I had PRK surgery on 3/18/2008 and I thought I'd post how it went for others who're thinking about getting it. PRK is the exact same price as LASIK, uses the exact same excimer laser, but has a significantly longer heal time and is more painful. People who have poor near-sightedness, large pupils, and/or thin corneas are generally not the best candidates for LASIK, and that is where PRK comes in.
Short version: if you're as fed up with glasses/contacts as I was, you're patient and you're not a candidate for LASIK, get it. And the long version...
The Procedure (from my point of view)
I scheduled my appointment for 8am and I was up until about 3am the night before because I was so nervous. It worked out in my favor though since I was able to sleep so easily the rest of the day. We arrived at StrongVision at about 8:10am. They gave me some numbing drops for my eyes and I could feel tremendous anxiety, my extremities felt cold and clammy and I could feel the blood draining from my face. I fainted during one of the tests at my first pre-op visit, and I really didn't want that to happen during the procedure. Then they gave me a Valium to relax, and I felt much better in about 5 minutes. They took me into the laser room and gave a brief explanation of what was going to happen. Then they cleaned my eyelash area with an iodine solution, no big deal. The numbing drops work really well, it almost feels like you're blinking over empty eye sockets.
My instructions were to basically to stare at a red blinking light. With the Valium, numbing drops, and everything being blurry anyways, it was really easy to do this. They popped the little eye propper-opener into my eye in about 1 second, it is actually more comfortable than it sounds. Then they slide my head under the big machine.
From here on everything was blurry, but here's what happened from my point of view. There's a green light and another red light, ah there's the blinking red one. A ring-shaped object is placed on my eye, I feel a slight pressure as if I was resting my finger on my closed eyelid. Then a second ring is plopped on there with about the same pressure, this one is filled up with liquid, and held in place for 30 seconds. I see a white blur then the liquid is rinsed off. The stuff they rinse your eye with is ice cold, and that is the most uncomfortable part of the whole procedure. Some goop-like substance is then wiped off my eye. Another rinsing with the cold water. The light is turned off momentarily then my eye is given one more wipe before the cool part. The light is turned down again, then *BZZZ*crack*crack*crack* the laser fires up. There is a faint smell of a curling iron, but not as bad as I had expected since other people told me that was the worst part. With every *buzz* of the laser, the shape of the blinking red dot changes shape. After the laser finishes something blocks my vision for a second or two, then something white is placed on my eye, making it difficult to watch the blinking red dot. Then a translucent white disc is placed on my eye for a bit. Another swab then more squirts of that icy water, damn it's cold. A "bandage" contact is placed over my eye and a few drops placed in it. The eye-propper-opener is gently removed from my eye and I blink. My eye is closed then given a good wipe down.
At this point I can sit up and they switch the eye patch to cover my right eye and prepare my left one. They ask me to read the clock on the wall, I only see a blurry white disc. The laser runs through a few tests in the mean time, then they repeat the same procedure on my left eye. When it is finished I can easily read the clock on the wall. It is miraculous. I think I could only say "wow."
What Really Went On
They gave me a DVD of the procedure which I've uploaded to both Vimeo (higher quality) and Youtube. Watching the procedure is somewhat difficult if you're squeamish. I am still amazed at how little I felt. It's funny watching it because it looks like the most soothing part is the water squirted on my eye, and to me it was the most uncomfortable.
So here's the play-by-play of what really went on. The first metal ring scores a circle on my eye. The second ring is placed onto the score and filled with an alcohol solution that dissolves the epithelium layer of the eye. After its drained and rinsed, the epithelium is wiped off. The laser works in the UV spectrum and breaks down the carbon bonds in the cornea's cells, reshaping it. The white blur they rest on my eye is what they called the popsicle, some sort of frozen artificial tears. The white disc is Mitomycin-C, it changes the cell's mitochondria so that your eye doesn't heal too quickly, making your eye blurry. The bandage contact just reduces the chance for infection and makes it much less painful to blink. It gets removed 5 days later.
Each eye takes less than 8 minutes, and the entire procedure is less than 20 minutes. We were on the road heading home in less than an hour.
This is really the most frustrating part. The pain is very tolerable with medication, but having blurry vision is frustrating. Especially if you're like me and usually spend about 16 hours a day staring at a glowing screen. You're not supposed to read for extended periods of time either, so plan on being bored, listening to music, and sleeping a lot. The pain meds will definitely help you sleep.
The worst day pain-wise for me was the third day. Every time I opened my eye, the light felt like a hair stuck under a contact. I just kept my eyes closed as much as possible and slept most of the day. The day after was basically pain free, but was the blurriest. At day 6 I had the bandage contact removed and my vision was still a bit blurry. I couldn't even read the top line. At this point I was thinking: WTF have I done. But each day since my vision has improved noticeably.
While some people can see 20/20 after the first 5 days with PRK, it wasn't that way for me. This is really where LASIK is so much better, since you see clear right off the bat. As of 3/31, my vision was already 20/25. It will continue to get better hopefully to at least 20/20 over time (many people's vision is corrected better). The more that you blink, the more your cornea smooths out all of the imperfections from the healing process.
I'm now 2 weeks out, and the only real problems I have is a nagging head ache, the occasional blurriness when I blink, slightly dry eyes, and relatively poor night vision. The Dr. said today that all of those will get better with time so I'm not too worried. and I have another appointment 3 weeks out, and I'll be sure to post any major updates if I have any.
Update 4/22/08: Eyes were 20/20 today. I have nearly zero discomfort, aside from my seasonal allergies. I rarely use the drops any more, I wish I hadn't bought so many. Night vision is clear enough to drive and will improve over time.