5 years and 1 month update

State after 5 years and 1 month:

• Vision is still very good. I would say still around 125% (1.25). I see better than most people around me. The vision has stayed on this good level since about 1 month after the surgery.
• Although I am now 42, I don't see any signs of difficulty with near distance seeing as of yet (no need for reading glasses). I expect this to start to become between the age of 46 and 50 in my case.
• Dryness: I still use lubrication when I sleep and a drop now and then day time. The day time dropping is however so infrequent now that I think it has no longer anything to do with the surgery, just getting a bit dry eyes now and then from long hours by computers and/or dry air at home an in the office.

I can still testify to that making this eye laser surgery was one of the best decisions I have made in my life. I no longer remember the struggle with contact lenses and glasses.

3 Year 10 months update

Went to an independent eye doctor (not the clinic where I did the later) today for a eye health and vision check. Everything was good with the eye and I could very easily see the 1.25 line with both eyes open. For single eye he only want to 1.0, but that was very easy to vision probable 1.2 per eye as before. Still a bit dry from time to time but very seldom compared to 1-2 years ago.

He also tested that I can see wide, see Color, have enough contrast and no ghosting. All good.

3 year 5 months update

Quick update after 3 years and 5 months.

I didn't go for any more check ups but I feel that my vision is still as good as one year ago.

Regarding my dry-eyes they have got significantly better. I still drop a lubrication drops a couple of times a day, this might be related to the fact that I work in front of computer screens 12 hours per day. I would say that my dry-eye level is now the same as pre-surgery. Back pre-surgery I felt that my eyes got dry after 10-12 hours of contact lens usage, that's probably the same level of dryness I feel now, just that I got spoiled from all the drops, meaning that I got used to the feeling of being completely non-dry.

I plan to do a check-up latest at 4 years, will update the blog again then if not before.

2 years checkup

Today I did my 2 years checkup although it’s soon 2 years and 1 month since I did my TransPRK eye laser surgery. In Switzerland where I live you usually don’t do a checkup after 2 years (normally last one is at 1y) but its recommended to do a yearly checkup of eye health, especially for people who did eye laser surgery. I choose to do it as I wanted to check my general eye health, do a vision test and talk to the surgeon about why I still have dry eye symptoms (although very mild now). I will break this post down accordingly below.

General Eye Health

My general eye health was fine. I had normal eye pressure and my cornea looked healthy. Nothing special to comment here.

Vision Acuity Test

My vision was unchanged since the 1 year checkup, which was exactly what I hoped for. I could see the 1.0 line very clearly with one eye open at the time and with both eyes open I got all digits right on the 1.25 line.

I am very happy my vision stayed on this level after 2 years. This is really more than I could ever have hoped for since I only achieved about 1.0 binocular with contact lenses and glasses before the surgery.

Quick translation for those of you that are used to a different scale:

Decimal (used in Europe)    Foot (used in US)            Popular talk

1.0                                                     20/20                                          100%

1.25                                                    20/16                                         125%

             

Dry Eye Symptom

I got confirmed that my eyes are a bit dry. I was however told that it’s not because my tear glands produce too little tears, instead it’s my eye lids that produce too much tallow. I was recommended a treatment of cleaning the eye lids in the evening and putting in a night cream. I will make a new post in a month commenting on how this worked out.

2 years

Already 2 years have passed since I did my TransPRK eye laser surgery. Everything feels good, except that I am still a bit dry sometimes. Vision feels sharp.

Decided to actually go for a 2 years checkup to check vision, health and humidity/dryness levels of my eyes. Will write on the blog again after I have done this.

23.5 months

23.5 months today - not much new to report. Trying a new Type of Systane drop and a spray called "Tears again". I have a feeling they work pretty good, I drop quite infrequent. Will make a larger update here after I pass the 2 year mark.

22 months update

So, more then 22 months have passed since my TransPRK eye laser surgery. Not much changes to report since my 21 month update, I still see very good and I use even less lubricating eye drops compared to one month ago. I think I am starting to get my nerve recovery status back over some threshold where I soon don't need to drop any more. Compared to the same time one year ago, I am dropping significantly less. Getting more and more happy with my decision to do this surgery.

Next update in a month.

21 months update

11 days late with this one and now it's Christmas Eve so I make it quick. Nothing much changed since last month, only thing is that I drop a bit less lubrication drops, but I am still using that. Still hoping it will all be fine at 24 months. Merry Christmas !

20 months update

Now at 20 months, still nothing really new to report. Same story as at 19, still seeing very good, and still dropping some lubricating drop. Winter is coming here now, generally with drier air, will be interesting to compare my drop frequency this winter compared to a year ago, expect it to be lower. More on this in my 21-24 months reports.

