This article only reflects my experience with laser refractive surgery. I am not a medical professional and thus not licensed or trained to recommend any course of treatment or procedure. If you have any question regarding laser refractive surgery, please contact your ophthalmic care provider.
I pretty much hated wearing glasses for as far back as I can remember. I started wearing glasses a few weeks before I turned 14 years old. I will never forget. I was in the 8th grade watching my cousin play basketball and had to ask my godmother if the score was 45 or 46 because I wasn’t sure. I could not see clearly enough to distinguish the numbers. I had been suspecting that something might be up with my eyes, but I was hoping it would go away and fix itself… it didn’t. After a visit to the ophthalmologist, the verdict came: myopia, commonly referred to as nearsightedness.
I tried wearing contacts a few times, but my eyes would feel so dry and uncomfortable that it was almost worse than having to wear glasses. I never understood my friends who “forgot” their contacts at night and slept with them. Mine felt like a suction cup was hooked to my eyes, and all I wanted to do when I came home was take them out. I had a few pairs of daily contacts that I kept for special occasions like weddings or parties when I wanted to look nice and still be able to see.
I have wanted laser refractive surgery from the moment I heard it was a possibility. If you are considering surgery to correct your nearsightedness, I hope this article gives you a clear and detailed picture of the process from start to finish. Here is what you will find out:
- What is PRK?
- Who is eligible?
- How much does it cost?
- Before the surgery
- The day of the surgery
- After the surgery
- What next?
What is PRK?
I am no optometrist, but it is my understanding that during photorefractive keratectomy (PRK), unlike LASIK, the excimer laser removes the entire layer of corneal epithelium before reshaping the cornea. During LASIK, the surgeon creates a hinged, corneal flap before using the excimer laser and placing the flap back.
While LASIK offers much quicker recovery, it is also much more damaging to the eye in the long term, thus not recommended for those with dry eyes like me.
Who is eligible?
Patients suffering from myopia (nearsightedness), hyperopia (farsightedness), or astigmatism are eligible for PRK laser refractive surgery. Patients suffering from presbyopia (aged-induced farsightedness) are not.
How much does it cost?
I opted to have PRK laser refractive surgery in Belgium – a pioneer in the field of ophthalmic surgeries – where the procedure costs less than half compared to the United States. The table below compares average costs for each step of the procedure without vision insurance coverage. Even with vision insurance, very little is covered regardless of the country as the procedure is considered elective. Ophthalmic clinics in the US often offer package deals covering all pre- and post-op appointments along with the surgery.
|Surgery||1000€/ eye||$2250/ eye|
|Drops||30€/ refill||$85/ refill|
Before the surgery
I knew my vision had to be stable for 3 years before I could be eligible for the surgery. When I visited the ophthalmic clinic for the first time, I was really nervous to find out whether my nearsightedness had finally stabilized or not. That was my biggest hurdle to getting surgery, or so I thought. During my first visit, the optometrist took several measurements and determined whether my vision had stabilized or not. It turns out that my dryness was a bigger concern than my diopter change, which was minimal and did not keep me from having surgery. I knew my eyes were dry, but I never had to use drops, so I did not think it was too bad of a condition.
For my second appointment, I went in for a full set of measurements. The human eye is like a fingerprint; it’s unique to each individual. I saw 4 different specialists who took different sets of measurements. The appointment lasted 2 hours. One of the specialists analyzed my tear ducts, the amount of tears I produced, and the quality of my tears. I received a dry eye packet with a gel-pearl mask, omega-3 pills, and artificial tears to help with dryness. The last specialist I saw took a final set of measurements with my eyes dilated for better accuracy. She put 2 drops in each eye, and my dilated pupils made me look like I was high for 3 days straight. When I met with the doctor again after all the measurements were taken, he reassured me that I was indeed operable but advised me against LASIK due to the dryness of my eyes.
I followed his advice and was scheduled for PRK laser surgery a few weeks later. I was given all the pills I would need for my surgery and prescriptions for anti-inflammatory and antibiotic drops to begin my treatment 2 days prior to the procedure. Because my eyes were dilated, I experienced photophobia (sensitivity to light) and had to wear sunglasses while outside for 48 hours. My mother had to be present, so she could drive me home, as the dilation caused blurriness and made me unfit to drive
The day of the surgery
In order to prepare for the procedure, I was given anxiety medication to take 1 hour prior to surgery along with an anti-inflammatory pill. Upon arrival at the clinic I was escorted to the OR floor. I was given a private room with my mother to relax before the procedure. The team also provided me with a gown, surgical booties, and a cap to slip on above my clothes and shoes. I was offered virtual-reality goggles that used luminotherapy to walk me through the premises and give me relaxation tips. I am very receptive to hypnosis, and this helped me to enter a semi-sleep state.
