This is a long post and I hope you will forgive me for providing such a detailed report of my PTK laser surgery. I thought I would share my experience since I have gotten so much information from this forum. It has helped me make educated decisions on my treatment and I always felt I was better able to discuss my condition with my physicians. Prior to my surgery I could find little information about PTK generally and really not that much here. Hopefully, this post will provide some real life experience for those who may have to undergo this procedure in the future.
A little bit about my dry eye history . . . I have been suffering from this condition for almost 3 years. I was first diagnosed with rosacea, then ocular rosacea and blepharitis. I have seen 3 opthamologists and a corneal specialist. According to the doctors, I have many things going on all contributing to my dry eye. I have been on steroids, antibiotic drops, doxycycline and Muro 128. I have lower permanent plugs and collagen upper plugs. I was on Restatsis for 8 months and came off of it after my first visit with the corneal specialist. I think I have tried every over the counter drop, gel and ointment. I have tried warm compresses and cold compresses. I was being treated by an opthamologist who had a lot of experience with the condition, but after 2 years, and only getting progressively worse (one visit I had 11 abrasions on my right eye and 4 on my left), he was stumped and suggested that I see the corneal specialist.
It took some time to find a corneal specialist and even longer to get that first appointment. I was diagnosed with recurrent corneal erosions complicated by map dot fingerprint dystrophy. The doctor and I discussed possible treatments and it was decided that I would go on a regimen of drops /ointments that she preferred for 3 weeks to see if the condition improved. She told me that if there was no improvement, she thought PTK Laser surgery would be the best option. I have always been a compliant patient and followed the regimen she suggested without any improvement.
When I returned for my follow-up, she examined me again and we decided to proceed with the PTK. She told me that I have the condition in both eyes and that I would need to have both done. She asked me which I wanted to do first and since my right eye has always been worse, I told her I wanted the right eye done and that after the procedure we would discuss doing the left eye. She explained the procedure in great detail. Since I work at a computer all day, she told me that I would have to be out of work for a week.
There was no prep needed for the surgery. Once at the facility, they took some more readings of the eye, cleaned my eye area, gave me a xanax and some prednisone (pills) and put numbing drops in my eye. The doctor came in and described step by step what she would be doing. The procedure lasted about 15 minutes. They taped the upper and lower eyelids open and then they put something on your eye to keep it open, but it seemed like you could still blink your eye without closing it. It was not uncomfortable at all. Then they put a patch over my left eye to protect it from the laser. The first step was to remove the cornea epithelium. I didn’t feel a thing. The doctor told me what she was doing every step of the way. They flushed the eye with fluid, then they ran the laser twice, calibrating each time. You see green and red lights and bright white light. The doctor told me the worst part of the procedure would be after the laser treatment when I would feel really cold in my eye, almost like getting an ice cream headache. It was cold, but it wasn’t that bad. After that they inserted a patch contact lens and had me sit up for a moment or two before proceeding to another room where the doctor checked to see if the patch lens was inserted correctly over the cornea.
I went home with steroids, antibiotics, prednisone tablets for three days, eye goggles and an ice pad. I was to wear the goggles for 24 hours and after that to bed for a week. She told me to go home, lay down in bed, keep my eyes closed as much as possible and listen to my ipod. No book , computer or tv for 24 hours. I think the xanax must have made me tired because I slept on and off for most of the day. I took an advil since there was some discomfort after the numbing drops wore off. I would say that by the evening I no longer felt any discomfort, but of course, my eye was very blurry. I had a follow-up appointment the next morning to make sure the cornea looked good and that the patch lens was still in place. Everything looked fine. I was to return to the doctor 3 days later to remove the patch lens. The doctor had warned me that often the patient feels worse on day 3 instead of day 2 and for me that was the case. Not only did I feel worse, but I also felt that my vision was getting worse instead of better.
