinion before undergoing this surgery and don't think this will happen. So, bottom line, if anyone has some positive input, I would love to hear it... Thanks for all of you. Judy

[Guest]

Judy

This may not be the positive post you are looking for but I had lasek (very similar to PRK ie, surface not lasik flap) surgery nearly 3 years ago (as did Barry (Hangus)). Neither of us had any exisiting dry eye condition prior to our surgery.

Thus, they will be doing the PRK ASA as this "does not result in long-term dry eye syndrome". They also spoke to him about starting on Restasis which they will stop once he has completed the surgery and is healed.

I personally am not convinced that there is sufficient evidence that any refractive surgeon can claim that any form of laser surgery "does not result in long-term dry eye syndrome". What evidence is used to justify this claim. After all my surgery "should not have resulted in dry eye" either.

Restatis seems to be getting used a lot prior to laser surgery these days (based on the number of people mentioning its use here and lasermyeye.org). It is my opinion but I would be very wary when a surgeon suggests that you have to treated for dry eye to enable a better refractive surgery outcome. Again, it is my opinion, that pre-existing dry eyes should be a red card given the documentary evidence supporting dry eye post laser eye surgery.

I would tread with a great deal of caution, and would be very wary of the sales pitch and claims.

Just my thoughts.

Ian

[Rebecca Petris]

Thus, they will be doing the PRK ASA as this "does not result in long-term dry eye syndrome".

Here is a sentence lifted verbatim from a just-published abstract of a medical literature review performed at Johns Hopkins. Emphasis mine.

"Dry eye is one of the most common complications after photorefractive keratectomy and laser in-situ keratomileusis. Keratorefractive surgery is known to cause damage to the corneal sensory nerves. Several studies have demonstrated a decrease in corneal sensation, tear secretion, and tear film stability several months after keratorefractive surgery."

[Lucy]

Judy, after you've made a concerted effort to INFORM him, let it be. You'll be talking to a blank wall and the only thing you'll be doing is creating stress (and probably bad words) between the two of you.

This goes for anything like this. If you talked him out of it NOW, chances are he'd still want to do it down the line "when things get better." We all know things don't "get better" with new technologies, they just change a bit.

If he really is going to do it, he'll find a way. Chances are it will turn out just fine, and if not well, he has you to turn to for sympathy.
Lucy

[MyDryEyes]

I had PRK last July and have nothing but problems. I, unfortunately, was not screened for dryness issues prior to my surgery. I suspect that I was having mild to moderate dryness issues and that the surgery put me into the severe category. This has been life altering and painful.

Please feel free to pm me if you want my story. It might help your husband to hear about another patient. If he already knows he is dry, he really shouldn't do it. Save those precious corneas!!

MDE

[Mort]

PRK gave me significant Dry eyes

Hi all,

First, please forgive me if this subject has been discussed in detail elsewhere here. My husband has just decided to go ahead with PRK Advanced Surface Ablation and is very excited. When he initially went to the Dr., he was tested and they determined he had 'slight dry eyes" already. Thus, they will be doing the PRK ASA as this "does not result in long-term dry eye syndrome". They also spoke to him about starting on Restasis which they will stop once he has completed the surgery and is healed. OOOOYYYY. This is so scary to me as I have severe dry eyes (not from LASIK or PRK surgery) and he sees me leave a trail of Refresh Plus vials, using Restasis, having red eyes constantly, and all the other routine things I need to do continuously for Blepharitis, etc. He knows the wind and fans and bright lights are all painful for me. I have asked that he get a second opinion before undergoing this surgery and don't think this will happen. So, bottom line, if anyone has some positive input, I would love to hear it... Thanks for all of you. Judy

I believe I may have had slight dry eyes prior to PRK but I am unsure. However, 8 months after PRK I developed significant dry eyes. I use Restasis, plugs, numerous drops and I always have to wear glasses outside. If I knew about this web site prior to my PRK I would not have went through the procedure. I was not tested for dry eyes prior to PRK.

[Judy]

Thank you to all for your responses. I will probably try one more time to discuss this rationally with my Hubby, then keep my mouth shut and let him go ahead, as I know he will. Thank you Lucy for your frank response. I agree, there is no way I can stop him so at least I will be there for him afterwards. If there are no issues for him after recovery from surgery, praise God. If there are problems resulting, I will definitely be able to empathize...

