This year I had a two-step procedure of Lasik eye surgery followed by PRK eye surgery to correct me from -10.0 to 20/15 (better than perfect) vision. Here’s my experience.
I’ve had terrible vision for as long as I can remember.
I got my first pair of glasses in kindergarten. By fourth grade, my eyes were so bad I was impaired without glasses. I was in ballet at the time and my eye doctor signed off on my first pair of contacts because I couldn’t dance with glasses.
At the beginning of this year, my vision was -10.0 in both eyes. To put that in context, you are considered legally blind if your prescription is -2.5.
Click through for more about my patient experience having PRK and Lasik eye surgery. This is a long one, so buckle your seatbelt…
My Reasons For Getting Lasik & PRK
Living in California, the fear of earthquakes is a real thing. I worried that we’d have a devastating natural disaster in the middle of the night and I would wake up and not be able to find my glasses. It was downright dangerous.
Add to everything chronically red and dry eyes from how thick my contact lenses were. My glasses were so heavy they were constantly falling down my nose. And giving me headaches. For me though, that was a reality I’d accepted.
I’d always been told I wasn’t a Lasik surgery candidate because of my extremely bad eyesight, but I had also heard that technology was improving. I scheduled consults with a few local surgeons here in San Francisco. What I learned was surprising.
Experience with Free Lasik Consults
Most clinics offer free Lasik consults where they check your eyes to make sure you are a good fit for the procedure. Two of the surgeons in the community here immediately passed on taking me on as a patient. Even though they acknowledged that the procedure was possible, it required technical skill that they didn’t feel comfortable with.
Next, I visited one of the top private practice Lasik eye surgeons in San Francisco. She has photographs on her walls with all the local celebrities she has cared for. The experience getting ushered in to the exam room and being the only patient in the entire clinic with four people focused on me was very impressive.
As they started to do the consult, the tests showed that I wasn’t a good candidate for Lasik surgery due to having corneas that were too thin. Instead, they recommended PRK. I hadn’t heard of PRK until that appointment, but it’s an older version of Lasik surgery that involves resurfacing the eye with a laser instead of doing a flap. The downsides are longer recovery time, more discomfort and more variable healing and results.
Despite this, the staff assured me it would be a breeze. “Most patients drive themselves to their four-day follow-up appointment.” “It will hardly even hurt.” They made a lot of promises for how low risk and high benefit it was. What gave me pause was the price tag – for PRK it was $7,000 for two eyes.
One thing that bothered me was that the surgeon was nowhere to be found. Here I was agreeing to an expensive and potentially risky procedure and I couldn’t even talk directly to the person who would be doing the procedure. Instead it was staff, some of whom had financial, and not medical, backgrounds pushing me to sign up for the procedure.
My last stop was UCSF to see Dr. David Hwang. Given that I work at UCSF, I actually asked the retina fellow (a physician who is training to do retinal surgeries) who she recommended at UCSF and Dr. Hwang was her recommendation.
At UCSF, there was no polish of the private practice experience. There was nothing shiny and new about it. My appointment started 45 minutes late. They didn’t offer a free initial consult. You had to pay $150, which was put towards your procedure if you decided to have it. This covered an almost 2 hour appointment where they did all the pre-op tests and measurements instead of just a short free initial consult like the private practice offices offered.
The welcome difference is that I was finally getting real talk. The risks of both procedures were explained in detail, put specially into the context of having such bad eyesight. It was almost annoying now blunt they were. They laughed at the private practice quote of a 4 day recovery for PRK with a correction from -10.0 to 20/20. They told me for that I would likely be out of work for a month. The pain could be extreme – the sensation of chopping onions that lasted for days, if not weeks.
Even though the PRK recovery was prohibitive for me, Dr. Hwang mentioned a third alternative. He’s the guy for extreme eye surgery vision correction and has actually run clinical trials on the best way to improve eyesight in people like me. He was the person that was recommended when I talked to colleagues at UCSF.
What he recommended was a combo procedure – first Lasik surgery to correct me to somewhere between – 3.0 and -2.0, followed by PRK six months later when I was completely healed to correct me to between -1.0 and perfect eyesight (20/20). He still cautioned that I may not end up with 20/20 eyesight. It was possible that one eye would have a -1.0 correction which would mean I could function without glasses or contacts, but would need them for seeing far away and possibly for driving. He also told me that he does partial corrections for people with eyesight as bad as -13.0! These patients aren’t able to be corrected completely, but even taking them to -4.0 vision is life changing.
I was reassured by his honesty, experience and creative approach to getting me out of glasses. An experienced academic medical center was a better choice, even though it didn’t have the convenience and patient-centered experience of private practice. I decided to move ahead with the first step, Lasik eye surgery.
