Recovery and the Healing Process
| Staring Into a Laser Beam Recovery and the Healing Process | |
| --Scott Rainey | |
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I've had no complications, other than my own incorrect expectations. More about that later. PRK healing takes 12 weeks to achieve 99% of your final resolution, if everything works perfectly. If things follow Murphy's law, you'll be glad you lived close enough to the clinic where your procedure was performed to see your surgeon for follow up care. It turns out that the 27 second Zap isn't the end of the story. After surgery care is extremely important. Each individual heals differently and the supervision of your surgeon as you heal is of critical importance. The first healing issue is going to be the roughed up surface for PRK patients. This A formerly near-sighted patient will be far-sighted for most of those 12 weeks, This is normal. Your farsightedness will diminish progressively each day. You will want to purchase some standard, inexpensive +1.25 to +1.50 reading glasses which will allow you to read during the healing process. The reason you will be far sighted for a while is simple and easy to understand. PRK, PARK or LASIK are big time injuries to the most sensitive organ in your body. Better than half your brain is devoted to processing visual information, which may partially explain the popularity of movies, TV and video games. Your cornea heals quicker than just about anything on your body, mostly because it's pretty wet right there. After laser surgery, your cornea heals the same way that a scraped knee or elbow does - from the outside to the center. Like a scraped elbow, closing the wound is your body's first priority. In the case of the elbow scrape, after the last scab falls off additional healing takes place below the surface. You'll the tender red skin become almost normal skin, often without even a scar. On both eyes and elbows, healing is not complete when surface cells have grown back to close the site of the "injury." The skin on your elbow will be slightly shrunken when compared to the surrounding tissue at first, but it fills out in time and is soon nearly invisible. The same thing happens to your cornea after being re-shaped by an Excimer Laser. This healing process is well known, well documented and highly predictable. The regrowth of your corneal tissue has been factored into the program that controls the laser. Most of the time. However every human being is different, and that includes the way we all heal. The zap is pretty simple, really, but the follow up care may mean the difference between perfect results and imperfect results. I'm going to take a moment to digress and discuss the value of a skilled surgeon. As we say in the computer biz, this issue is decidedly non-trivial. In the early days of refractive corneal surgery, one of the pioneers of the field was a very talented doctor who found that he could achieve near perfect results by cutting the cornea clean off of the patient, freezing it, placing the "button" on a sterile version of a common machine tool called a lathe, changing the shape of the button using sterile versions of standard tools and sewing the cornea back on the patient. Sounds pretty gruesome, I know, but it worked. Visually my Right eye has progressed as follows: 20/40 after 5 days 20/30 after 10 days 20/25 after 30 days 20/15 after 60 days The anesthetic eye drops they sent home were not nearly that good but, they could be described as excellent as well. I had some trauma when I dislodged the "bandage contact lens" the night after the operation, but other than that, which was certainly my own stupidity, there has been nothing other than dry scratchy eyes, mostly at night when I was sleeping. The Doc told me to not use the antibiotic or anesthetic drops after 4 days, but I was happy to have them on hand and did indeed use them a couple of times in the 2nd and 3rd week. What he wanted me to use instead was little ampules of sterile wetting solution. These eye drops are not "preserved" and I was told to toss them out after 24 hours because there was no "preservatives" in them and they could go rancid. My Advice for the prospective PRK/PARK/LASIK Patient This is not a one-size fits all procedure even with computer cartography of the surface of your eye. Everyone who experiences laser corneal surgery will have a slightly different short and long term outcome. Your Doctors will give you terrific information and advice about everything except how things will go during your recovery period. Your cornea will take 2-4 weeks to loose the "haze" caused by atomizing some of the living tissues of your cornea. During this period you'll feel like you're looking at the world through dirty eyeglasses. You'll probably be a little bit far-sighted for a while as your cornea grows back from the intentional over-correction. This will be especially annoying if you were already wearing bi-focals, because the muscles of your eye won't be strong enough to bring the world into perfect focus. If you know this going in, it's not going to be any big deal. Just plan on buying a cheap ($1-$10) pair of +1.25 to +1.75 reading glasses for reading etc. You may only need them for a few weeks, but you'll be happy to have them on hand anyway. If you are a medium to high myope, someone who couldn't really navigate at all without glasses or contacts, you're going to feel really great at how well you can see without glasses, even if you're not seeing perfectly right away. If you're a low myope who can function at some level without glasses and see 20/20 or better with your glasses, you may not be all that happy with how you resolve the world right after surgery. Be patient. Remember that the first couple of months post-op are the worst, and it will get better each and every day. Healing simply takes time. You'll get a lot better quickly but the final healing will feel like very long in coming. Because everyone is over-corrected at first, myopes will loose an emergency fall-back survival capability most have come to rely upon: the ability to put something right in front of your nose and read it without glasses. That just won't work anymore. Next Chapter |
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 Focus problem in a nearsighted (myopic) eye |  Animated GIF of PRK process (91k) |