Those with PRK experience.

[Royal Gramma]

How impressed are you all that have had PRK with your vision quality post PRK (after several months of stabilzation and improvement)? How noticeable and annoying are the visual aberrations that come with PRK?

I just want to get some qualititive observations from those that have had PRK. Maybe they will get me off the fence regarding PRK. I still would consider pretty hard to convince. Here's why:

Despite what many claim they experience, you cannot have better vision post PRK than you would have pre-PRK with correction. All types of refractive surgery induce higher order aberrations. Even customized wavefront ablations. The aberrations that wavefront guided ablations induce are just not as severe.

From the Bausch and Lomb website regarding their Zypotix vision correction systems which couples their Zywave aberrometer and their orbscan topographer with their Technolas 217z laser:

Although the ZyWave® Wavefront System measures the refractive error and wavefront aberrations of the human eyes, including myopia, hyperopia, astigmatism, coma, spherical aberration, trefoil, and other higher order aberrations through fifth order, in the clinical study for this PMA, the average higher order aberration did not decrease after Zyoptix Personalized Vision Correction.​

The aberrations induced by wavefront PRK are simply not as bad as those induced by traditional PRK. What does this mean?: All refractive surgeries induce aberrations, which can lead to decreased contrast sensitivity (among other things such as haloes, double vision, starbursts), and it is impossible, at least with todays technology, to have better vision with PRK than what you would be able to get with contacts. This is especially true with RGPs, which can decrease higher order aberrations by around 70% (much better than you would get with PRK, which at best is no net gain in aberrations).

You definetely get a reduction in the quality of your vision with PRK. However I can see why the military has been such an enthusiastic adopter of PRK once it was proven as medically safe: It's good enough vision to get the job done (pilots included) and a much preferred alternative to glasses and contacts which can problematic in a combat zone. It's the issue between quantity (Snellen acuity) and quality (how good is you vision, even if it is 20/20).

All these folks who tout how great their vision was after PRK, I think don't remember how good their vision was corrected before PRK, especially with contacts. Especially with bilateral PRK, which is most common right now, you have no reference point to judge you post PRK vision with. With me, for example, if I go without glasses or contacts for a few days, I will oftentimes say to myself, "Hey, my vision isn't so bad...". However the minute I put my contacts in, it's "WOW! What a difference!"

I am hoping that the Coast Guard will adopt the Navy's new SNA contact lens policy. Granted, it usually takes the Coast Guard a few years before they will adopt Navy policy, so I probably shouldn't be too optomistic that the Coast Guard will have this policy in the books in time for my second tour about 3-3 1/2 years from now.

To all those who have had PRK, how happy are you with your vision?

 

[feddoc]

I am very happy post PRK...by about 5 years. My vision is still 20/15 and 20/12. The visual aberrations you spoke of went away after about 2 months and were only minimally noticed....

BTW, my corrected vision before, with contacts or glasses was 20/20. Your statement about "..despite what many claim they experience.." is simply not true. My experience is based upon many interviews (and access to both pre- and post-op records with the initial group of Aviators and SEALs who had PRK completed. Some had better vision afterwards, some had the same (as before with corrective measures)...only one guy had worse vision.

"You definetely get a reduction in the quality of your vision with PRK." Huh??? On what do you base this statement?


"All these folks who tout how great their vision was after PRK, I think don't remember how good their vision was corrected before PRK, especially with contacts."

That is a pretty broad statement without basis in fact. I remember vividly not looking for my glasses or contacts anymore. Although my visual acuity was good with corrective measures, it was, and remains, better with PRK....and, I don't have to worry about losing a lense or glasses.

To answer your last question...I am very happy with my results

 

[Royal Gramma]

"You definetely get a reduction in the quality of your vision with PRK." Huh??? On what do you base this statement?