PRK & Lasik Surgery Cost
To be completely transparent, a two-step eye surgery was extremely expensive. It cost $7,000 to get both procedures done, and that’s after 20% of the fee was covered with our VSP vision insurance. Whew! Other single procedure estimates I got in the community ranged from around $4,000 for both eyes to the $7,000 I mentioned at my first private practice experience. Both of these estimates are after the 20% VSP discount.
??? If you watch my IG stories, you’ll know I had LASIK surgery yesterday! I’ve had glasses since kindergarten and contacts since fourth grade! I have an extreme correction (-10), so I never thought I’d be a lasik candidate. I’m working with a specialist at UCSF to do a two-step LASIK then PRK process that should get me close to 20/20 in the next few months! The first step was to -3 yesterday. Glasses are so heavy and uncomfortable with my correction even having a 70% improvement in my vision is going to be a game changer! Anyone else have an experience with LASIK or PRK? ? ?: @cyneats
Lasik Surgery Experience
I usually have nerves of steel, hence my job in the pediatric ICU. I don’t really get rattled. I’ve also had several major surgeries myself, so I figured a short eye procedure would be nothing.
To get me ready for the procedure, Dr. Hwang prescribed a benzodiazepine, which is a class of relaxing medications. You might be familiar with Valium and Xanax, both of which are benzos. I contemplated skipping it because I hate the feeling of not being in control. I did end up taking it and thank goodness I did!
The Lasik surgery itself was more intense than I expected. I was actually pretty panicky during the procedure. It was divided into two parts, about 5 minutes per part, for each eye. There was nothing more than minor discomfort for any part of the procedure. The hardest thing was having my eyes propped open while focus on a green light. All I wanted to do was close my eyes and turn my head. I kept repeating over and over in my head, “You are a good patient. You are a good patient.” For some reason this pep talk helped me follow directions.I tried to stay rational – this was 20 minutes of discomfort for a lifetime of better vision. Dr. Hwang did a great job of being my champion and telling me how well things were going.
Before I knew it I was in a cab and headed home to recover.
Lasik Surgery Recovery Experience
I addition to being surprised by the stress of Lasik surgery itself, I also didn’t expect to have so much discomfort after the procedure. I’m glad I brought sunglasses as I was extremely photophobic (light sensitive) after the procedure. I was also quite uncomfortable – I had a foreign body sensation similar to chopping onions.
I took ibuprofen but it didn’t really seem to help. When I got home, I felt so grumpy and miserable that I thought the best thing to do was to take a nap.
When I woke up, I was disappointed to still have extreme photophobia and eye discomfort. Pat was home and I could feel myself being irrationally grumpy with him, adding guilt to the constellation of feelings I was having. I made some popcorn and cuddled up next to Pat on the couch while he worked, although I wouldn’t let him have more than one lamp on in the living room. Even then, I still had to wear sunglasses.
Finally I could feel things getting better, about four hours after the procedure. That’s right, it had only been four hours at this point! Within five hours, the light sensitivity had resolved and I could start to appreciate just how much better my vision. I had known I’d be bored after the procedure. I had been instructed to not read or use my laptop for the first evening. Instead, I decided to tackle a big batch of cookie dough that I had in the fridge. Baking cookies was an activity that didn’t take wearing glasses.
The rest of the recovery was just, well, annoying but not terrible. There were rewetting drops hourly at first and then every couple of hours. I actually used them more often than I needed to and never missed a single drop. I was so motivated to have a good outcome I was meticulous about following my post operative instructions. No eye makeup for two weeks. No touching or rubbing the eyes for a month.
It was also annoying that I had to wear glasses for six weeks. That’s the downside of only being partially corrected with Lasik. As I mentioned, I hate wearing glasses. They are always in the way and working out is such a pain! I don’t think I had quite the satisfaction of someone who was completely corrected with Lasik surgery and everything was behind them.
Initial discomfort aside though, the recovery was actually pretty mild. Perhaps the worst part was having to take goggles to my face every night before bed to keep me from hitting my eyes and dislodging the flap. Peeling off the tape in the morning was brutal on my sensitive skin.
My prescription after Lasik ended up being about -2.5, which is a massive improvement from -10.0. Complaining about glasses aside, it was incredible.
I think the biggest problem is that my expectations weren’t set correctly, so the discomfort came as a surprise. Lasik is such a positive experience for people all they talk about is how amazing it is to not need glasses and they forget to tell you the first 12 hours are pretty traumatic. I hope my perspective will help you be a little more prepared for your Lasik eye surgery!
