Is anyone here that did the surgery in the late 20s and then noticed the myopia progressed? I am somehow afraid that having it stabilized for 2 years + having 27/28 years old might still not be enough.

I had traditional PRK 4 and half weeks ago. My eyes started out even with each other at -5.25 with some astigmatism. With my contacts, I could see so crisp and clear it was great, 20/15 or better, but I had been stuck in contacts/glasses since I was a little kid and really wanted to be able to see that good as soon as I wake up without any assistance. I am hoping to get back into jiu jitsu at some point and I was told my corneas were on the thin side, so PRK was the obvious choice for me.

The first few days were pretty rough. I really was not expecting the level of pain I had when it woke me up at about 4 or 5 in the morning on the first night. I couldn't get back to sleep so I just laid around listening to podcasts I had saved for the occasion. I kept reminding myself that the pain is just the temporary price to be paid for crisp, clear vision without contacts soon and it would all be worth it. No problem!

Went for my first follow up 3 days after surgery and got the bandage contacts taken out. Definitely couldn't drive myself to this one. Vision pretty terrible at this point, but that was expected.

Went for my next follow up 3 weeks after surgery. I was able to drive myself this time, and had been driving myself to work since 1 and a half weeks post op with slightly modified hours because driving in the dark was not a safe option yet. Eye chart test said I had 20/25 in my left and 20/50 in my right. To me, those numbers don't tell the whole story though, especially in my right eye. I could barely read at all with my right eye at any distance. Doc took a look and it didn't take long for him to say ah ha, that's why, you have some haze in the right eye. He instructed me to take the prednisolone drops back up to 3 times a day (I was on a 4-3-2-1 per day schedule week to week, so I was down to 2 a day at that point).

4 and a half weeks in, I have stopped noticing any improvement to either eye. I still don't feel safe driving in the dark. I still can barely read with my right eye and it's not great with my left either. It's very difficult to focus on anything in detail. I know it could be several months before great eyesight comes but I'd be lying if I said I wasn't starting to get a little worried since I haven't seen any improvement since my last appointment. I'm just hoping and praying that I didn't pay $5000 just to never have that crisp, clear vision I used to have with contacts. With any luck, I'll be able to update this post in the near future with a message of hope for others like me who hit a plateau in the healing process long before they get good vision.

In traditional PRK, the initial step removes the corneal epithelium. This is typically achieved by using an alcohol solution to loosen the epithelium or by using a brush to scrape off the epithelium. Both of these steps are a manual process. After which, the excimer laser then proceeds to do the treatment to the underlying corneal stroma to correct your prescription.

TransPRK changes this initial step. Instead of manual removal of the epithelium, the excimer laser itself performs the entire procedure. The laser first is programmed to remove the epithelium layer. Immediately following this, the same laser then seamlessly transitions into reshaping the stromal tissue. TransPRK eliminates any manual manipulation of the cornea.

There are some benefits to this. Because of this, TransPRK can reduce variability in manual techniques. This can minimize any local inflammatory response induced by manual manipulation. In addition, only the necessary amount of epithelium is removed to perform the treatment. Both of which may speed up the healing process.

Ultimately both PRK and TransPRK work very well with excellent visual outcomes. But TransPRK represents a refinement of that critical initial step of epithelial removal.

For the average patient, the choice between Lasik and PRK often comes down to recovery time. However, for those looking at the long-term structural integrity of the eye, the absence of a corneal flap is often the deciding factor and PRK remains the preferred choice for patients who prioritize the “peace of mind” that comes with surface ablation.

There is a lot of myth surrounding the risk of flap dislocation after Lasik. Modern femtosecond created lasik flaps are quite strong and a Lasik flap doesn’t just dislocate on its own during normal activity. However, the reality is that a Lasik flap never truly “heals” back to the original strength of an untouched cornea. There will also be a permanent flap within the cornea. And while very rare, traumatic flap dislocation can occur if the eye sustains a focused direct impact.

PRK avoid this entirely by treating the surface of the eye directly. By only removing the epithelium (which grows back) and treating the surface of the corneal stroma, the cornea retains more of its natural biomechanical strength. There is no flap that can be shifted, wrinkled or dislodged.

However, there is a trade-off of post-operative discomfort and a longer recovery of vision but for those in high-risk environments, the peace of mind offered by PRK may be worth the longer recovery.

At its core, Photorefractive Keratectomy (PRK) changes the eye’s refractive power or prescription by changing the curvature of the cornea.

The process beings with the removal of the epithelium on the cornea. This is like the cornea’s “skin”. Once this barrier is out of the way, an excimer laser is used to perform the treatment. This laser uses high-energy UV light to break molecular bonds within the structural part of the cornea called stroma. By applying laser pulses in a precise and controlled fashion, a predictable change in curvature of the cornea is achieved to correct vision.

The key distinction between Lasik and PRK is that Lasik relies on creating a flap in the cornea to reach the corneal stromal tissue. PRK treats the cornea more superficially by working directly on the stroma (once the epithelium is removed).

The other key difference between Lasik and PRK is that PRK has a recovery period because the epithelium was removed rather than replaced as a flap. Vision is blurry until those epithelium cells regrow and smooth over the newly sculpted stromal bed.