[Teri]

more PRK truths

Judy,

I also had no prior dry eye problems prior to my PRK in January 2007. If I had known there was even a chance of this happening, I would not have done it. Like everyone else here, dry eye has been life-altering in so many negative ways.

But, like Lucy said, he may not be open to hearing this, or may think it won't happen to him. After all, the surgeon probably sounded so confident and knowledgeable.

So, other details about PRK that he might not know....

The usual line is that it takes 10 weeks to "heal" from PRK. They say that you'll have a short time where reading will be difficult.

The truth is that, even if everything goes well with your surgery, you it will be difficult for you to work (at any job I can think of) for about 4-6 weeks. Your vision will be so blurry, "over-corrected" (far-sighted), and constantly changing that you won't really be able to see. I could not focus on a computer screen or a written page for weeks after my surgery. Glasses were of no use as the corneal surface was continually changing as the epithelium healed.

There is a lot of pain and discomfort after PRK. This is not limited to the first 3 days or week after surgery, and they usually don't give you any more pain meds after the first week.

After 10 weeks, the epithelium should be superficially healed, but your vision will continue to fluctuate for 6 months to 1 year post-surgery. This might not sound like a big deal, but for someone who was used to seeing the same, clear way with glasses for so many years, it was difficult to deal with.

He should also know how surgeons measure their "success." They measure success by visual acuity alone, and how they measure visual acuity is, in my opinion, misleading. They ask you to look at the eye chart, and if you can make out any letters on the 20/20 line, no matter how blurry, you are 20/20. So you may have 20/20 vision and have such a bad astigmatism that everything will look blurry all the time.

There have been studies (someone here had a link to one) that state that it can take 1-2 years after PRK for the nerve density to reach its pre-surgery levels.

This is all if you have no complications.

Perhaps an argument along those lines will give him pause? It worked on my vet, who I recently talked out of refractive surgery. If anything, he will be better informed of the risks and likely outcomes.

Teri

[bernmee]

NNNNNNNNNOOOOOOOOOO.......

That is what I would telll my loved one......

And what do I now tell myself.....NEVER again have elective surgery....

[Silverlady]

Another thing that he needs to know

My little daughter-in-law had "slight" dry eye before the surgery. Now she can't drive after dark. She is only 36 years old. Her surgery was 7 years ago and was done by one of the "top" surgeons in Dallas, Texas. She says it's nice not having to wear glasses BUT....now she can't drive if there is an emergency and there was. My son had a kidney stone. She couldn't even drive him to the emergency room. She regrets the surgery very much.

This is one of the complications your husband needs to know about. They don't tell you about this. I would bet that you can't drive after dark either. What would he do in a case like this with you or a child??!

Why don't you print this out for him and let him read some first hand experiences? And maybe the one Bermee posted about taping his eye shut.

Billye

[Guest]

After my original post, I agree with Lucy that regardless of how any one of us may relay our personal experiences, he will most likely do it anyway - I would have. After all, there is only a 5% chance that it could go wrong - right!!!!. How many of us have heard this story????

Unless you experience dry eyes as a debilitating condition (as most of us do) the usual response is "surely one of those artificial tear things will sort you out" - if only it was that simple, and maybe for some this is the answer.

Or the other one I love is "your eyes look fine - what are you complaining about, you don't seem to wear glasses anymore".

I guess the only thing left to say now is that if he goes ahead with it and does have problems (heaven forbid) at least he can rely on your eyes to post and read responses to this BB as it is a lucky draw how his surgery might turn out, afterall dryness may be a minor inconvenience to deal with along with the night kelidescope of vision, or driving on a motorway where a guy fawkes night is minor in comparison, or seeing through a scratched train window and struggling to focus on detail for every waking hour of your life.

Or for me the exciting prospect of waking every morning of your life (nearly 3 years on) wondering if your eyelid will be stuck to your eyeball and remove yet another layer of cells. Joy oh Joy.

Judy, you have done what you can, the decision is ultimately his and for that I wish him well (sorry if my post is a little negative but I have lived this - as have many of the other well wishers in this thread)

Warm regards

Ian

[calli66]

the exciting prospect of waking every morning of your life (nearly 3 years on) wondering if your eyelid will be stuck to your eyeball and remove yet another layer of cells.

That reminds me of the happy-happy line people use---how they are so thrilled upon waking every morning and being able to see the alarm clock across the room.

Calli

[Judy]

Once again, thank you to everyone for your answers and stories... July 17 is his surgery day, so say prayers...