Vision Correction Surgery

RECOVERING FROM PRK

Healing after PRK happens in two phases. The first phase is the healing of the epithelium over the area of laser treatment, which takes three or four days. During this phase the eyes can be uncomfortable and the vision is blurry. The second phase begins when the epithelium heals. During this phase the eye is comfortable but the vision is still blurry.

MANAGING DISCOMFORT

During PRK the epithelium was removed from the center of your cornea. The epithelium is a clear skin, and its absence is uncomfortable, just as the absence of skin from your fingertip is uncomfortable. While the epithelium is healing, you may have mild to moderate discomfort in your eyes. Typically, patients say that it feels as if they’ve scratched their eye or have a grain of sand in their eye. During this time, our efforts are directed at making sure you are comfortable. The bandage contact lens is very helpful in improving comfort because it acts like a bandage on the eye. One of the eyedrops you will take is a nonsteroidal anti-inflammatory agent, similar to ibuprofen. This is a good pain reliever. We also prescribe an oral pain reliever, such as Vicodin, though most people find they don’t need it.

Finally, at least at our center, you will be given numbing eyedrops so you can numb your eyes at home if they start to hurt. These methods will keep your eyes comfortable after the PRK while the epithelium is healing.

After four days, the eyes are usually comfortable again, though the vision is still quite blurry. At this point the epithelium has completely healed and covered over the area of the laser treatment. The bandage contact lens is then removed.

ACHIEVING GOOD VISION

The second phase of recovery from PRK begins when the epithelium has healed. During this phase the eyes are comfortable but the vision is initially blurry. As this phase of recovery progresses, the vision gradually clears up.

During the first month after surgery, you will notice a gradual improvement in your vision. It is common to experience fluctuations in your vision during the first two to three weeks, especially for those with higher corrections. Your eyesight will continue to improve until it becomes stable. The time it takes to reach visual stability after PRK varies for each patient. For some, stability can be achieved in a few weeks. For others, stable vision may take three to six months.

Until your vision stabilizes, you may feel more comfortable with a thin pair of eyeglasses to assist you with critical distance vision activities, such as driving at night. Patients over forty-five years of age will require a thin pair of glasses for reading, unless a monovision correction was done.

At your consultation, you will have decided whether to have surgery on both eyes the same day or to have each eye treated on different days. With LASIK, we routinely do both eyes on the same day. With PRK, the return of clear vision is slower. If we do both eyes together, you will have blurry vision for a while in both eyes. If we do one eye at a time, you can rely on the vision in the un-operated-on eye while the blurry vision in the operated eye recovers. The major drawback to operating on one eye at a time is the inconvenience of going through the procedure and the recovery twice. Our experience is that most patients choose to do both eyes at the same time.

POSTOPERATIVE CARE

You will come into the office the day after your procedure for a checkup. You will return about five days later, once your corneal epithelium has healed to have the bandage contact lens removed. Then you will typically be seen one and six months after surgery to ensure that healing is occurring properly. Six months after surgery your vision is usually completely stable.

You will use several different eyedrops. These include an antibiotic drop to prevent infection and a steroid drop to promote healing. As mentioned previously, you will also use a non-steroidal anti-inflammatory eyedrop and the numbing drops as needed. The surgeon’s staff will instruct you in how to use these drops.

It is fine to wear makeup, but avoid wearing old mascara and eyeliner for the first week after surgery. Old mascara and eyeliner can accumulate germs, which you do not want to introduce into your eyes. If you wish to wear mascara or eyeliner during the first week after surgery, open a fresh tube. For the same reason, avoid dusty environments until the contact lens bandage is removed. While the bandage contact lens is in your eyes, avoid rubbing your eyes; doing so could dislodge the lens.

RESUMING ACTIVITIES

Don’t drive on the day of surgery. Resume driving only when your vision is clear enough that you are safe on the road. It may be a few days before you feel comfortable enough to drive, and even longer before you feel comfortable driving at night. Also, stay away from swimming pools, Jacuzzis, and hot tubs for at least a week after surgery. Bacteria in the water could cause an infection. It is fine to shower or bathe, though, because tap water has very few bacteria.

Otherwise, there are very few restrictions on your activities after your surgery. Reading, computer work, watching television, and flying are all fine to do immediately. You can restart your regular exercise regimen the morning after surgery.

Results You Can Expect From PRK