Six years after having laser eye surgery: my perspective (PRK (Photorefractive Keratectomy))

Member Name: rdobbie

Product:	PRK (Photorefractive Keratectomy)
Date:	09/07/02 (2825 review reads)
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Advantages: The gift of unaided vision, Cheaper than a lifetime of glasses or contact lenses

Disadvantages: Perfect results not 100% guaranteed

Six years ago my life was changed by PRK treatment for my short sight.

Anyone considering this treatment will be well aware of the magnitude of their decision, so I hope it will be useful to read an impartial opinion by somebody who underwent the surgery. I have dug out my old paperwork relating to the surgery in order to make the occasional reference to the sciencey stuff, although my opinion is intended primarily as a real-life snapshot of the experience from a layman's perspective.

In the mid-nineties, laser eye surgery started to hit the headlines as it became widely available in Britain. At this time I was only 19 and I had been living under the cloud of a hate-hate relationship with glasses and contact lenses since the age of 10. My loathing of glasses was such that I had been wearing disposable contact lenses for the last few years, which despite their advantages over glasses were always an expensive albatross.

After seeing several articles about PRK (Photo Refractive Keratectomy) in newspapers and on television I decided to pursue the idea of treatment. I chose Optimax Laser Eye Clinics because they seemed, at the time, to be the market leaders in their field and had a branch conveniently located in Manchester. They had recently dropped their prices as a business decision to make the treatment affordable to a greater number of people.

It was necessary to wait until my 20th birthday before Optimax would even consider me for treatment. Optimax required that I sent them copies of my optician's prescription from the last four years, after which they agreed a consultation and treatment date. Although the treatment was provisionally booked to take place two hours after the consultation, Optimax made it clear that there was no obligation to undergo the surgery if I changed my mind for any reason.

My short sightedness was approximately minus 3 dioptres in each eye, which is classed as 'mild to moderate' al
though I remember being barely unable to walk across a room without wearing my glasses! Optimax claim that anyone whose sight is between 0 and minus 6 dioptres has an 80-90% chance of achieving normal sight with PRK (normal is defined as being at a level at which glasses would not be prescribed). Optimax will treat patients who are healthy, short sighted and not too badly astigmatic. Luckily I did not have any astigmatism, although technology has since advanced to allow more astigmatic patients to have corrective treatment.

Until more recently Optimax only treated one eye at a time, with a gap of at least three months. Prior to the surgery it was necessary to leave my contact lenses out for four weeks, as they can leave an impression on the surface of the eye which affects the precision of the laser.

The consultation at Optimax's clinic in Albert Square, Manchester, involved a normal eye test and a series of more precise tests which involved placing my head in a hi-tech machine while lights were shone into my eyes. The doctor who did my consultation was courteous, patient and friendly, and after confirming that I was suitable for the operation, did not pressure me into making a decision on the day. He simply explained to me that PRK involves using an excimer laser to remove a microscopic layer from the front of the eye (the cornea) to allow light to correctly focus on the retina at the back of the eye. The procedure was also described in great detail in the comprehensive literature and free video which Optimax sent me before the consultation.

It is important to note that Optimax, in common with all eye clinics, will never offer a guarantee that you will achieve perfect vision. However, Optimax claim that everyone benefits to some degree, and that the risks of permanent damage are virtually negligible. Despite a great deal of scaremongering by my parents ("you could go blind if it goes wrong - don't risk it") I felt confid
ent enough to proceed with the surgery.

I was asked to read and sign a lengthy four page consent form. This is basically a glorified disclaimer form which Optimax's barrister would wave in court if it all went pear shaped. "Mr Dobbie, you signed on the dotted line to say that you were happy with the level of risk involved". Of course, it is a risk, but a risk that is no greater than the decision to fly on an aeroplane.

Upon entering the treatment room I was absolutely petrified. The mere thought of having somebody poking around in your eye is enough to deter many people, although if you have worn contact lenses you will be slightly less squeamish about having your eyes messed with.

I was placed in a dentist's chair and told to lie back. What you are about to read should NOT horrify you or put you off having the treatment. It's unpleasant but it's not painful. And it's over in the blink of an eye, if you will pardon the pun.

My eyelids were held open with a small clamp to stop me blinking during treatment. The doctor placed a few anaesthetic eye drops into my eye, and then used a scapel to scrape away the fine coating on the surface of my eye. Once again I must stress that this was NOT painful, and only lasted for around 30 seconds. I was aware of what was being done to my eye, as I could obviously see it happening, but I could not feel a thing. Immediately after this I was told to stare at the red dot above my head as the laser fired pulses at my eye's surface. This was identifiable by a clicking noise that lasted for around ten seconds, after which I distinctly remember a strong smell similar to burnt human hair. This smell was the tissue on my eye which had been burnt away by the laser. The clamp was then removed and a patch was placed on my eye.