19 months

At 19 months now - no real news to report. Dropping a bit less artificial tear drops versus at 18 months, otherwise all the same. 

18 months - 1.5 years

Today is a big day! It's 1.5 years since I did my TransPRK eye laser surgery. This means that on average it's only 6 months left until my corneal nerve endings are fully recovered. At the moment I would be on 40 + 0.75 * 60 = 85% of my original nerve count, assuming linear recovery.

So how are my eyes and my sight ? Actually very good. Vision is still excellent, didn't do any test since the 1 year day but I would say it's unchanged - around 1.25 on the decimal scale and 20/16 on the scale used in the US. So far all good.

How about the dryness ? This month I can actually report a significant improvement over 15m day. I drop much much less. I think soon I will not need lubricating drops anymore. Since I drop much less I have also decided to switch from the expensive preservative free drops (first picture) to the much cheaper version of the same drop with preservatives (second picture).

Ok good folks ! Until 17 months 

17 months update

So now is 17 months and 3 days since I did my TransPRK eye laser surgery ! Actually not much to report today, will report more on the 1.5 year (18 months update). The only thing I can report today is that I still see very good and that I drop less lubricating drops compared to the 16 months day. In kind of naturally declines, sometimes I even find myself forcing myself to drop Ayer realizing I didn't drop for a couple of hours, better one drop too much then one too little I would say. I am still waiting for the day I just "forgot to drop" as a result of feeling zero dryness over the whole office day , let's see when and if it comes .

16 months update

Wow already 16 months since I did my TransPRK refractive eye laser surgery! These updates are starting to get repetitive ! I guess that's a good thing though, no dramas after so many months.

So how are my eyes ? Basically same story as at 15 months. I see very good and I still have slighlty dry eyes, especially when sitting in the office with my 6 high resolution screens all day. That said, I am already down to 3-4 of these small single use bottles per day (picture below) which is pretty good since I was at over 10 per day one year ago. It might sound a lot to some of you, but I drop more then I really need, I like to keep my eyes fully moisturized  all days to maximize my vision and avoid any future dry eyes related problems.

I would say at 16 months I start to get 100% sure I did the right choice when I decided to do eye laser. The dry eyes will soon be gone (latest at 24 months according to my own research) and vision is super. I see better then most people around me. The extra vision I have gained compared to when I had contacts and glasses for example helps me when I play Golf, I can follow the ball all the way, even when hitting a 250 meter drive. Another positive side effect is that my eye whites are starting to get whiter. Less small blood vessels in there competed to how it looked after 20 years of contact lenses. 

Ok readers ! Until next time !

New hope for eye laser patients with prolonged dry eye syndrome!

Today FRA approved a new drug against dry eyes! Good news for all of us with post refractive eye laser surgery dry eyes! Seems to the first of its kind !

Check the following links to read more!

FDA approves new medication for dry eye disease

FDA Approves Shire’s Xiidra™ (lifitegrast ophthalmic solution) 5% – The Only Treatment Indicated for the Signs and Symptoms of Dry Eye Disease

15 months update

Today is exactly 15 months since I did my trans-PRK eye laser surgery in Switzerland. 

Vision is great, a few days I ago I even got a live confirmation on this fact. Was waiting for a tramway with a few friends and when I could see the right train coming  I said "great nr 4 is arriving soon", my friend then said "wow, you see good, I can't see the number of that team yet". Small thing, but felt good. This friend of mine did LASIK, but 10 years ago.

I also often compare to my girlfriend who always had great vision, I always see things slightly before her, confirming that while she is around 20/20 (1.0) I am slightly better (20/17-16, 1.20-1.25).

Dryness is getting much better. Not sure if it's my eyes that healed or if its just the higher humidity during the summer that helps.

14 months update

Friday 13th of May was my 14th months since surgery day. Nothing new to say really, I still see good and I still use lubricating eye drops, slightly less of that then one month ago I giving. 

One thing I do notice happens over time though is that I accept my new vision more and more. First year I constantly reflected on what I could see and not see, and if that was normal or not. On top of that I had a constant fear of that things would get worse, and a constant hope that things would get even better. Now at 14 months, I have kind of accepted the new reality. Thinking less and less about my eyes (but still more then before surgery).

13 months update

Hi readers, today its 13 months and 3 days since I did my TransPRK surgery. Not much news to reports versus 12 months. I have a very good and stable vision. I still drop a bit of lubricating drops, but much less then before!

