I reported some of the following a few weeks ago, but for people interested in corrective eye surgery, I wanted to post some overall impressions after one year. I believe I must make some important disctinctions in case you are using my experience to evaluate if you want to pursue this option:

1. I am 45–was 44 when I had the surgery performed. I’d been wearing bi-focals for a couple of years before the surgery. If you are younger, you can expect slightly different results–namely, the likelihood of needing reading glasses a little sooner than you might have needed them without the surgery (if I understood my pre-surgery discussion–make sure you ask if this concerns you). If you already wear bi-focals or will be needing them soon, the surgery won’t correct that part of your vision.
2. I had no post-surgical pain. From what I understand, this is extremely rare. Talk to other people who’ve had the procedure to find out about their experience with pain.
3. Follow your after-care instructions to the letter. This is vitally important for preventing infection. You do not want infection in your eyes. I had no problem. I took all the drugs they gave me when I was supposed to take them except for the meds they provided in case the pain was unbearable–that was the same drops they used to numb the eyes for the surgery, and, since I didn’t have any pain, I didn’t need them. Maybe I didn’t have any pain because I took all the other drugs. I don’t know.
4. Whomever is performing your surgery should be very willing to answer your questions and answer them to your satisfaction. Ask lots of questions. Do lots of research. These are your eyes. You only have two. This is serious business. If, at any point, you’re not comfortable with having the procedure done, walk away. Call them and cancel the appointment. They should tell you this up-front. If they don’t, I’d be very concerned about their interest in your welfare.
5. Make sure your corneas are thick enough. During the pre-op exam, they measured my corneas, and the doc casually mentioned if the corneas aren’t thick enough, some people have had trouble with glaucoma after the surgery. I had nice, thick corneas. If I hadn’t, this would have been a no-go issue for me. I didn’t have glaucoma before the surgery, and I didn’t have a likelihood of developing it. No way would I have done something to increase the risk of glaucoma. I was surprised by this news, and I’d hate to have not learned about it until after the surgery.
6. Study both PRK and LASIK beforehand. This site looks useful for comparison. Note that these procedures only correct near-sightedness. If you’re far-sighted, techniques are just being developed to help you. What sold me on PRK over LASIK–LASIK cuts a flap in your cornea. When it heals, the seal is very solid where the edges of flap heal, but the flap never heals onto the eyeball. LASIK’s complications can be more devastating to the eye than PRK’s. As an added issue, PRK is the only solution for Air Force fliers. Granted, I don’t do g-force related stuff, but my eyes are every bit as precious to me as theirs are. Aside from these things, statistically, for the average person, PRK and LASIK are equally safe and effective. I’m a strong advocate for PRK over LASIK, based upon my experience and what I’ve learned. Your mileage may vary.
7. I was on the edge of them being able to perform the procedure for me. My eyes were greater than -5.00 diopters, and that placed me at risk for needing additional surgery. In my case, that didn’t materialize. (You’d know at around the six month point if a re-do would be needed.)
8. I was very fortunate. Cost was not an issue for me, and neither was time off work to recover. My surgery was covered by the military in a military medical facility near my home, and my post-operative time was authorized medical time off. Most of you won’t be that fortunate, so economics (either in the facility where you have the surgery performed or in the recovery time will be a factor). In fact, the military embracing this procedure was the final factor in deciding to go ahead with it. I’ve watched them go from cautious experimentation with limited groups to encouraging people to have the procedure because it facilitates people in combat situations (no more gas mask inserts to fight with, no lost or broken glasses in combat, and the list goes on). It’s still a tough procedure to get into. I was incredibly lucky and in the right place at the right time.

Prior to the surgery, my uncorrected vision was 20/700 (correctable to 20/15). (Check blog archives for March 2005, to get the first hand version of this process–check March 3 and the daily entries beginning March 7 (the day of my surgery).) Within one week after the surgery, both eyes were within the parameters needed for me to drive legally (although, I didn’t get my driver license updated until mid-April, so, technically, I drove illegally for something like three weeks–a logistical problem related to me being stationed in Virginia and being a legal Texas resident). My right eye was 20/40, and my left was 20/30. Even a year later this is phenomenal (in the operating room, they had me look at an A/C unit across the room and see if I could read the label before the surgery (I could detect there was a large beige thing in the corner); afterwards, they had me read it, and I could–docs like to see the thrill on their patient’s faces too when they can see for the first time, I’m sure.).

At the two-week follow-up, they were 20/30 and 20/25. At one month, one was 20/20 and the other was almost 20/20. At three months, both were 20/20, and I was using my former reading glass prescription. At six months, everything was mostly the same.

At one year, my unaided distance vision is now 20/15-the best possible outcome from the surgery, since that was my best correctable vision before the surgery. I was also fitted for bi-focals-what we call workstation glasses, because my mid-range vision has decided to go out. On the bright side, without the PRK, I would be wearing tri-focals now.

The optometrist says if she didn’t know I’d had the surgery, she wouldn’t be able to tell from examining my eyes (that tickles me to no end to hear that). From that statement, I conclude Portsmouth did a superb job on the surgery.

(Assuming you’re over 40) For those of you who haven’t lost your macro vision (the real close vision that you have to take your glasses off to see better), be prepared for it to be gone as soon as they perform the surgery (you lose it as you age anyway-the surgery speeds the process). Your near vision prescription will remain the same, but unless you have tri-focals now, you’ll be able to buy over-the-counter readers in your current prescription and be just fine. If you have tri-focals, they’ll set you up with a bi-focal prescription 3-6 months after the surgery (allowing your eyes time to settle down). Until then, over-the-counter readers-perhaps in two different strengths-will tide you over.

Immediately after the surgery, I didn’t have any pain, but from what everyone tells me, that’s extremely unusual. Do everything they tell you to do post-surgery. My biggest frustration was the first week when my eyes stayed blurry through that first weekend. By Friday when they put a fresh bandage lens on, I was pretty bummed. If you experience something similar, don’t let it get you down-it really is temporary.

Lastly, your eyes will be drier than they were before the surgery. Post-surgery, one treatment is saline eye drops several times per day for several weeks after the surgery. I never had dry eyes before the surgery. Now, I keep eye drops next to the bed and at work. The eyes are driest as I wake up in the morning. Frequently, I need to apply drops immediately upon waking, because one or both of my eyelids “stick” shut. I believe this is also a normal part of aging, and the surgery may have accelerated the process just a little.

Knowing what I know now, would I do it? I think so. My frustrations are age-related and not surgery-related. You’ll have to decide for yourself. It’s wonderful to be able to look across the room at night and be able to read the clock. I’m annoyed that I have to carry a set of glasses for reading, but I’m adjusting.

Only you, in consultation with your eye care professional team can decide if this procedure is right for you.