I felt a little disorientated but incredibly relieved as I left the clinic and was driven home by a friend. Optimax gave me a tube of eye oint
ment and four days' supply of painkillers (paracetamol and dihydrocodeine) and sleeping pills (temazepam). The importance of these tablets soon became clear!

As the effect of the eye drops wore off, my patched eye started to feel increasingly uncomfortable. Contact lens wearers will identify with the sensation of having a piece of grit, or an eyelash, trapped under your lens. This feeling was about five times worse. Luckily the painkillers provided to me were highly effective in numbing the discomfort, but I wished that I had taken them straight after the operation instead of waiting for the pain to kick in.

There followed two days of daytime television and cups of tea as I recuperated on the settee. At times it felt as if the grating sensation in my treated eye was getting worse rather than better, but this was a perfectly normal part of the healing process. After the third day I was able to remove my patch and marvel at the pin-sharp vision in my right eye. The view was slightly hazy, as if there was a teardrop clouding my vision, but this did not hide the unmistakable clarity with which I could see distant objects. The crystal clear sight was better than anything I had achieved with glasses or contact lenses.

In order to attain normal vision in the period until my left eye was treated, I was in the slightly bizarre position of having to wear a pair of glasses with only one lens. Strangely nobody noticed this odd imbalance in my eyewear (although I am informed that for a small fee an optician will fit a dummy lens if you wish to avoid looking stupid!).

I found that my treated eye was ultra sensitive when chopping onions or accidentally getting shampoo in it (ouch!) but after about four months all the side effects had disappeared and I was left with an eye that gave me the gift of perfect vision, as confirmed in my periodical check-ups with Optimax.

Having the second eye treated some nine months later was plain saili
ng as I knew exactly what to expect. Again, the healing process was uncomfortable at times, but it is hard to fully describe the feeling of euphoria when the patch came off the second eye. After the reality had sunk in I carried out a ceremonial destruction of my old glasses with a hammer. This was a very emotional experience as I had always dreamed about the moment when I was finally able to do this.

There are many conspiracy theories abounding which claim that PRK and other such similar eye surgeries are not as safe as the clinics would like people to believe. In response to the sceptics I would point out that there are over one million people worldwide who have undergone PRK surgery, and yet there is not one recorded case of a patient "going blind" after the treatment. If there are any such victims then I hardly think they would have kept quiet about it.

Optimax are a decent, bona fide company who are registered with the relevant British health authorities. Since they were founded a mere ten years ago they have treated an incredible 100,000 people in the UK. They now have nine clinics across the country and 36 doctors.

Back in 1996, Optimax charged £395 per eye plus a £25 one-off consultation fee. Assuming that you have two eyes, this totals £815.00 which initially sounds like a lot of money. But when considering the alternative - a lifetime of glasses/contact lenses and eye test fees - the surgery makes financial sense. I had been spending in excess of £200 per year on contact lenses, so even somebody with my mathematical skills could see that I would have broken even in only four years. So in economic terms, laser eye surgery makes perfect sense. But in terms of the improvement to your quality of living and general happiness, the cost of the treatment is small. What else can you buy for under £1,000 that will change your life so fundamentally? By my reckoning, nothing.

The price of laser eye surgery is always fluctu
ating as special offers come and go, but the benchmark price seems to be around £1,000 (for both eyes) at most clinics in th UK. The PRK procedure has changed somewhat since my eyes were treated. Both eyes are now treated at the same time and a soft contact lens is used afterwards to enable vision and healing at the same time. PRK is gradually being overtaken by a newer procedure called LASIK which has pros and cons over PRK, but is widely seen as the way forward.

Unfortunately laser correction of short sight does not have any effect on the deterioration of sight which develops in everyone as they reach their mid-forties. This is a completely unrelated condition to short sight, and therefore you will still need reading glasses as you get older. Oh well, you can't have everything!

The appreciation of having this treatment done is something that grows with every month and year that passes. You find that you are able to swim, play sports, go camping and live spontaneously without having the constant hindrance of glasses or contact lenses. I think that PRK is a miracle of modern science, and I would not hesitate to recommend it to anyone with short sight.

Six years on, and a recent eye test showed that my sight is still absolutely perfect in both eyes. I am often able to amaze people by reading road signs from long distances. Although it's easy to take for granted, perfect eyesight is a wonderful blessing.

Don't just take my word for it. If you're considering laser eye surgery, ask your clinic for a list of people who've had the treatment and give them a call. I think you'd be hard pressed to find anyone who wouldn't recommend it.

You can find Optimax on the net at:
www.optimax.co.uk

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