Sonntag, 13. Dezember 2015

9 months day - Sunday 13.12.2015

Dear readers

Today is 9 months since I did my TransPRK (popular name is "no-cut", the most modern version of PRK) eye laser surgery. I should point out to my US readers that there is only one eye laser system who can do this surgery: the Schwind Amaris laser system from Germany. This system is not yet FDA approved so if you want to do this one you have to fly to Europe.

So to my eyes. Vision still excellent! That's great. I guess the only problem I have is that I am still a little bit dry in my eyes, especially when I sit 10+ hours in front of my computer screens in the office or when drinking alcohol. However, one drop of lubricant "Protagent" fixes this problem. I still drop relativity frequent, maybe once per hour, but I think I drop more then I really need to be on the safe side. I have hopes that I can stop with drops within 3-6 months.

As information for you anyone considering eye laser I should point out that you loose 60% of the nerves regulating the tear film when you do laser. It can take up to 2 years after PRK and up to 5 years after LASIK before all your nerves have grown back. 

Ok! This was all for this time. Next update  will be at the 10 months day.


Donnerstag, 12. November 2015

8 months day - Friday 13th of November 2015

So today is exactly 8 months since I did my PRK eye laser surgery (TransPRK). I have no real problems at the moment so not sure what to write. I guess the I could write three things though:

1) I still use lubricating tear drops. I hope I can stop with this before the 1y day.

2) my eyes get tired end of day which gives me the feeling I don't see as good then. I think this is unrelated to surgery however , think it's related to my job where I sit and watch small numbers on 8 screens 10-12 hours per day.

3) I have started to doubt I still see 120% per eye and  125% binocular. This I will first know at the 12 months day though. Even if the end result would be 100% I would still be happy though, even if 120-125% forever would be nice though.

I still think a lot about my eyes, I guess I look forward to the day I no longer think about them.

Montag, 12. Oktober 2015

7 months since TransPRK


Today is exactly 7 months since I did my PRK surgery with the modern TransPRK method.

No big news today really, I see very good, guess around 125% (1.25 Decimal) 20/16 US) and I have no side effects such as glares and halos, those I never got, except maybe during day 1-3, by the way.

The only thing I notice is that I still have a bit dry eyes, dropping lubricating drops such as the one of the picture while in the office. I should probably mention that the small dry eye symptom I have experienced after my eyelaser surgery never stopped me from working 12 hours per day in front of 8 computer screens in an office with dry air, so it's not that big of an issue actually, I do still hope t improves to my 1 year day though.



Donnerstag, 24. September 2015

6 months checkup

Yesterday I had my 6 months checkup which happened roughly 6.5 months after the actual surgery. Vision was still as good as at the 3 months checkup:

Left eye: 120% (1.2)
Right eye: 120% (1.2)
Together : 125% (1.25)

The corneal thickness was now more or less exactly the same in both eyes, which was to be expected as I had more or less the same corneal thickness before surgery and the same vision problem to correct in both eyes. Results:

Left eye: 446 micrometer  (before surgery 495)
Right eye: 443 micrometer (before surgery 494)

My tear film had also improved, but I still use lubricating eye drops. Doctor thought this would not be needed any more in 3-4 months, lets see.

She also said that the thickness measured at 6 months are more accurate then at 3 months as the measuring device are not able to measure very exact when the tear film is very uneven, which was my case at the 3 month checkup.

Last my not least the doctor said my cornea was crystal clear, which is good.

Next checkup is now the 12 months checkup, around March 2016.

Mittwoch, 12. August 2015

5 months day

Hello all

Today is 5 months since I did my single step TransPRK surgery. The surgery was done with a Schwind Amaris laser system, the only system in the world that can do single step TransPRK today. 

So how am I feeling now compared to the 4 months day? I guess the main difference is that my vision is very stable now, I always see very good on all distances. The first couple of months the vision fluctuated a bit, but since somewhere between the 4 and the 5 months day everything got very stable.

