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.

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.

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 !

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.