PRK, also known as LASEK (with an E), is a technically more simple procedure. Instead of creating the flap, the surgeon simply dissolves/removes the entire epithelium and then reshapes the cornea with the excimer laser. The benefit of PRK is that far less can go wrong during the procedure as the entire complicated step of creating and securing the flap is removed from the equation. As mentioned, it is also more stable in the long term as the patient does not have the flap that can come lose. The negative is that the recovery is far longer and can be painful, as the entire epithelium has to regrow.
For the curious, this is how the whole process went for me:
Pre-Op Week:
I arrived at Travis a full five days before my actual surgery date. This is due to the extensive pre-op workup the Refractive Surgery Center has to do before the procedure. I went through hours of eye tests, some normal, (reading from the Snellen eye chart) some totally bizarre (having the surface of my cornea digitally mapped). I learned that I have extremely active tear ducts. This has actually been a huge asset in my recovery as dry eyes are a major complication in the healing process. So, in terms of the genetic hand I've been dealt, I have a receding hairline but productive tear ducts. I guess that is a push. The way I learned about my tear ducts was interesting. After the nurse applied numbing eye drops, she stuck what are essentially acupuncture needles into my tear ducts. The numbing drops worked quite well and I did not feel a thing, but it was still somewhat disconcerting to look down and see needles sticking out of my lower eye region.
TD-0, Surgery Day:
I was scheduled for an 0815 surgery time and I arrived 45 minutes early for all the pre-surgery procedures. This consisted of tons of eye drops, ranging from numbing to antibiotic. To classify my mood as "anxious" would be a considerable understatement.
When it was my turn, I was taken into the surgery room and I laid down on a reclining chair/table, similar to what dentists use. My blood pressure was absolutely through the roof at this point. The Doctor explained what all the equipment was and fired the laser so I would be prepared for the sound of the machine. I paid absolutely zero attention and simply tried to keep myself from hyperventilating.
My left eye was the first to be operated on, so they covered my right with an eye patch type thing. The Doc then put in spreaders, essentially an eye speculum, to keep me from blinking. This would have no doubt been terribly painful but for the gallons of numbing drops they had been putting into my eyes. It was still uncomfortable, in that "you're going to feel some pressure now," way you get at the dentist.
This is how I was feelingThe natural fear of most people is that they will move their eye as the laser fires. This is now essentially impossible, as the laser computer's system tracks the patient's eye position up to 4,000 times per second. In short, the laser moves far more quickly than the patient's eye muscles and also automatically shuts off in the event that the eye moves too far out of range.
The Doctor then gave me a brief countdown and the actual procedure commenced with a series of flashing lights and mechanical clicks. The clinical term for what happens here is ablation, a fancy word for VAPORIZING portions of my cornea with the laser beam. In that I did not need extensive correction to my eyes (I was only -2 diopters in each eye), the laser only fired for maybe 15 seconds. Talking to other patients, it seems the worse your eyes, the longer the laser is engaged. It was utterly painless, though I was still white knuckled on the stress balls they had given me. The doctor then sprayed some water into the eye to wash everything out. The water came as a bit of a surprise and was horribly unpleasant. The process was then repeated for my right eye. The Doc then inserted bandage contact lenses to act as a buffer between my cornea and my eyelid, as my epithelium was no longer there to serve in that role. I was out of the operating room in a grand total of maybe 12 minutes.
I felt absolutely fine following the procedure. My eyes felt weird but I was not in any pain whatsoever due to the numbing eye drops. I was issued cheap wrap-around sunglasses to protect my eyes from UV rays and some insane Chronicles of Riddick goggles to cover my eyes when I showered and slept.

If I were bald, I would look exactly like action superstar Vin Diesel. TD-1:
I slept fitfully, though I account most of that to having slept for the bulk of the preceding day. I had my 24 hour follow up appointment in the morning which was not terribly eventful. I was not experiencing significant pain or light sensitivity, which was a relief. My actual vision was 20/35 in both eyes, which allowed me to see but not really focus my eyes with any real precision.
My sensitivity to light increased throughout the day. I kept the lights off and curtains drawn for the entire day and needed to wear my sunglasses to watch TV or look at my phone/laptop. All in all it was not too bad, especially compared to the stories I had been told or found on blogs/message boards.
TD-2:
This was the reason they prescribed me Percocet. Holy shit did my eyes hurt. I was extremely sensitive to light and would classify my eyes as being "on fire." My visual acuity had definitely regressed compared to the day before, though that was not really an issue as I tried to keep my eyes closed for most of the day. The only slightly positive part of Wednesday was scaring the bejesus out of the maid who came by - she knocked only to have me open the door to a completely dark room, curtains drawn tight, with me in a robe and wearing my Riddick goggles. She had absolutely no idea what to make of the situation.
I passed the day trying to sleep or listening to the perils of Michael Bluth and Liz Lemon.
TD-3:
Everything was back to normal. I could see better and with no acute pain. My eyes still felt weird but nothing terrible, just something I would notice. I actually drove around the hotel parking lot to see how I would measure up and felt absolutely fine.
The day was just more of the same. Dozens of eye drops on hourly intervals, microwaved Lean Pockets, and watching TV/DVDs.
TD-4:
It was finally Friday and time for my five day checkup. I was seeing 20/25 in both eyes, which is already a huge improvement. My middle to long distance vision is great, though I am still struggling in reading my computer monitor. Most importantly, I am well beyond the 20/40 cut off for driving legally in California, so I no longer have to fret about getting back to Las Vegas on Monday. The bandage contact lenses were taken out which was a huge plus as they were getting uncomfortable to wear, especially for someone that had never worn contacts in his life.
I am through the painful part of the recovery and now simply have to be patient as my eyes heal. I ran into some pilots and special operators who did the procedure years back and who now see 20/15 or better, but said they did not get to that level for 3+ months. I guess it will all be little improvements hereon in. If nothing else, it was an easy enough recovery and I can see enough now to be totally functional.
I will have my one week check up tomorrow morning and be on the road back to Las Vegas immediately thereafter.





















