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. 

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.

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.

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

http://apps.elsevier.es/watermark/ctl_servlet?_f=10&pident_articulo=0&pident_usuario=0&pcontactid=&pident_revista=310&ty=0&accion=L&origen=optometry&web=www.journalofoptometry.org&lan=en&fichero=S1888-4296(14)00086-7.pdf&eop=1&early=si

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.

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.

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.

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%