By the time I had my follow-up appointment to remove the contact lens, my vision was very bad. I did not see my doctor, but another from the practice. He removed the lens and told me that my eye looked good. He told me not to worry about my vision and that it should begin to get better within the week. I was supposed to come back in a week, but my doctor was going to be on vacation so I scheduled an appointment for two weeks, hoping that by then, things would be better. However, by the end of the week, my vision was still poor. I was anticipating that things would at least begin to improve. My husband urged me to call the doctor to see if I could see her before she left on vacation. Her schedule was booked, but the doctor called me a while later to assess what has happening. She assured me that what I was experiencing was normal. I told her what the other doctor said, but she told me that it would take several weeks for my vision to get better and that I needed to be patient as they removed several layers of the cornea and each layer would take approx. 1 week to heal. I felt much better after speaking with the doctor. I think that I had misinterpreted what my doctor had said. She had told me that I would feel better approx. 4 days after the surgery. She said “feel better” and in my head I thought “see better”. I did feel better, but I did not see better.
My vision slowly improved. Best of all, I have had little or no discomfort. No more grittiness or foreign body sensation. No more scratchiness. It did take approximately 6 weeks to see better. Approximately 3 months after the surgery, I was able to get a new prescription. My biggest issue was adjusting to my new prescription which changed significantly. My eyes are still a bit dry. The surgery does not correct the dry eye. I still use drops 3 to 4 times a day and I use Genteal Gel at night, along with my tranquileyes. Right now, I am on a regimen that works for me. The doctor has indicated that it will still be possible to get an abrasion from time to time, but that they will be much less frequent and less severe. Knock on wood, I have not had one since the surgery.
At my last visit both eyes looked good, although the doctor said my right eye looked dry and that I needed to be especially vigilant during the winter months. I am not scheduling the other eye for the procedure until it becomes necessary as it feels fine right now, although my vision is not perfect in that eye. Since the surgery, I have been having some issues with extreme dry mouth (scalded mouth syndrome) and since my blood work tested positive on some autoimmune tests, I will be seeing a rheumatologist to discuss possible ties between the dry eye and dry mouth. This surgery has made a tremendous change in my life. It is only one person's journey, but it worked for me and I hope that anyone else who may need this procedure will have the same success.
A little bit about my dry eye history . . . I have been suffering from this condition for almost 3 years. I was first diagnosed with rosacea, then ocular rosacea and blepharitis. I have seen 3 opthamologists and a corneal specialist. According to the doctors, I have many things going on all contributing to my dry eye. I have been on steroids, antibiotic drops, doxycycline and Muro 128. I have lower permanent plugs and collagen upper plugs. I was on Restatsis for 8 months and came off of it after my first visit with the corneal specialist. I think I have tried every over the counter drop, gel and ointment. I have tried warm compresses and cold compresses. I was being treated by an opthamologist who had a lot of experience with the condition, but after 2 years, and only getting progressively worse (one visit I had 11 abrasions on my right eye and 4 on my left), he was stumped and suggested that I see the corneal specialist.
It took some time to find a corneal specialist and even longer to get that first appointment. I was diagnosed with recurrent corneal erosions complicated by map dot fingerprint dystrophy. The doctor and I discussed possible treatments and it was decided that I would go on a regimen of drops /ointments that she preferred for 3 weeks to see if the condition improved. She told me that if there was no improvement, she thought PTK Laser surgery would be the best option. I have always been a compliant patient and followed the regimen she suggested without any improvement.
When I returned for my follow-up, she examined me again and we decided to proceed with the PTK. She told me that I have the condition in both eyes and that I would need to have both done. She asked me which I wanted to do first and since my right eye has always been worse, I told her I wanted the right eye done and that after the procedure we would discuss doing the left eye. She explained the procedure in great detail. Since I work at a computer all day, she told me that I would have to be out of work for a week.