I terms of dryness I still drop lubricting drops. It has decreased slightly, but not significantly since the 4 months day. Will report on this again at the 6 months day. My case is a bit extreme as I sit 11 hours per day in front of 8 computer screens at work in a office with not the best air.

Okay good folks, until next time !


Sonntag, 12. Juli 2015

4 months post Trans-PRK update

Hi there

So today is exactly four months since I did my laser eye surgery. To be honest, I don't have a lot to write today. My vision is sharper then ever and I still use lubricating eye drops relatively frequent while in the office. According to my internet research this should solve itself 3-12 months post PRK so I wait and hope. Think it has decreased a bit lately, but hard to say.

Next update at 6 months. 

Montag, 6. Juli 2015

How much corneal tissue was actually ablated away during my PRK / How much corneal thickness was removed by the laser during my PRK / Thickness of my residual cornea after my (Trans) PRK

Before I did my PRK surgery I tried to find out how thick Cornea I would have after the surgery. I found various forums and posts around the web on this topic, but never got a fully satisfying answer. Anyhow, here is my numbers at before my surgery and 3 months after. I will update this again at the 6 months checkup.

Before the surgery my correction was:

Left eye: -2.75 and -0.75 astigmatism

Right eye: -2.75 and -0.75 astigmatism.

My Corneal thickness was:

Left eye: 494 micrometer
Right eye: 495 micrometer.

The minimum thickness in Switzerland to do LASIK or FS-LASIK is 500 micrometer, that's why I did single-step trans-PRK instead.

Thickness at 3 month check up:

Left eye: 442 micrometer (-52)
Right eye; 426 micrometer (-69)

Based on my actual prescription the "cost" per diopter was:

Left eye: 18.9 micrometer/diopter
Right eye: 25.1 micrometer/diopter

Some thoughts about this: 

First this is way more then I expected based on my google searches (the pages I found on internet said 8-15 micrometers per diopter).

Second there is a standard practice to over-laser a bit to compensate for certain back healing. I for example overheard my surgeon saying I was actually laser for -3.10 on right eye, assuming this way the same on the left eye, the new cost per diopter would be:

Left eye: 16.8 micrometer/diopter
Right eye: 22.3 micrometer/diopter

Now the numbers start to look more reasonable for the left eye, although still a bit high. The right eye still look a bit over-treated. However, my right eye got a strong overreaction and an aggressive healing response, including corneal haze, directly after the surgery. Due to this I had to use significantly more Steroid drops on my right eye during the first month. Steroid drops actually slows down the healing process. So my theory is that the difference in residual cornea is related to this. It could be that my right eye (or both) are still healing so the residual cornea might even out with time. I will ask my laser clinic to measure again at the 6 months checkup. What is interesting is now at the 3 months and 3 weeks point I have started to get the feeling that my right eye see slightly better then my left eye, a very small, but noticeable difference. I think this is to be expected though since my right eye is my dominant eye.

Okay, time to sleep here, will continue on this topic at the 6 months day.

By the way, if you have any questions, feel free to leave a comment, I will try to reply as soon as I can.

Sonntag, 28. Juni 2015

3.5 month update

Today is exactly 3.5 months since my single-step Trans PRK eye laser surgery. Update:
Vision is awesome. I still have to use lubricating eye drops but getting less and less. Now the eyes just feel a little bit dry in the morning, but I still lubricate roughly every 2 hours throughout the day. I hope this will resolve itself over the next couple of months.

Also a quick refresher on the various versions of PRK surgery:

PRK: Epithelium removed with surgical instrument, before the Excimer laser reshapes the Corneal stroma.

LASEK: Epithelium removed with alcohol, before the Excimer laser reshapes the Corneal stroma.

Trans-PRK (no touch) : Epithelium removed by the Excimer laser, before the Excimer laser reshapes the Corneal stroma. In the single-step version which I did the Epithelium is removed and the cornea reshaped in one step which makes the whole procedure very short (35 seconds per eye in my case).