On the results of clinical studies which show that PRK, whether traditional or wavefront, induces higher order aberrations. The laser isn't perfect. Go to any laser manufacturer's website and you will see a similar statement in the fine print. Remember that 20/15 isn't neccesarily better than 20/20, and that having 20/20 isn't neccesarily good vision. There are many who claim that despite having 20/20 or better Snellen acuity after PRK, their vision is not as sharp and crisp as it was with corrective lenses, particularly contacts.

To those who have been under the laser: How is your night vision. And how pleasant is your vision in low contrast situations. Don't give me this Snellen 20/x stuff, which really tells you little about your vision. Has anybody taken a contrast sensitivity test?

 

[feddoc]

To those who have been under the laser: How is your night vision. And how pleasant is your vision in low contrast situations. Don't give me this Snellen 20/x stuff, which really tells you little about your vision. Has anybody taken a contrast sensitivity test?

My night vision is fine, according to my own judgement (as well as pre and post operative results) and the MCT 8000. I have taken both the Pelli-Robson and the VCTS (6000 and 6500). That should answer your question about how 'pleasant' my vision is under low contrast.

I must disagree with your statement......about the Snellen charts, "which really tells you little about your vision" . It, the chart, is the standard by which we are judged and either allowed or denied access into aviation. While MCT and VCTS do provide more information, they are not readily available.

 

[NavyOCS]

Its sounds like you have made your decision already Royal.

I had PRK and am glad I did. I can do anything I want to without worrying about losing a damn contact or messing with glasses. I am very pleased with the results.

 

[TheBubba]

I had PRK about 2 years ago. I'm perfectly happy with my vision as it is. I was 20/400 NOT correctable to 20/20 with glasses/contacts (only 20/30). However, I am now 20/20 2 years after I had the procedure.

My night vision is virtually perfect... more defined than with glasses. Depth perception, perfect. I can actually distinguish dark blues and black better than I could pre-PRK. Overall, I am more than happy with my PRK results. My vision is sharper and clearer than when I wore glasses.

The worst problem I have is a little bit of dry eye every now and then, but with a life-time supply of refresh drops, its not a problem, and itusually goes away on its own after a minute or two. So no big deal there.

Most of my classmates wo recieved PRK are extremely happy with it. I say most because there was 1 person who's vision did not get better. In fact, it stayed pretty much the same. But inany medical procedure, there's the risk for an adverse result.. its the nature of the science.

 

[NozeMan]

My vision is 20/20 and 20/25 now after 11 months or so. I had trouble with my vision for maybe 2 months before the healing really took over. I dont know these "aberations" you speak of after PRK. I had the full custom job and the results are awesome. As far as not seeing as "sharp" as 20/20 but having it on the scale....what the hell does that mean? How the hell can you see 20/20 but not crisply/sharply? You either see it or you dont. Granted I didn't correct all the way to 20/20 in both eyes, the results are still incredible compared to what i was seeing before the operation.

 

[Circle K]

After 3 years post PRK, I really couldn't be happier. I'm not entirely sure I understand the talk about higher order aberitions and crisp vision with contacts. Before the surgery I was extremely close to the limit where the Navy will not even attempt to operate on you (some sort of addition of your refractive error and your astigmatism). Afterwards my vision was 20/18 and 20/16. I'm not really sure I remember how "crisp" my vision was before hand. I did wear the RGP lens (Rigid Gas Permiable, the "new" hard contact, for those that don't know) before my surgery. Although my vision may have been more crisp it was far and away less comfortable. Even my dry eye has gone away with PRK, but with the contact lens, even after wearing them for years to "get my eyes used to them" I still had a limited amount of time before I wanted to rip my eyes out instead of keeping the gas perm contacts in.

In short, if you can handle the few days of pain associated with PRK, the benifits far outweigh the negatives.

 

[Royal Gramma]

As far as not seeing as "sharp" as 20/20 but having it on the scale....what the hell does that mean? How the hell can you see 20/20 but not crisply/sharply?

