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 !!!

Custom Wavefront LASEK story

A good friend of mine just did Custom Wavefront LASEK at the same laser clinic I did my TransPRK at, follow his story here:

http://wonderswondersmighthavehad.tumblr.com/

11 months update

Dear readers

Today is exactly 11 months since I did my  Trans PRK eye laser surgery.

On the vision quality and acuity side everything is still good. I good, better then many people around me and have no glares or halos.

On the dryness side the 11 month have been good. After shortly after the 10 months day I suddenly has to drop much less frequent. I still use drops, especially early mornings or late evenings but I feel a significant improvement. There is light in the tunnel finally, I might be able to live without lubricating eye drops soon.

I also did a interesting discovery. For a while I used drops with preservatives, roughly month 8-10, then I switched back to preservative free again, and my eyes directly felt much better overall. Worth keeping in mind. The preservative free drops are more expensive, but better for your eyes.

Next update after the 12 month checkup which I have after 11 months and 21 days roughly.

10 months day

It's now 10 months since I did my "nocut" TransPRK eye laser surgery with the Schwind Amaris laser system.

Not much news to report since the 9 months day. I still see good and I still experience a bit of the dry eye symptom, especially when in the office with my 8 screens. Sometimes I wonder if this really is a side effect of the surgery or a consequent of working 9-12 hours a day in from of 8 old screens at various heights and with different contrast and illumination properties. Maybe my eyes simple get tired. Not sure. I have read that the dry eyes symptoms are generally gone within 3-12 months following PRK so I still have two months left in the normal period. However, according to my own studies of scientific reports on the topic the nerve endings are firstly fully back 24 months after PRK so I guess that would be worst case. For LASIK the extreme case would be 5 years according to the same study. 

My vision is still sharp. I am curious to see if I still see 125% at my 12 months checkup. You never know, as the epithelium takes a full year or more to heal following PRK, and if too much grows back, so it becomes much thicker then pre surgery, that could cause the vision to regress slightly.

Next update at 11 months.

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.