When one of the team member came to get me, I was almost napping. The surgery itself lasted less than 5 minutes and was completely painless thanks to anesthetic eye drops. I was worried about blinking during the surgery as I had been told my eyes could roll backwards, but it turns out that isn’t true at all, and even when my eyes tried to blink, the spreaders did their job. My eyes were hydrated at all times, which was another major concern of mine. The laser first cuts through the epithelium of the eye which is then removed by the surgeon. Drops are put in to keep the eye from drying before the second laser treatment that cuts through the cornea to correct the myopia. Finally a contact lens is put over the cornea to protect it from abrasion. The procedure is the same for each eye. Once the surgery was over, I was brought back to the room and ready to go home. My mom couldn’t believe how fast it had gone, and neither could I.
After the surgery
I felt no pain and had slightly blurry vision as I exited the building wearing my sunglasses to protect my eyes. About 1-2 hours after my surgery, I began feeling some discomfort which quickly morphed into intense pain, like the feeling of peeling an onion and having to forcefully shut my eyes to drown the pain. My eyes were also extra watery. Thankfully the pain went completely away with the pain medication. I was given 4 tablets to take every 12 hours but only needed 3. The pain had entirely subsided after just 36 hours. My treatment regimen was as follows: 1 antibiotic drop every odd hour and 1 anti-inflammatory drop every even hour, each to be taken 6 times a day for a week. Additionally, I had to put in artificial tears every hour, 15 minutes after administering the prescription drops.
I was given sleeping pills to ensure that I slept as well and as long as possible. The more the eyes stay shut, the quicker they recover. I basically slept for 2 days straight with the exception of small meals and drop administration. I set reminders on my phone to remember to take my drops and napped almost all day. I also lost my appetite, which is frequent when I oversleep.
I was virtually pain-free from the moment I took my first pill. When came time to take the second and third one, I could feel very slight discomfort. On day 3 and 4, the worst feeling was the dryness in my eyes. I did not know it at the time, but I was free to put lubricating drops in my eyes any time I wanted as long as it was 10 minutes away from the antibiotic and anti-inflammatory drops. On day 4, I returned to the clinic to remove my protective contact lenses, and the old-contact feeling went away, which was a huge relief! The doctor also confirmed my recovery was going well and sent me home.
After a week, I stopped taking the antibiotic drops and lowered my anti-inflammatory regimen from 6 to 4 times a day. Days 8-21 after my surgery, I experienced slight photophobia and lots of blurriness as well as double vision. My vision would be extremely clear in the morning but would quickly deteriorate as the afternoon approached. I was really disheartened and getting frustrated at times because not only was my vision blurry in the distance, it was also practically impossible for me to read. I had been warned that the recovery might take a few weeks, but I saw almost no improvement during this period which I found worrisome. I explain the reason for my slow recovery in the next paragraph. Things really started to improve after the 3-week post-op mark. The blurriness was much lighter and finally allowed me to function.
I went in for my one-month post surgery appointment in the United States. My nearsightedness was completely gone, but lingering astigmatism from the swelling caused some remaining blurriness to remain. The first question the doctor asked me after looking at the numbers and hearing my story is, “Do you shake your drops before putting them in your eyes?” “No… Was I supposed to?” I replied. Apparently I was. My surgeon, and none of the 4 different pharmacists who had refilled my prescription had told me I was supposed to shake before administration. Thankfully PRK recovery is much slower than LASIK, and all it took was upping my anti-inflammatory regimen back to 6 times a day for a week. My vision improved within 2 days, and the blurriness faded away. I understood then why my recovery had been so slow and why it had improved so much at the 3-week mark. That is when I used up the last of my second bottle of drops where all the anti-inflammatory agent had been stagnating.
I was released from treatment 2 weeks later with 20/10 vision in my right eye, which is not only excellent but exceptionally rare – a complete surprise as it used to be my weakest eye – and 20/15 vision in my left one. I was weaned off steroids (anti-inflammatories) the following week and no longer suffered from dry eyes, probably thanks to the omega-3 pill I took daily. My tears were no longer oily, though the doctor recommended to keep administering artificial tears as needed to help improve any remaining astigmatism.
If your driver’s license indicates the need for corrective lenses, make sure to remove this condition when you renew your license.
You may also wonder what to do with your old glasses. Why not donate them to charities providing eyewear to impoverished communities around the world? I’m not a hoarder, but I also hate throwing anything away, so I recycle any chance I get! Below I provided a list of locations that collect glasses to give them a new life.
- Charity Vision Sight Buddies (located in Provo, UT)
- Lions Club Eyeglass Recycling Centers (worldwide locations)
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