Next update at the 4 months day.






Montag, 15. Juni 2015

Modern research on PRK recovery

For anyone seriously interested in how the eye recovers after any type of PRK surgery (PRK, LASEK, TransPRK) read this article


I don't mean to put anyone off with this, but you will learn very interesting things, like that nobody really understands the healing process that follows eye laser surgery. That's why individual results always are a bit unpredictable. It for example takes up to 2 years for all the nerves to grow back in the eye after PRK and up to 5 years after LASIK. I guess this means that's how long you can have post surgery dry eyes in worst case. The research also shows that sometimes regression occurs also after 1 year post surgery - for example due to that the epithelium sometimes grows thicker after the PRK surgery then it was before. Anyhow, if you are really interested, start by reading the article above. The language is quite advanced so you might need google and Wikipedia as support while reading.

Donnerstag, 11. Juni 2015

3 months checkup


Hi all
Today I had my three months checkup. Everything with my eyes was fine and I got another appointment 3 months later. I still am a bit dry but the doctor thought it would go away in 1-3 months now. Vision was excellent! See below!


Day 1: Very poor. US 20/100, Decimal 0.2
Day 4: Poor. US 20/60, Decimal: 0.35
Day 7: Pretty good. Left 20/25 (0.8), Right: 0.63, Combined: 20/22 (0.9).
Day 35 (~1 month): Left 20/20 (1.0), 100%, Right 20/20 (10), 100%. Combined: Could read 4 out of 5 letters on 20/16 line (1.25), 125%

Day 90 (~3 months): Very good! Left 20/17 (1.2) Right 20/17 (1.2) Combined:  20/16 (1.25)

Left eye: 0
Right eye: +0.25 - so slightly over corrected but well within error margin.

Will post again as my dryness gets better and then at the 6 months check.

Montag, 8. Juni 2015

Having a cold in the recovery phase after eye laser


Today I have a slight cold. Although in general my dry-eye symptoms start to get less and less noticeable approaching the 3 months check-mark, I really feel a difference when I have a cold. I remember from my contact-lens time that they felt sticky and annoyed the eyes as soon as I got a little bit sick. Now after the surgery I also notice the same effect, I drop far more tear drops in the office when having even a minor cold.

Vision wise I am very happy, looking forward to see the result in the upcoming 3 month vision test, but I have a feeling it will take another 3 months before my eyes are fully restored in terms of self-lubrication.

Sonntag, 7. Juni 2015

Vision development first 35 days

To make it easy for the reader, here is a summary of my development so far. Will update again at the 3 month test in a couple of days.

Vision development first 35 days

Before surgery (near sighted): Left -2.75, -0.75 astigmatism. Right: -2.75, -0.75 astigmatism.

After surgery (Day 1 = 1 day after surgery, Day 4 = 4 days after surgery...)
Left = Only left eye open
Right = Only right I open
Combined = Both eyes open

Day 1: Very poor. US 20/100, Decimal 0.2
Day 4: Poor. US 20/60, Decimal: 0.35
Day 7: Pretty good. Left 20/25 (0.8), Right: 0.63, Combined: 20/22 (0.9).
Day 35 (~1 month): Left 20/20 (1.0), 100%, Right 20/20 (10), 100%. Combined: Could read 4 out of 5 letters on 20/16 line (1.25), 125%




Montag, 1. Juni 2015

First night run after PRK

Dear reader

Went for a evening run today after some rainfall. Halfway through the run I get into a dark forest section. I had a feeling something was very different running in the dark now after laser compared to be sure, but I am not 100% sure as I don't really remember how my night vision used to be. Anyhow my experience was that the running path and the tree leaves glowed white somehow. Maybe this has something to do with the water on the leaves, not sure. Will observe how this develops in future night runs.

Other then this I don't really see any problems with night vision, no "Halos" or Starbursts to talk about. I had Starbursts the first 3 days after surgery, but it quickly disappeared.

