My 2017 TransPRK/Lasek Experience — Part Three: The Recovery

In this three part series I talk through my recent TransPRK Laser treatment for the benefit of others. In Part One I cover my reasons for opting out of Lasik, whilst Part Two and Three look at my recovery and tips for anyone thinking about treatment.

Day 0 Monday (Surgery)

5PM: I arrived home less than an hour after my operation and felt fine though light sensitive, most likely because the anesthetic drop was still in effect. I wore sunglasses around the house and immediately drank vitamin C. Honestly I had expected to be much worse straight after the treatment. My biggest annoyance was the contact lenses in my right eye. For whatever reason I could feel it much more. On the surgery day you are required to apply artificial tears every 15 minutes. I made a complete hash of this due to my extremely long eyelashes. Lowering the bottom eyelid didn’t work so I alternated between the inside of the eye and lifting the upper-lid. It took about 4 attempts each time to get 1 drop in, every 15 minutes. Soon my face was covered in tears that had missed my eyes. An excellent start to an already daunting recovery process.

Drop schedule for Week 1

6PM: It became increasingly difficult to keep my eyes open though I wasn’t in pain. The eyes felt scratchy and irritated more than anything. This made it hard to apply the drops but you have to persevere.

8PM: Shortly after dinner my eyes began to stream with tears for a short period. This didn’t hurt but was uncomfortable as I could feel it in the lenses. If I opened my eyes they would tear, but shutting them didn’t feel right either. I ended up alternating between the two before taking a voltaral eye drop (note not anaesthetic). This seemed to really help and soon the tearing eased.

10PM: After my last round of drops I went to bed for the first time with Lasek goggles. These are not comfortable but I was able to sleep fine with them on. Overall my first day was much better than anticipated, and I felt confident I would make a quick recovery.

Day 1 — Tuesday (Day after Surgery)

6AM: I woke up early and felt OK. I put in some tear drops as my eyes were dry and went back to bed.

9AM: I woke up properly and drank some vitamin C as this is supposed to aid the healing process. I applied my first set of proper drops, which began an hourly schedule from now until 10PM. I still haven’t needed to use the numbing drop for any extreme pain. I could read phone messages up close all throughout the day and felt good. My vision was slightly blurry though it kept going in and out of focus like a camera lenses — a strange sensation as if you are adjusting the focus on an iPhone. The TV and computer screens remained too bright to look at comfortably, but provided useful background noise. I could glance at the screen for periods through my sunglasses. Mainly I listened to an audio-book — Tony Robbins Unshakeable (highly recommended reading).

7PM: By the evening I was getting very cocky about the whole recovery. Two of my friends had warned me It would be a process but I hadn’t experienced any of that. Safe to say I had my comeuppance, as around 7PM my eyes started to stream uncontrollably. My eyes started to hurt and I could feel tears stuck around both contact lenses. At first I was laughing and then soon I was literally rolling around in fits of pain. I screamed at my mother to get the pain-killer drop as I couldn’t read or see anything. Upon entering my room she turned my light on which led to me falling to the floor in some sort of epileptic fit and swearing very loudly. I had never experienced this kind of sensitivity or discomfort. During this period my nose also began to run like crazy. I managed to force the drop in and took an oral tablet as well (still avoiding the anaesthetic drop). I lay under the covers eyes closed as slowly the pain subsided over the next hour. As all the blogs tend to agree, at one point the recovery will hit you.

High tech lasers require Low Tech goggles

Day 2 — Wednesday

6AM: On Wednesday I woke up with both eyes streaming through the Lasek goggles. It wasn’t so much painful though again I could feel my contacts meshing with the tears. I applied some artificial tears and took the Volatarol pain drop as precaution. The tears helped ease my streaming and I was able to sleep some more.

10AM Onwards: On this day my vision was much blurrier than previously. I couldn’t really read anything properly or focus on any screen. Whereas before I could read my phone at a close distance, I really struggled and had more frequent headaches which required oral painkillers.

7PM: From Day 1 on-wards you are allowed to reduce artificial tears from 15 mins to every hour. Today I realised I needed them more frequently, as my eyes were not feeling the same as the previous days. For the rest of the evening I upped my tears to every 15 minutes using my newly found eye-drop skills. Immediately my eyes started to feel relieved and healthier. Keeping the eyes hydrated has been noted as important in the healing, and given I have dry eyes already it is increasingly more important for me to frequently apply the drops.

