PRK Day 45: More Vision Ups and Downs

It's been 45 days--or over six weeks--since my PRK surgery in my right eye, and my vision still fluctuates a lot. I was surprised to hear at my last appointment that my eye was really dry, which is something I have never dealt with. I've been trying to stay hydrated and use lubricating eye drops often, but I'm not sure it's helping. I recently read about a research study that showed that 5% of eyes developed chronic dry eye after PRK, even though none had dry eye before the surgery! I hope that doesn't happen to me, but I also live in a dry climate now and spend a lot of time in front of my computer, so dry eye is a possible side effect.

What starbursts look like to me

I also reported in my last post that my ghosting/double-vision had resolved. Well, that doesn't actually seem to be true anymore. Sometimes I see ghosting and sometimes there's none, which again, is probably related to dry eye. Starbursts are still present during the day and night. My vision is still significantly better than weeks 2-4, which I'm very happy about, but it goes up and day throughout the day and between days. Some days I wake up with great vision and it stays pretty good throughout the day, other days I can't see very well for the entire day. The instructions from my surgeon say to use lubricating eye drops at least four times a day as needed, and the past few days I've been using them once every hour or two (while awake). 

I'm also looking forward to stopping steroid eye drops. I have to take them for three months and I'm about half way through. The first month I used prednisolone (tapered from four times a day for one week, to two times a day for three weeks), the second month I'm using fluorometholone 3 times a day, and the third month I'll use fluorometholone 2 times a day. They sting when I put them in my eye and leave a bad taste in my mouth. I think I had to use the drops for so long (3 months) because my prescription was so high (-6.5 diopters, +1.5 astigmatism). I've read that steroid drops reduce the risk of corneal haze, but they also slow down healing. 

PRK recovery is soooo slow, but I do think it's worth it to avoid additional complications that can come with LASIK. I wasn't a candidate for LASIK anyway, according to my surgeon, so it was PRK or nothing in my right eye. Still no regrets, and I'll keep updating with my progress. 

PRK Day 39: PRK Follow-Up and Visian ICL Measurements

Today I had an appointment that served two purposes: my one-month check-up for the PRK procedure I had in my right eye in December and repeat measurements for the Visian ICL to be implanted into my left eye in March.

PRK Update

My PRK update is pretty uneventful. I had my vision tested using the phoropter and Snellen chart, and I scored 20/30. This means I could see about the same number of letters at my 6 day follow-up appointment as I saw today, but my vision now is definitely crisper and I'm seeing more details. I should note, however, the my best corrected visual acuity (BCVA, so best vision I could get with glasses or contact lenses before PRK) was 20/25, so I'm pretty close! I couldn't get to 20/20 in that eye likely to due the cataract I was born with. I have a small amount of astigmatism left (formerly +1.5 now +0.5) which could potentially improve over the next few months. My eye pressure is great (sometimes the steroid drops can elevate eye pressure which can cause glaucoma). The tech said my eye was somewhat dry and to keep using the preservative-free eyedrops. I was then taken to a machine that mapped the shape of my corneas, and that was it for the PRK follow-up part of my appointment. 

In the last couple of days, the ghosting I was seeing has completely gone away. I'm still seeing some starbursts around bright lights both during the day and at night (like car headlights, TV light, etc.). My surgeon said this should improve over time as my cornea continues to heal. 

I am very happy I went through with PRK in my right eye and hope I see a bit more improvement in the next 3-6 months!

Visian ICL Update

I had a couple of measurements double-checked in my left eye for my upcoming Visian ICL surgery in March. The tech took me to another machine and said it takes "a bunch of measurements of your eye," like height and some other things I can't recall. Then the surgeon came in a took a white-to-white measurement to compare to the ultrasound measurement for sizing the ICL. 

I asked the surgeons some questions about potential complications, specifically from the iridotomy (small hole in the iris to prevent increased eye pressure and glaucoma) and from the ICL itself. She said that she hasn't encountered patients with the side effect of glare or white lines from the iridotomoy, but it's always a risk. I then asked about the risks of cataracts, which is the most common complication of posterior chamber ICL. At this point, it's a risk I'm willing to take. 

I'm nervous but looking forward to being able to see out of both eyes! For the last week, I've been wearing my glasses (with -11.00 in my left lens and non-prescription in my right eye) so they could get accurate measurements today of my eye that will have an ICL. Wearing my glasses has given me some terrible eye strain due to aniseikonia, where my left eye sees the world much smaller than my right eye. Even if I need glasses for driving after I get the ICL, today is the last day I'll ever have to wear my coke-bottle lens! There's no guarantee that the ICL will get me to 20/15, which is my current best corrected visual acuity in my left eye, but I should see a substantial improvement. 

My Visian ICL surgery is scheduled for the second week in March so I will post an update then. I'll probably also update about my PRK eye before then. 

PRK Day 35 (One Month): Vision Fluctuations

My follow-up appointment with my surgeon isn't for a few more days, but I wanted to post today to give an update on my vision. It's been 35 days, or exactly five weeks, since my PRK surgery.

My vision during days 1-4 after PRK surgery was very clear during the daytime. I wasn't seeing a lot of detail (which was never as good compared to my left eye due to the congenital cataract in my right eye), but my vision was still good--so much better than before! My vision got a lot worse after the contact lens bandage was removed and stayed pretty consistent for the next three weeks! I saw huge starbursts and glare at night around any light source. I wasn't comfortable driving at night for the first three weeks, which wasn't an issue since I take the bus to work. I also couldn't read very well with just my right eye. I'm so happy that I only had PRK in one eye, since my left eye made up for the poor vision completely when I was wearing a contact or my glasses. I do a lot of reading and computer work, and can't imagine I would be able to function at work if I had PRK in both eyes at once.

Speaking of glasses, I went to Costco and bought non-prescription lenses for my glasses, so I could wear them for the next couple of months without having one missing lens and looking completely ridiculous before my left eye Visian ICL surgery. I still look ridiculous with my glasses on since my right lens is prescription-less and my left lens is -11 diopters and makes my left eye look tiny in comparison! I usually wear my contacts but my eyes get red and itchy so it's nice to take them out after work.

Even though I read a lot of blogs and knew that healing time was really variable, I will admit I was worried during the first three to four weeks. I ended up doing a lot of research to ease my mind. I learned about residual astigmatism, corneal haze, central island healing, and high-order aberrations, which can all be caused or intensified by PRK.

View of Trees Outside my Window

In the last week or so (from about day 28, or week 4) my vision has really began to improve, both during the day and at night. I look out my living room window at trees to compare my vision day to day. I'm seeing a lot more detail close up and mid-range, though things very far away are still blurry. During the day, I am still seeing starbursts around small lights (like the Wii or TV light), but they seem to be getting smaller. When I go outside during the day, I have ghosting (double vision) where I see one or two copies of the number on a street speed sign or icon on a walk sign. When I go outside at night, I can now tolerate looking at traffic lights and headlights. There's still some starbursts and glare, but they are much less intense than a few weeks ago. I have never experienced halos.

My vision is also best right when I wake up, and gets worse throughout the day, especially if I have to read or use the computer for extended amounts of time. I'm still using preservative-free lubricating drops every hour or two, so I don't think it's a dryness issue, but who knows. My next follow-up is just a few days away and I'm so curious what I will score on the Snellen chart, consider I wasn't able to read the big 'E' 35 days ago!