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Everything you've wanted to know about PRK laser eye surgery, but were afraid to ask.

2004-01-19 - 9:11 a.m.

I had PRK laser eye surgery on January 12th, 1999. A number of people asked me about it because they were curious, or even contemplating it themselves. Tiring quickly of having to recount the same story over and over again in the immediate week after, I wrote the following piece and sent it out in an email on January 18th, 1999. Over the several years since then, I have lost it a couple of times due to hard-drive crashes or changes, but someone always has a copy still in their files to email back to me. I still get asked for the story, and I still send this in response rather than trying to dredge the details out of my memory. After five years, I’m still pleased with this piece and I hope people still find it useful, and perhaps just a smidge entertaining.


Date: Mon, 18 Jan 1999 15:55:34

Today is my first day back at work. I’m not sure it was entirely wise to come back so soon but I seem to be managing, despite my vision not having stabilized quite yet. But I’m getting ahead of myself.

Last Tuesday I worked until 3:15 and then toddled down the hall for my appointment (the advantage of working in the same hospital). They checked and double-checked my prescription for my right eye (2 people did it independently) and went over in detail what the procedure would be like as well as what to do afterwards. They then handed me over to a nurse whose job it was to get me to sign my life away and then drug me (hm, what order was this in?). I had various drops put in my eye (I like how they put the first type in and then said “this one will sting a bit”) and was told to swallow one huge pill (codeine) and put one tiny one under my tongue (called something like ativan -an anti-anxiety drug) to dissolve. So far, so good.

I then have one of those blue things that cover your hair put on my head and my left eye bandaged - to help me focus my right eye only - and am positioned on the chair. They then inserted what’s called an “eyelid speculum” to keep me from blinking. Those of you who have seen Clockwork Orange will be familiar with this little dohickey. It’s a small metal device which is reminiscent of scissors with a couple of little flat prongs sticking outwards from each side. These prongs are slipped under your eyelids and it is then used to force your eye open to keep you from blinking. It is only really a problem is your eye wants to blink (which mine did) or if, as in my case, they want you to blink to clear your eyeball of guck so they take it out, make you blink, and then re-insert it – which they did three, count ‘em, THREE times.

Once they swing you under the laser they have you focus on a little red blinking light. They tell you to focus on that light without wavering for the whole procedure. They failed, however, to mention that once your eye starts being zapped you can’t actually focus on ANYTHING. I was only dimly aware that there was a red blinking light and I was inwardly panicking that I would shift my gaze and have a plane of cornea SHEARED off accidentally. As you can tell by the fact that this letter didn’t start out “well, I’m now blind,” this fortuitously didn’t happen. The laser-zapping part is actually amazingly short - two bursts of about 40 seconds each. In the first stage they remove the epithelial layer of your cornea. Once this is done they stop the laser and use a small metal spatula-like thing to remove the stray bits of eyeball (OK, corneal epithelium) from the surface (actually this is my least favourite part though the eyelid speculum would have to be second). They then have you try, once more, to focus on the now blurry blinking red dot and, another 40 seconds later your cornea has its new shape. At this point I have to add that during the first eye, as soon as the laser started there were immediately several voices chanting things like “don’t move, focus, focus, don’t move” and “doing fine, not long now, doing great” over and over again like a cheering squad mantra. This was done to a much lesser degree (only 1 person that time) during the second eye when I guess they figured I was an old hand at it.

After the laser part was done a bandage contact (a clear contact which didn’t have any corrective prescription and was supposed to protect my eye until the epithelium regenerated in about 3 days) was placed over my eye, instructions for care were repeated, I was given a lot of codeine to take home and I was sent on my slightly dazed way.

The first 24 hours after the anaesthetic wore off were pretty miserable. Added to the stinging of my eyeball was the unanticipated effect of the aforementioned eyelid speculum. Turns out it’s pretty common for it to bruise the eyelid muscles and having it taken out and re-inserted several times only exacerbated the problem in my case. My eye was swollen into a red puffy slit. I looked like I’d gone a couple of rounds and lost. I was seen the next morning for follow up and I looked so rough that the tech guy anaesthetized my eye before even trying to examine it. He told me to go home afterward and take a double dose of codeine and sleep it off. I did but even so didn’t sleep for more than a few hours at a time.

The good news: The following day my eye felt a lot better.

The bad news: That was the day I was slated to have the second eye done.

The place I got the operation won’t do both eyes at the same time. In fact, they won’t usually do them in the same week and the only reason they let me is because I promised I wouldn’t be alone during my blind period. This is because they don’t want people to not be able to see at all during their recovery. Also, if a person has complications such as an allergic reaction to the drops or unusual scarring or something, they can modify their approach or cancel the second eye surgery.

The second surgery seemed a lot more rushed. I suppose it may have been because I had already had one eye done and hence didn’t need such careful explanations. It may have been because the doctor who did the second eye had less time. In any case, he put the machine that checks your prescription right to the setting that had been previously recorded and said, “read this line” and when I could he seemed satisfied and on things went. Now some of you at this point may be saying “I wouldn’t have gone ahead with the surgery if the doctor seemed rushed. We’re talking about my VISION here!” To this I say that he had done a lot of these before and I did voice my concerns to both the nurse and the technician who I’d seen before and they reassured me that there was nothing unusual with the way things were progressing, they just tend to be over-cautious with the first eye. I overheard the technician mention my concern to the doctor as well and the seemed satisfied that all was going according to plan.

The second surgery went much the same as the first with one interesting addition; when they asked who’d be driving me home and I mentioned my friend who was in the waiting room, they asked if he’d like to watch. I said they were welcome to ask him and I knew he’d said yes when I heard his voice saying “wow Shawna, I’ve got a really great view of your eyeball”. He told me later that it was interesting but if he’d been a more squeamish person he’d probably have had some trouble watching, especially when they were using that spatula-thing to, as he put it “scrape the surface of (my) eyeball”.

The other difference with the second one is that they gave me Demerol pills instead of Codeine both before the operation and to take home (since the Codeine wasn’t making me sleep much).

Oh my God.

Have any of you out there ever had Demerol? It knocked me on my ASS! I tell you, I took the one at the hospital and another at about 3 that morning and I was still dragging my butt around a full 24 hours later. Actually, I wasn’t even dragging around so much as functionally inert. All-in-all I spent a total of about 4 days in a drug-filled haze, once you take both eyes into account. Saturday was my first full day of non-pain and while I didn’t go out like I usually do on the weekends, I did manage to do some very low-key socializing and re-join the waking world. As it stands now, my right eye is pretty good but my left is still pretty foggy (it’s only been 4 days after all). Both have had the bandage contacts removed and the epithelium has grown back. The doctor seems pretty pleased with my progress so far.

I still however, look for my glasses in the morning before remembering that I don’t need them any more. I also push up my glasses-which-are-no-longer there sometimes which I’m sure looks pretty peculiar (“Psst. Why did that woman just smack herself in the face?”) I expect both of these to taper off as my vision gets more reliable and I get used to not wearing glasses anymore.

Well that’s pretty much it for the promised eye-news. Take care all and in case I haven’t talked to you in awhile, welcome to 1999. I have a feeling it’ll be a big year.


P.S. I’m going looking for sunglasses soon (like maybe this weekend). How exciting! I haven’t been able to wear sunglasses and see at the same time in over 10 years!

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