Day 3 — Thursday

6AM: I woke up with dry eyes so applied tears immediately. This felt much better and I noticed less blurry vision already.

10AM Onwards: My vision had improved overnight though I still had mild light sensitivity and headache. The biggest difference was being able to watch TV comfortably through glasses. I was also able to look at a screen more comfortably and catch up on e-mail for brief periods. I maintained a strong schedule of frequent tears every 15–30 minutes. My right eye had become increasingly uncomfortable with the contact lenses, so I arranged for a follow-up appointment the next day with the surgeon. I was extremely paranoid about infection as my eye drop technique was initially poor. Better to be safe than sorry!

Day 4 — Friday (First post-op appointment)

9AM: I met the surgeon at Moorfields Private clinic early for the aforementioned check-up. His assistant first checked my right eye to investigate the contact lenses discomfort. He acknowledged the lenses had been moving around much more than it should have and promptly removed it. He also performed individual eye tests. My right eye ironically was seeing quite clearly, though I could see nearly nothing in the left (extremely blurred). He assured me this was normal, and that the right-eye was ahead of schedule. I was then reviewed by Romesh who was pleasantly surprised to find that both eyes epithelium had healed. This proved to be very quick healing time, which was attributed to my adherence to applying artificial tears. The remaining contact lenses was removed freeing both my eyes. I immediately felt so much better and less blurry. I was told to keep applying the drops and my vision would continue to improve over the next few weeks.

Frequent drops are key to recovery

Rest of day: I felt much better for the rest of the day with no lenses poking my eyes. My light sensitivity was almost gone though I still had horrific halos when looking at traffic/car lights. It feels like you are playing real life sonic, chasing rings all throughout London. Regardless it became easier to look at screens, though I am still not reading at distance, nor am I seeing my computer screen clearly. I am still not ready for work but I am showing great improvement only 4 days out from the operation. I have not had a fit like the Day 1 since, and have not had to take the pain killed drop for two days.

Day 5 — Saturday

General: I slept without the Lasek goggles for the first time as I no longer had the contacts. I probably should have waited till Monday but I felt they were more likely to poke me in the eye. I woke up early to apply some tears but for the most part I was feeling very normal. I could watch TV easily and read my phone without difficulty. The only issue I had was maintaining focus on a computer screen and glare from bright light. I was not at driving vision or able to work properly, however I could see myself improving day by day. I still had not showered fully (below head only) to avoid water getting in the eyes, however I expected to resume more normal life on Monday on the surgeons OK.

Week 2 and Beyond

From Week 2 things became much easier. After one full week I could have returned to work but I decided to take two weeks to avoid straining. When I returned my vision was still alternating between crystal clear and slightly blurry, often refocusing throughout the day. After 4 weeks I really started to feel fully healed and enjoy the benefits of my new vision. I continued taking drops to ensure healing and increasingly saw improvements in the consistency of my vision over time.

Three Month Check-Up

I am pleased to say at my three-month check-up I had no prescription and was seeing better than 2020. I could read lines on the chart which I never could with glasses, and I could not be happier with my results. It has been truly liberating to rid of glasses and play sports freely without worry. Ultimately it is an individual decision, however I would recommend this to anyone on the fence or wanting to do it.

If you are queasy about the eyes or the process in general, I highly recommend Mr Anugunwala as someone who will ease your concerns (checkout the link below) or any of the professionals at Moorfields. For me it was worth the extra fee than going to a high street Optician.

https://advancedvisionsurgery.com/

My 2017 TransPRK/Lasek Experience — Part Two: The Surgery

In this three part series I talk through my recent TransPRK Laser treatment for the benefit of others. In Part One I covered my reasons for opting out of Lasik, whilst Part Two and Three look at my recovery and tips for anyone thinking about treatment.

Day of the Surgery

If you haven’t read Part One, I decided to get my laser treatment privately at Moorfields through Mr Romesh Anugunwala. I was sh*tting it all the way up to the surgery. My head swirled with doubts about whether I was doing the right thing — should I try harder to use contacts? Does my prescription justify this? If I could offer one tip, keep your treatment to only your trusted friends and family. The sheer amount of nonsense and passively nasty things said to me was outrageous. Why people think it’s funny to instill doubt in someone who is having their freaking eyes lasered is beyond me! I also made the mistake of going alone, leaving me the only person sat in the waiting room without someone for support. Just me and my crazy thoughts. I was soon called in by an assistant who took me through all the drops I would need to take on a tight schedule. I had already seen the regiment, though it did my confidence no favours given I couldn’t get any drops in on a normal day.