Time to sleep here

Samstag, 30. Mai 2015

2.5 months day

Today marks the 2.5
Months day since surgery. Vision-wise my vision is very stable and feels equal or better to my vision with newly fitted contact lenses. My only problem is that my eyes still are a bit dry - taking tear drops every 2 hours. Hope this will get better soon!

Dienstag, 12. Mai 2015

2 months day


Today is exactly two months since my trans-PRK surgery.

Generally I would say my vision is stable and good. The only "problem" I have is that I still have to use tear drops during the day, especially in the office. I have a feeling this gets better and better though, i.e. less and less drops.

My vision is sharp and I can work with my 8 computer screens in 2 rows without any problems in the office.

Mittwoch, 6. Mai 2015

Day 55

Today was the fourth morning I woke up without taking steroid drops. First two days without felt weird, like the eyes felt swollen and more dry then usual. It all turned around day 3 though, could go down to dropping tear drops every 3 hours or so and this morning I woke up without feeling very dry in my eyes, just a bit dry. Let's hope this is a trend, if so, I expect to stop using tear drops altogether around the 3 month mark. 

Sonntag, 3. Mai 2015

Day 52 - first day without Steroid drops

Today I stop with steroid drops ...which is great as I now only have the tear drops left. At the one month checkup the doctor told me she thought I would need tear drops for about 3 months, until tear channels and nerves are healed. This is yet to be seen, but I have feeling the eyes get less and less dry.

Before the surgery I didn't really have a problem with dry eyes. I could have the contacts in the office from about 10 to and leave them in to I went to bed around 23. I usually had glasses 7 to 10 to give the eyes some air. I had problems when I drunk alcohole though, after 3-5 drinks my eyes got really dry and started to run tears. This problem is completely gone now after the surgery. I do have to drop tears a bit more often when I drink though.

The tears I use are a preservation free tear called "Protagent SE". It is quite expensive but the surgery came with a "free medicine first year" package so I get  any amount I need for free first 12 months. By then I hopefully don't need any more artificial tears, time will tell. 



Sonntag, 26. April 2015

Day 44 - Back at the Golf course


Went to the driving range to hit some balls for the first time of the season and for the first time after my surgery.

Both the golf shots and the vision were good. Could see the ball during the flight and when it landed even with a good drive of 250 meter. Very happy!

I am trying to compare to how I could see with fresh contact lenses before, this is quite difficult as I already forgot how it was to live with lenses and glasses. I could see good in contact lenses. My feeling, although hard to prove, is that I now can see as good as with contact lenses before, or maybe even slightly better. I guess my conclusion is that I am happy with the results so far. 


Sonntag, 19. April 2015

Day 35 - 1 month checkup and vision test

Day 35 - 1 month checkup and vision test

Doctor said eyes where healing good. Main healing phase now over, but it would take another 2 months for the end result. Have to continue with cortisone drops for another 2 weeks, but only morning and evening. Next checkup the 3 month checkup.

Vision test:

Could see the 20/20 line (1.0) clearly with both eyes.
Binocular I managed to read 4 out of 5 letters on the 20/16 line (1.25).


Samstag, 4. April 2015

Day 21 - First day of Alpine Skiing after surgery



First day back in the alps for snowboarding. My clinic recommended to avoid mountain holidays the first 14 days post surgery so day 21 felt safe. We were lucky with the weather and had extremely strong sunshine. I made sure to use gold googles with 100% UV protection. In general all went fine but sometimes the light felt too strong, even through the googles. 

I had the feeling that I could see further then any time earlier in my life, this was awesome !

We went skiing also day 22, but luckily we had a lot of fog so the eyes got to rest a bit. I still made sure to use googles or sunglasses all the time though, well aware that UV rays penetrates both fog and clouds.

