Laser eye surgery has become pretty common, but I feel there’s a lack of information on what the experience is actually like, so I wrote about my own. Here’s what to expect when undergoing PRK surgery, along with some survival tips on making your way through the darkness.
What is PRK surgery?
Photorefractive keratectomy (PRK) is the less popular, big brother of LASIK. If you have thinner corneas, like me, you can’t undergo LASIK, because it involves cutting a thin flap in the cornea which is replaced once the eye is reshaped by the laser, like a natural Band Aid. The benefits of this are accelerated healing time, less discomfort, and faster stabilisation of your vision. Which is what initially made me disappointed that I wasn’t a good LASIK candidate.
With PRK, the outer layer of the cornea is entirely removed and discarded, which sounds way scarier than it actually is. Because there’s no corneal flap to protect the eye after surgery, it takes a bit longer to heal and is more uncomfortable. The trade off, however, is practically no risk of flap-related complications either post-surgery or later in life, which is apparently why it’s the preferred method for the military and people doing martial arts or other, high-intensity sports.
The difference in healing time is significant, though – I’m talking days versus weeks. It’s scary to think about when you have no point of reference and being able to see is kind of important, if it’s something you’re used to.
So, hopefully this will help anyone who is booked for PRK surgery and is freaking out a little about what “mild discomfort” actually means. We’re all different, but here’s my experience:
My pre-surgery prescription for both eyes was around -8, with my left eye being more feeble than my right. I always wore glasses and used disposable contact lenses for surfing and special occasions. After 15+ years, I was over it. Following the recommendation of a friend, I found a laser eye surgery specialist nearby and booked an appointment. Decisions were made and a surgery was booked. I put in for a week off work, for recovery, and read up on all the scary things that could go wrong (I don’t recommend that last bit).
On the day of the surgery, my partner drove me to the Life Peninsula Eye Hospital, took a photo of my face, bespectacled for the last time, and we sat down to wait. I wore warm, comfy clothing, on the recommendation of my doctor, as the surgery room is kept quite cold. One of the lovely ladies gave me a little pill to help with anxiety and started the process of administering numbing eye drops. Do not be alarmed when you do not get equal amounts of drops in both eyes before going into surgery. They will apply the last drop to your second eye before they do anything to it, otherwise the effect might wear off while they’re working on the first – less than ideal.
I was taken to the surgery room, and lay down on the padded bed part of the machine, to look up at the circular array that houses the laser. Someone held my hand, which made me wonder what I was in for.
First: scrubbing away the outer layer of the cornea – I didn’t feel anything other than mild pressure and cold on my eye, which was held open by a gentle lid speculum. It was kind of like watching a car wash through a sunroof and was over pretty quickly. Weird, but not in any way painful or upsetting.
Second: laser reshaping – I didn’t think I could be trusted with maintaining steady eye contact with a dot, but it turns out you only have to do it for literal seconds. Like, three of them. The red laser light passes across your eye, doing its thing. I felt something, but not pain. Like, if sparkles were a feeling, it would be that. Maybe something like static? There was also the mildest scent of burning, but not the odour of roasting flesh that your friend, who has never had laser eye surgery, told you it would be.
Third: covering the eye with a protective contact lens – this keeps the raw cornea safe while new epithelial cells grow back, sort of like the flap would have done if you were having LASIK. You won’t feel these much at the time, but they’ll feel like annoying contact lenses later on.
Repeat on second eye. Whole thing takes about 20 minutes.
I was able to see, way better than before, on leaving the surgery, but light had become my temporary nemesis. Bring sunglasses, proper, polarised, block-all-the-things sunglasses. I was also given medicated eye drops, lubricating eye drops, and painkillers. Follow your doctor’s instructions on what to take, when, and how. Go to bed in a darkened room when you get home. Your eyes heal better when they’re closed.
The Next Week
This wasn’t painful so much as severely uncomfortable. Make use of the lubricating drops to avoid rubbing your eyes, because they will be super scratchy. I downloaded a whole bunch of Welcome to Night Vale podcasts before the surgery and listened to them for hours, while lying in the dark.
The protective lenses were taken out by my doctor after two days, which brought some relief. The persistent discomfort is a lot to take, though. I recommend judicious use of the lubricating drops, the feeling of dry eyelids peeling away from healing corneas is hellishly unpleasant. I also recommend those gel eye masks, that you can cool in the freezer, to help soothe the heat and headaches.
Become a creature of the night, cover lamps with whatever you can find, and tape the curtains shut. I found even the suggestion of light unbearable. It got better, day-by-day, I could even watch TV in the evenings, as long as the screen brightness was turned down and there wasn’t a lot of white in the show. I’d usually end up peering at the screen through narrowed eyelids anyway, or covering one eye to somehow half the annoyance.
After a week, I went back to work, which meant driving, using a computer, and engaging with humanity. I couldn’t get the screen brightness low enough for comfort, so I took to wearing sunglasses in the office. It was a couple of weeks before I could comfortably read from a screen again.
My vision improved over the weeks and, by my 6-month follow-up appointment, I had almost 20/20 vision, with my left eye still a little more feeble than my right, but a far cry from what it had been before. I was still subconsciously adjusting the phantom glasses on my face, but there was a kind of euphoria at being able to see detail I’d apparently been missing all these years; things like roof tiles or the interplay of light and shadow on birch leaves. It’s like getting new glasses, but forever.
I hope this helped. Good luck with the surgery!