You can, for example, have double vision but still have 20/20. You can also have 20/20 (or better) but have scattering of light in your on you retina from HOAs leading to less perceived contrast. Remember the Snellen (or the logMAR, which is what they use nowdays to get Snellen equivalents) is a high contrast test. It gives no indication of how you see in low contrast situations nor is it a test of the qualitative aspects of vision.

This is all compared to your BCVA with glasses and contacts, or course. PRK has the advantage that you're not a disabled human being without glasses or contacts.

So far I've been only hearing good things about the surgery from people who have had it. You all are slowly pushing me off the fence little by little. I am going to continue playing devil's advocate though until the day I possibly get the surgery.

 

[theduke]

PRK hurt like hell. I went from 20/30 to 20/15, but it took months to stabilize at that. I have no aberrations--I'd never know I had PRK except that I can see a little better, but not that noticeably...I didn't wear glasses or contacts before.

The only reason I got it was so I could be a pilot, and then they came back and said "Just kidding about that whole pilot thing. We need FOs too badly to switch you back to a pilot contract." (I tried to switch 3 times and didn't get anywhere...I'll try again when I hit the fleet.)

Knowing what I know now, I wouldn't have spent the money (not to mention the suffering), but it's cool I guess being able to see really well instead of "ok". I don't notice a big difference in day to day stuff, and I haven't experienced any negative effects since the rather lengthy healing process finished.

 

[Physicx]

Does PRK cause your near-sightedness to go away with age?

 

[Texan]

A bit dry, but that's about it.

I went from really bad (-3.75 / -3.25) to no correction (20/15 both eyes) and it's been almost exactly a year since the procedure. I occasionally notice that my eyes are dry, especially after a long day in my humidity controlled (very low humidity) lab. Also, a short night of sleep is brutal and I find myself putting a drop of eye lube in as soon as I open them in the morning.

The problem is that when my eyes are really dry, the abberations are a bit more clear, and although I can still see clearly, a bit of a starburst is noticible around bright lights at night.

For those of you who are unsure of what abberations look like go here: http://www.visionsimulations.com/

it's an interesting site to play around with, especially pre and post surgery as you can simulate what you see and more clearly describe it to a doctor by printing a picture of what you're actually seeing.

The funny part though is that until you get it done, you dont realize how much of a disability it is to have to wear glasses / contacts. I couldnt see $hit without my glasses or contacts before, now I wake up and still get a kick out of being able to read the labels on the shampoo bottles in the morning.

PM me if you have any other questions you'd like to ask off the post.

-Texan

 

[Cordespc]

I had PRK in July. Went from 20/400 to 20/15, which was my best corrected vision with contacts. I can tell no difference in my vision now compared to when I used to wear contacts, except it's a hell of a lot more convenient.

Echo what bubba said about the dry eye, I do get a touch of it from time to time, and it does tend to go away on its own pretty quickly. All in all the surgery is definitely worth it, and being free made it cost effective as well.

Cheers/
Paul

 

[nugget81]

I had PRK done last March and it was by far one of the best investments I've made. I wore contacts for 8 years prior, and I am very happy with the fact that I do not need to take the time to put on, remove, clean, purchase, etc contact lenses. And glasses, I could never stand to wear glasses. I hated the fact that my peripherial vision was blurry while wearing glasses.

I've found that my vision is roughly the same as when I wore contacts, but I do also get the occasional dry-eye. As everyone else has stated before, an eye drop or two quickly takes care of the problem.

As for differences in clarity, both of my eyes are 20/20 but I can distinguish the slightest difference in sharpness between each eye. If my left eye were a 10, then my right eye would be a 9.5. It seems rather odd, but when I think back to my days in contacts I can remember having the same issue with different prescriptions in each eye.

Should you get the surgery? Take a look at what we've said and decide for yourself. Would I recommend PRK? In a heartbeat....

Remember: No Risk, No Rewards....

 

[Av8or72Dan]

I had PRK done a little over a year ago. My contact prescription was -1.25 and -1.75 before the surgery. Now my eyes are 20/15. The only down side is that I am a broke college student and I am still paying off the surgery.