Drops, drops and more drops

The surgeon then met with me for a brief check and a quick eye test. He then talked me through the procedure and calmed my nerves considerably, rewarding my faith in his patient care over the other Moorfields professionals. He noted not to panic if I smelled burning, as it is just my eye molecules turning to carbon! It was then time for business, and I was taken through to the laser room, heart pounding…

The Procedure

I lay comfortably on the medical bed with the ominous laser poised over me. I began to squeeze my stress-ball (recommended) rhythmically to take my mind off any anxiety. A series of numbing drops were applied repeatedly which I found uncomfortable as I hate anything in my eyes. The surgeon then taped back my eye-lashes and applied a small clip to hold my eye-lids in place. This was unexpectedly painless and really eased my nerves — blinking was one of my biggest concerns and I really thought he would struggle to get my lashes back. The laser was lowered over my right eye like a binocular whilst the left was taped. At first the laser reviews the structure of your eye so there is a small period of anticipation. I was then asked to focus intently on the green dot and was informed the treatment was beginning. It began with a loud buzzing noise and soon I could smell the burning very prominently. The surgeon counted down for 20 seconds whilst encouraging me that everything was going well, which I very much appreciated! For the final 5 seconds the green light became blurrier and blurrier before suddenly turning crystal clear, and then less blurry at the finish. The laser head was removed and I breathed relief at still being able to see functionally. The eye was then washed with water (very strange sensation not being able to blink) before medicine was applied with a cloth for 30 seconds. After a final wipe with a mini brush, a bandage contact lenses was carefully applied. My eyelashes were freed from the tape and clip, allowing me to sit up and have a sip of water. I lay straight back down as the process repeated for the other eye, this time more confident having been through the experience already.

Me and Mr Anugunwala post-operation — you can’t tell I had my eyes burned off!

Post Operation

When the procedure concluded, my sight was not much different and I felt good. I was taken through to a post-operation examination. To my surprise, I could actually see two lines clearer on the eye-chart making me one above 20:20. For 3 minutes out of surgery this is a good outcome. The only discomfort stemmed from the contact lenses as I have never worn them before. My first set of drops were applied by the assistants and I was sent home to begin the recovery. I caught an Uber from outside Moorfields and was able to send some WhatsApps on the journey through my sunglasses. I returned home less than an hour later and still felt good though light sensitive. Now it was time for the legendary recovery that Lasek treatments are known for…

Overall I could not have been more impressed with patient care offered to me throughout the procedure. All my questions were answered and at no point was I rushed or pressured. If you are queasy about the eyes or the process in general, I highly recommend Mr Anugunwala as someone who will ease your concerns (checkout the link below)

https://advancedvisionsurgery.com/

In Part Three I discuss the first week of recovery and beyond. This will provide a useful read for anyone thinking further about a surface treatment over Lasik.

Please feel free to comment below or reach out with any questions.

My 2017 TransPRK/Lasek Experience — Part One: Why I chose TransPRK over Lasik

In this three part series I talk through my recent TransPRK Laser treatment for the benefit of others. In Part One I cover my reasons for opting out of Lasik, whilst Part Two and Three look at my recovery and tips for anyone thinking about treatment.

Thinking of getting lasered?

 

In 2007 I tried on a friends glasses in absolute shock. I was seeing in 4K High Definition before it became all the rage. It was at an indoor cricket net session and all of a sudden I could see EVERYTHING. I tried them on when batting and realised I could see the seam on the ball. I scheduled an eye test the next day, and spent the next 10 years wearing glasses (prescription -1.75). I acknowledge glasses are not that bad , though when you need them to play sport, read clocks, or watch movies, they can be a real inconvenience. Many opt for contacts, however I (and Vision Express!) could never get them in. In fact any touching of the eye makes me queasy and uneasy. I opted for laser surgery on the recommendation of two friends who had been recently treated. I decided on TransPRK over Lasik, despite the latter being the most popular choice of treatment for many patients and clinics. This post aims to provide an useful and unbiased read for anyone thinking about the process, given many similar blogs are either dated or Lasik focused.