There was no prep needed for the surgery. Once at the facility, they took some more readings of the eye, cleaned my eye area, gave me a xanax and some prednisone (pills) and put numbing drops in my eye. The doctor came in and described step by step what she would be doing. The procedure lasted about 15 minutes. They taped the upper and lower eyelids open and then they put something on your eye to keep it open, but it seemed like you could still blink your eye without closing it. It was not uncomfortable at all. Then they put a patch over my left eye to protect it from the laser. The first step was to remove the cornea epithelium. I didn’t feel a thing. The doctor told me what she was doing every step of the way. They flushed the eye with fluid, then they ran the laser twice, calibrating each time. You see green and red lights and bright white light. The doctor told me the worst part of the procedure would be after the laser treatment when I would feel really cold in my eye, almost like getting an ice cream headache. It was cold, but it wasn’t that bad. After that they inserted a patch contact lens and had me sit up for a moment or two before proceeding to another room where the doctor checked to see if the patch lens was inserted correctly over the cornea.
I went home with steroids, antibiotics, prednisone tablets for three days, eye goggles and an ice pad. I was to wear the goggles for 24 hours and after that to bed for a week. She told me to go home, lay down in bed, keep my eyes closed as much as possible and listen to my ipod. No book , computer or tv for 24 hours. I think the xanax must have made me tired because I slept on and off for most of the day. I took an advil since there was some discomfort after the numbing drops wore off. I would say that by the evening I no longer felt any discomfort, but of course, my eye was very blurry. I had a follow-up appointment the next morning to make sure the cornea looked good and that the patch lens was still in place. Everything looked fine. I was to return to the doctor 3 days later to remove the patch lens. The doctor had warned me that often the patient feels worse on day 3 instead of day 2 and for me that was the case. Not only did I feel worse, but I also felt that my vision was getting worse instead of better.
By the time I had my follow-up appointment to remove the contact lens, my vision was very bad. I did not see my doctor, but another from the practice. He removed the lens and told me that my eye looked good. He told me not to worry about my vision and that it should begin to get better within the week. I was supposed to come back in a week, but my doctor was going to be on vacation so I scheduled an appointment for two weeks, hoping that by then, things would be better. However, by the end of the week, my vision was still poor. I was anticipating that things would at least begin to improve. My husband urged me to call the doctor to see if I could see her before she left on vacation. Her schedule was booked, but the doctor called me a while later to assess what has happening. She assured me that what I was experiencing was normal. I told her what the other doctor said, but she told me that it would take several weeks for my vision to get better and that I needed to be patient as they removed several layers of the cornea and each layer would take approx. 1 week to heal. I felt much better after speaking with the doctor. I think that I had misinterpreted what my doctor had said. She had told me that I would feel better approx. 4 days after the surgery. She said “feel better” and in my head I thought “see better”. I did feel better, but I did not see better.
My vision slowly improved. Best of all, I have had little or no discomfort. No more grittiness or foreign body sensation. No more scratchiness. It did take approximately 6 weeks to see better. Approximately 3 months after the surgery, I was able to get a new prescription. My biggest issue was adjusting to my new prescription which changed significantly. My eyes are still a bit dry. The surgery does not correct the dry eye. I still use drops 3 to 4 times a day and I use Genteal Gel at night, along with my tranquileyes. Right now, I am on a regimen that works for me. The doctor has indicated that it will still be possible to get an abrasion from time to time, but that they will be much less frequent and less severe. Knock on wood, I have not had one since the surgery.
At my last visit both eyes looked good, although the doctor said my right eye looked dry and that I needed to be especially vigilant during the winter months. I am not scheduling the other eye for the procedure until it becomes necessary as it feels fine right now, although my vision is not perfect in that eye. Since the surgery, I have been having some issues with extreme dry mouth (scalded mouth syndrome) and since my blood work tested positive on some autoimmune tests, I will be seeing a rheumatologist to discuss possible ties between the dry eye and dry mouth. This surgery has made a tremendous change in my life. It is only one person's journey, but it worked for me and I hope that anyone else who may need this procedure will have the same success.
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