PRK Vision recovery timeline

During my own research I did before deciding to do eye laser surgery I noticed that many people are wondering how long time it takes for the vision to recover after a PRK surgery. The recovery time varies of course a great deal between individuals, but to share some light on the question I will share my own recovery line below. I did the single TransPRK (single step, no-cut)  version but its more or less the same surgery as LASEK and normal PRK so the information below should shed some light for all people thinking about any of the three versions.

Vision recovery timeline

T = Surgery day

• T+1 day: Very poor vision. Binocular: 20/100, Decimal 0.2
• T+4 days: Poor.  Binocular: 20/60, Decimal 0.35
• T+7 days: Okay. Left: 20/25, Decimal 0.8, Right: 0.63. Binocular: 20/22, 0.9
• T+35 days: Good. Left 20/20, 1.0. Right 20/20, 1.0. Binocular: 20/17, 1.20.
• 3 months: Excellent. Left 20/17, 1.2. Right 20/17, 1.2. Binocular: 20/16, 1.25.
• 6 months: Excellent. Left 20/17, 1.2. Right 20/17, 1.2. Binocular: 20/16, 1.25.
• 12 months: Excellent. Left 20/17, 1.2. Right 20/17, 1.2. Binocular: 20/16, 1.25.

In terms of refractive power I ended up: 

Left: 0.0 = Perfect
Right: +0.125 = slightly slightly over-corrected but well within the errormargin of +/- 0.5 diopter.

Conclusion: I reached my final vision after 3 months. From month 3 to 12 vision didn't change despite the fact that my right eye epithelium grew 20 micro meter thicker from month 3 to 6.

LASEK vs TRANSPRK and a note on Corneal Wound healing after EYE laser surgery

Hi readers

Since a good friend of mine just did LASEK surgery at the same clinic I did my TransPRK surgery last year I googled a bit on how these operations compare. Different researchers say different things, since I am not a eye researcher I will not try to form my own opinion, instead I will just summarize a few things I read.

Uncorrected Visual Acuity and Residual refractive error  - or how good will you see and how fast

I found  an interesting and recent study comparing LASEK and TransPRK recovery and results. Summary:

After 1 month 58% of TransPRK and 75% of LASEK patients could see 20/20 or better.
After 3 months 83% of TransPRK and 83% of LASEK patients could see 20/20 or better.
At 6 and 12 months 92% of TransPRK and 92% of LASEK patients could see 20/20 or better.

20/20 = Snellen 1.0.

So according to this study the end result is the same, but LASEK patients seems to recover a bit faster on average. The same study also says that the epithelium heels a bit faster in TransPRK (3 days) vs LASEK (4 days). The initial pain was also higher after TransPRK according to this study.

Residual refractive error also declined slightly faster in LASEK vs TransPRK, after 1 month 83% of TransPRK patients and 92% of LASEK patients was within +/-0.5 Dioptre but already from 3 months and forward 92% of patients are within +/-0.5 Dioptre for both types of surgeries.

Then I also found another similar study. Here the results were slightly different as you can see here. This study indicates that TransPRK patients recover there vision slightly faster then LASEK patients (in this study TransPRK = ASLA, LASEK = Alcohol PRK).

Regarding wound healing an interesting aspect is the dry eye symptoms often felt after eye laser surgery. The reason is likely that a lot of the Corneal nerves are also removed when doing the eye laser. Some interesting numbers from this study :

After PRK based surgeries (including LASEK and TransPRK) the nerve density was 59% of preoperative level at 1 year, and near 100% after 2 years. After LASIK based surgeries, the preoperative level is firstly reached after 5 years.

So according to this study I would now be on around 59% of my preoperative nerve density. Maybe this can explain why I still have slightly dry eyes around 1 year after TransPRK. I symptoms are slowly disappearing however, but maybe it will take the full 24 months until I am complete free or lubricating eye drops. Will keep you posted here on my blog.


My friend will soon post a more in depth article about the healing process, follow him here Ongoing LASEK recovery.

12 months / 1 year checkup

Had the 12 months checkup today. To be exact it is 11 months and 20 days since I did my TransPRK/notouch eye laser surgery.

Vision test result - unchanged since the 6 month checkup which is positive!

Left eye: 1.2 

Right eye: 1.2 

Binocular: 1.25

The thickness of my residual cornea and epithelium was also unchanged.

I still have slightly dry eyes but also this is improving. Doctor said this is likely due to the fact that I work 12 hours a day in front of 8 screens. For the eyes this is comparable to running a marathon every day he said.

All in all the conclusion was my results are as good as it's gets. 

For people interested in the details:

The precision of eye laser is +/-0.5 diopter. My result is:

Left eye: 0.0 - perfect

Right eye: +0.125 - so a tiny tiny bit overcorrected.

Eyes looked fully healthy and no more checkups requires for 2-3 years now. Nice !!!