Mittwoch, 1. April 2015

Day 19 - Checkup and VISION TEST

Day 19 - Checkup and VISION TEST - I now see 1.0 (20/20) on both eyes

Checkup again with one of the eye laser surgeons that have been taking care of me during the process. Good news! The inflammation was now fully gone on the right eye and he put me back on "normal" medication schedule also on the right eye from day 20. Also did a vision test, results below.

Results vision test

Left eye: 1.0 (20/20) - could see all five letters clear and crisp.
Right eye: 1.0 (20/20)  - could see all five letters clear and crisp.
Together: 1.2 (20/17) - could see four out of five letters, not really crisp though.

Now at day 19 I can with confidence say I more or less see as good as I did before with newly fitted contacts or glasses. Maybe a few more days needed, think I could see the 1.2 (20/17) line a bit clearer with contact lenses, but I don't really remember to be honest.

Got a new appointment for a checkup in two weeks.

Day 15-18



Weekend and holiday. Started with sports again, it felt good as I avoided sports the first two weeks after surgery. Vision got better and better, from time to time I had the feeling it fluctuated a bit, especially in the morning. The eyes where less dry some days and more other days. Towards day 16-17 I had the feeling both eyes had the same vision quality also, more or less.

Day 14 - First time hangover since the surgery


On day 13 we had a big night out with my team from work. I was a bit worried that this would somehow mess up something with my eyes. However, everything was fine this day, except that the eyes where a bit more dry then normally, probably due to fact that I had a few too many drinks the night before.

Day 13

Day 13

Same story as day 10 and 11. Maybe slightly easier with the upper right screen. Still had the feeling that the right eye didn't see as good as the left.

Day 12

Day 12 - back to the doctor

This day I had the feeling of "dirt in the eye" on the right eye again. I got worried, emailed the clinic, they told me to come and see a doctor the same day.

The doctor checked both my eyes again and told me that the inflammation now as gone, but one of the cortisone drops were too strong and that it hurt my healing Epithelium. She changed the medication to only use the milder cortisone medicine, but to stay on "the additional medicine" schedule a bit longer. My new medicine schedule was now:

Left eye (standard): mild cortisone 3 times per day.
Right eye(extra): mild cortisone 4 times per day, antibiotic 2 timer per day, anti-viral 2 times per day.

Day 11

Day 11 

Same story as first day in the office. I think I was slightly easier this day though.

Day 10

Day 10 - First day back in the office

This was my first day back at work after the surgery. I have a very visually demanding jobs where I used two rows of computer screens (5 screens, 3 in eye height, 2 screens on top) with a lot of small numbers and texts. I was able to do my work good, but it was a bit heavy to read small text on the screen in the upper right corner. It worked, but I got a headache towards the afternoon.

Day 7 - follow appointment in the afternoon and VISION TEST



Both of the senior laser surgeons checked my right eye. They agreed that the problem was more or less gone. Medication was cut to half and I got a follow up appointment twelve days later.

Vision test results:

Left eye: I could see 4 of 5 letters on the 1.0 (20/20) line. They were not crisp however, so I would give my left eye at this day 0.8 (20/25).

Right eye: I could see 4 of 5 letters on the 0.8 (20/25) line. Also not crisp here so I give myself a 0.7 (20/28) on the right eye. Right eye was lagging behind due to the inflammation.

Together: Around 0.9 (20/22).

Doctors said my vision had improved very quickly for a PRK operation. Maybe TransPRK has quicker recovery as the advertisement says after-all.

Day 6 - follow up appointment in the morning



This day 3 eye doctors investigated my right eye. Left eye still good. Right eye had got a bit better but still not good. Medication was reduced however.

Day 5 - follow up appointment with eye doctor on right eye



Left eye still good. Right eye had got a bit better but still not good. Got two new medicines, one stronger cortisone drop plus anti-viral pills to take 3 times per day. Reason behind this is that strong cortisone treatments potentially could trigger a latent herpes infection, so anti viral drugs where given as a precaution. Got follow-up appointments scheduled for the two following days.

Very happy I bought a "all in package" with all treatments and medicines required for the first 12 months included.