The difference between Lasik and Lasek/TransPRK

There are two main types of laser treatment for standard refractive correction — Lasik and Lasek/TransPrk.

During Lasik, the surgeon creates a thin flap in your eye that is lifted to reveal the raw surface of the cornea. The cornea is then reshaped with the laser, before the flap is replaced. Patients are often able to see clearly immediately and return to work the next day with minimal discomfort. Over 90% of patients select this treatment given the quick recovery and results.

Lasek/TransPRK are known as the surface treatments — there is no flap creation however the thin layer of skin on top of the cornea (the epithelium) is removed to allow for the cornea to be reshaped. As the skin is removed, there is an extra healing process for the eye to go through compared with Lasik where the flap is replaced and secured through osmotic pressure. This extra recovery is more challenging for the patient and extends the healing time (at least one week off work), so why would I want to put myself through the extra hassle?

Note: TransPRK is a form of “no-touch Lasek” — the SCHWIND AMARIS laser allows for precise removal of the epithelium whereas traditional Lasek uses an alcohol solution for removal

6 Reasons Why I chose TransPrk over Lasik

1. Lasik has a faster and pretty much painless recovery but you will always have the flap in your eye, and always have a risk of it being dislodged. This is important if you do contact sports or any physical sport in general. There is no flap in Lasek/TransPRK so no worry of this.
2. There is still debate in the medical community whether the flap ever fully heals. It is difficult to know who to trust here as Optical Express insist otherwise, though everyone agrees it is held in place by osmotic pressures
3. I tend to rub my eyes a lot so having a flap is extra burden and worry
4. I have dry eyes which can be made worse by the flap creation in Lasik
5. Less tissue is taken from the eye in Lasek/TransPRK allowing for re-treatment should better surgeries come along in the future or touch up work be required
6. Lasek/TransPRK is easier for the surgeon to perform on patients who are queasy with eye touching or struggle to keep their eyes open. In fact new TransPRK is now done in one movement with the laser removing the skin more precisely than previous Lasek (which used alcohol), and reshaping the cornea together.

Lasek/TransPRK is a better option if you participate in contact sports

There is no doubt that Lasek/TransPRK has a tougher and more variable recovery than Lasik. The epithelium of the eye first needs to regenerate, whereas in Lasik the flap is lifted and replaced. It can be 1–2 weeks of major recovery, with an adjustment period up to months as your vision improves consistently. With that said, you are treating your eyes and want to make the correct decision for you. If you play sports, have dry eye, or don’t like things near your eyes, then you need to suck it up and embrace the recovery. It is a lifetime of results vs 1–2 weeks of discomfort, and a less invasivesurgery.

Choosing a surgeon — Optical Express or Moorfields?

Naturally you want to have the very best surgeon performing your treatment, though cost is always a consideration. I initially had consultations with three surgeons from Moorfields, and the free Optical Express appointment. My first alarm bell came when all three Moorfields professionals recommended Lasek, whilst Optical Express insisted I should have Lasik. They applied a lot of pressure to have the treatment in the next two weeks and not worry about my concerns above. As I resisted I was even offered discount, essentially reducing the price half that of Moorfields. I was told they use the same lasers (true) and have had a 99% success rate.

Still calling me for that Lasik treatment

I eventually chose Moorfields as I decided that I wanted the very best doing my treatment, and someone that was not worried about pushing sales. I also figured if I had any complications, I would rather have the private consultant managing my issues than Optical Express. The surgeon I chose was Romesh Angunawela (info below) as he showed the most patient care, took time to answer my concerns, and understood my queasiness for the eyes. The other two surgeons are world class in the field and a great choice for anyone. I felt I needed someone sympathetic to my eye queasiness. I viewed recommending Lasek/TransPRK as an integrity move — though they understood it would require more follow up care, all Moorfields consultants gave the best advice for my eyes even though I was eligble for Lasik.

 

Check out Romesh here

As humans it is very difficult to make a decision when it involves a tougher path, even if you know it is the right one. I hope that this post helps shed some light on why some might want to choose a surface treatment over Lasik.

In Part Two I discuss the surgery and in Part Three the recovery. This will provide a useful read for anyone thinking further about a surface treatment over Lasik.

Please feel free to comment below or reach out with any questions.