I had my PRK surgery done last month, my right eye seems to do well and then fluctuate throughout the day, however my left eye feels the same as the day of surgery...I am not happy with the results. What went wrong? Does this mean my left eye will need an enhancement? Is this normal? Will it get better?
Unsatisfactory PRK Results
Doctor Answers 8
PRK and healing
It is far too early to make any final conclusions about either eye. Most likely, both eyes will continue to improve over the next 2-4 months and you should end up happy. I have never been able to explain why one eye seems to progress more quickly than another, but I see this all the time! By the end of the first month the surgeon should be able to take another topographic measurement and give you some predictive information about what the next few months will be like. It is too early to decide if an enhancement is necessary and, of course, too early to do an enhancement, but the surgeon should be able to give you some peace of mind regarding your healing process.
If we could fast forward your situation to six months post PRK, and it became apparent an enhancement is necessary, it is nothing to be feared. I use an analogy related to golf. Your initial treatment is performed with a "driver" and the result is usually the ball in the hole(hole in one!) or very close to it. An enhancement, then, is just a very short putt....easier than the first procedure, though, to be honest, the patients anxiety is usually a little bit higher because it is the second time around. Not to worry, though!
PRK recovery can take months,
PRK recovery can take months, generally much longer than LASIK. That is the advantage of the flap. The healing time is much quicker and less painful.
PRK takes time to heal
The first laser procedure introduced was PRK since it seemed at the time that it was more straight forward, and it was rapidly eclipsed by LASIK for the very reason that the visual recovery is so much faster. In LASIK patients regain excellent vision in just a day or two, whereas PRK is much more variable.
From your question, it sounds like it has been about a month since your procedure, and in some cases PRK can take longer than this to fully stabilize. Usually the vision with modern PRK methods is fairly good after 1-2 weeks, but depending on the amount of correction and other factors it can take longer, sometimes 3-4 months.
You should talk to your doctor, and find out if something unusual is going on in your case or if this is just a normal healing process. If in doubt get a second opinion. You may have dry eyes, or other issues with the healing. In some cases, after 6-12 months if there is still some residual correction a repeat surgical procedure can be performed.
For some patients PRK is preferable, and the long term results are excellent, but it requires more patience to get the final results.
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PRK healing times
Healing times vary greatly with PRK surgery. They can range from weeks to months. Some of the healing time will vary based on your age, how much correction was applied the amount of astigmatism corrected, history of previous surgeries, and general corneal health. Its time to discuss this with your doctor since an exam is needed to determine what is going on.
Nothing necessary went wrong, and it is far too early to consider whether you need an enhancement. Have patience, in certain cases it can take months for vision to reach its final endpoint after PRK. I have seen many cases just like yours turn out perfectly.
Unsatisfactory PRK Results
- It is normal for visual acuity to fluctuate throughout the day after LASIK or PRK
- Fluctuating vision after LASIK or PRK is usually a sign of dry eyes
- Patients will frequently “see dryness” before they feel it (blurry vision, fluctuating throughout the day, worse at end of day, improving with blinking or administration of tears)
- Epithelial remolding may take weeks to months after PRK, resulting in some instability in vision
- Fluctuating vision 1 month after PRK doesn’t mean something went wrong
- Results should get better & be patient - it can take time
- At 3 months, I take a closer look at patients and begin to consider enhancement or touch up
- Surgery is usually held off until 6 months, to ensure stability of the prescription
PRK Eye Surgery Recovery
A lot of things may be going on here, depending on your prescription and other factors. One month after surgery is usually too early to judge whether you will need an enhancement. You may just need more time to heal. The most important thing is for your surgeon to make certain that you have no other eye problems (retinal detachment, etc).
Fluctuating vision after PRK
PRK is an excellent method of correcting nearsightedness, but its biggest drawback is that it takes longer to heal. Unlike LASIK where most people have good vision the next day, with PRK there is usually substantial fluctuation of vision for the first several weeks and it can take as much as three or four months before the final result is known.