Day 4 - Checkup and removal of protective contact lenses



Met the Optometrist after lunch to check my eyes and remove my protective contacts. Epithelium had healed enough o remove contacts so he did that.

My right eye still looked worse then my left eye however, so he send me to a eye-doctor and laser surgeon specialized in eye problems. She noticed my left eye looked normal but that my right had an inflammation, it had overreacted to the laser.

She ordered me to follow a special procedure for the right eye; two types of antibiotic drops 3-4 times per day plus cortisone drops every hour. Got a follow up appointment next day.

Did a quick vision test this day, long vision was still bad. We didn't pay attention to this very carefully this day, but I think it was in the 0.3-0.4 range (20/50-20/60) or worse, with a foggy/cloudy vision on the right eye also on near distances. This was due to the inflammation they told me. Before the surgery the right eye was my better eye as it is my dominant eye.

Day 3

Day 3

Could use my iPhone without any problems, could even read email. Computer usage still difficult. Could watch TV, but couldn't read the text.

This day also the right eye could see my eyes in the mirror, my feeling was that the right eye healed one day slower then the left eye. But I had the feeling both eyes improved every day.

Day 2

Day 2 

Could use my phone better. Could also watch TV, but I was not able to read the text.

Could see my eyes in the mirror using my left eye, but the right eye had a big of foggy vision.

Most of the pain was gone, just a slight feeling of "dirt" in the eyes, mainly in the right eye.

The feeling of waking up every day seeing clearly better and better is awesome...

Dienstag, 31. März 2015

Day 1 - Day of the first post-opp checkup



Had the post opp checkup in the morning. I felt more discomfort in right eye then the left. Doctor told me both looked normal and gave me a new appointment for removal of the contact lenses on Day 4.

I could use my phone a bit this day, although it was very difficult to read the screen. TV was also tricky. Could see good enough to handle most daily tasks on my own already. However, when I looked myself in the mirror from a close distance, I had a "foggy/cloudy" vision.

The good news was that the bad pain was gone. Only a slight feeling of "dirt in the eye" left, especially in my right eye.

Montag, 30. März 2015

Day - 0 - Surgery day



This was a nervous day, I was almost bailing out in the morning despite the fact that I was seriously thinking about doing eye surgery for the last five years. My correction was -2.75 (nearsighted) on both eyes, and  -0.75 astigmatism per eye.

At the laser-clinic a nurse talked me through the drops I need to take, gave me painkillers and relaxing pills. I think we spent nearly 30 min talking about the post-surgery drops. This might seem a lot, but it is very important, pay attention, as after the surgery you cannot read until next day.
Surgery itself went smoothly. 35 seconds per eye plus 10 seconds of some medicine on the eye, then the protective contact lenses were put on. Directly after the surgery I could see further then I could before without contacts or glasses, however, my vision was very foggy on all distances and I couldn't read anything, neither on paper or on my IPhone.

 Walked home in sunglasses with the help of my girlfriend.

The first 3 hours was painful, and I had to sit with closed eyes. After the 3 hours the dropping start. The first day it means dropping every 30 min until bed time. Got 4 different drops, one lubricating drop, one cortisone drop, one antibiotic drop and one steroid drop. The pain during hour 4 to the morning after was pretty bad so I took 9 painkillers, then it was okay.

Went to bed early and slept 12 hours, slept with protective googles provided by the clinic.

Welcome

Welcome to this little blog. The purpose of this blog is to share my TransPRK story. I did my TransPRK eye surgery in March 2015 in Zürich, Switzerland.


TransPRK is a modern form of the PRK surgery where the laser do the whole job. TransPRK also goes under popular names such as "no-cut" or "no-touch".


First a link to Wikipedia to get you started:

http://en.wikipedia.org/wiki/Transepithelial_photorefractive_keratectomy

If anyone out there in the world are thinking of this type of surgery, leave a comment here on the blog and I will try to answer based on my own experience.