PRK Procedure Day Experience
Six months later, it was time for eye surgery part 2, PRK. I wasn’t sure what to expect given all the extra recovery time that comes with this procedure.
Well, saying I was unprepared wasn’t completely true. Lasik surgery had been pretty traumatic initially so I was more prepared for the intra-procedure stress. I took the relaxing pill. The operating room tech asked me if it was starting to work and I asked him, “Does it seem like it’s working?” with a laugh. He told me I could take another one, but if I fell asleep during the procedure they couldn’t do it. I decided being awake and using the rational part of my brain to coax myself through the anxiety was better than passing out from an overdose on midazolam (Versed).
As I lay on the chair in the operating suite, the now familiar process started over again. My eyes were cleaned and then my eyelashes were taped out of the way. My eyes were numbed with drops and a dilator was used to prop my eyelids open. This part and the pressing sensation immediately following were probably the worse part.
Having done training in the operating room in medical school, the smell of cauterized flesh doesn’t really bother me, but that part I’m sure must be awful for some people. The first eye was similar in stress level from the lasix. The second eye Dr. Hwang told me he would talk the residents (eye surgery physician trainees) in the room through what he was doing.
It’s funny that this simple change completely altered the experience for me. I was able to focus on Dr. Hwang’s voice talking through the procedure and the left eye became like an out-of-body experience. I was no longer ‘Kelly the patient’. I was ‘Kelly the (former) medical student’ observing a surgical procedure. Well, except it was my surgical procedure. The second eye was over before I knew it.
As soon as I sat up, I could see. I didn’t have the extreme light sensitivity that I had with Lasik. Perhaps it’s a difference in expectations. I heard from so many people how great Lasik was, but nothing about how stressful the procedure and first day post op were. It was the opposite with PRK. All people talked about was the difficult recovery.
PRK Recovery Experience
For PRK, the first thing that everyone mentioned was the discomfort. It’s all I thought about for the six months learing up to the procedure.
I followed Dr. Hwang’s instructions to minimize discomfort to a T. 600 mg of ibuprofen every 6 hours and so many drops! There were steroid drops (to slow down healing of the eye leading to less scar tissue formation and an overall more uniform and better result), pain relief drops and antibiotic drops. I also used refresh eye drops every 2-3 hours. The instructions said, “keep your eyes closed as much as possible the day of the procedure”.
What better thing to do while closing your eyes for hours at a time than listen to podcasts?
Only three years late, I decided to dive into the Serial podcast series. I listened to the first half of the series in one day, mesmerized by Sarah Koenig’s voice. It was bedtime before I knew it.
Time for the worst part of the day – taping those freaking post surgery goggles to my face. Pulling the tape off in the morning is the worst. It totally ravaged my sensitive skin. Luckily this time it was only for five days post op – until the protective contact lenses came out.
The morning after the PRK procedure, I had minimal discomfort. I stuck to my pain regimen because I’d been warned it was easier to prevent the pain than to get on top of it once it starts. My vision was blurry and sort of hazy – like there was a big thick fingerprint square on the middle of each contact lens.
At my 24-hour post operative appointment, I asked why I didn’t have the discomfort I was expecting. Dr. Hwang explained that he used an advanced technique for reattaching the epithelium (top layer) of the eye in a way that minimizes discomfort. Not all surgeons do this. I can’t stress this enough – find a surgeon with experience, especially if you are undergoing an extreme eye correction like I did.
Fast forward to the second day after surgery. I went to bed the night before feeling very self-congratulatory. I was winning PRK. Minimal pain, great vision. I actually told Pat – “I’m so glad I have a week off. It’s going to be like vacation.”
If that doesn’t foreshadow a turn of events, right?
I woke up on Day 3 and couldn’t see $h!t. Everything was blurry. It was what I was expecting PRK to be like – just a day late. The day was a blur – literally. It was like I had the wrong prescription looking at the world. I kept having the sensation that if I could just put my glasses on, it would all be ok. Even with getting close to things or squinting I couldn’t get them to focus though.
Talk about boredom city. I blew through the remainder of the second season of serial and then through the entire season of s-town. Podcasts are a PRK lifesaver.
On Day 4 I could still hardly see anything. I was back to work in only 3 days, so I started to worry that I might not be ready. Would I be able to write patient notes with my vision like this? I put my phone in old people mode and could still just barely read my emails. Then, throughout the day, my eyesight improved in almost a stepwise matter. It was magical. There’s nothing like temporarily losing your vision to remind you what a gift it is.
The ‘aha’ moment, where I realized it was really working, came when I was laying in bed next to Pat. For the first time I saw his face clearly without the aid of contacts or glasses. Such an incredible feeling!
I continued the steroid drops and my vision continued to improve. Three weeks out, one eye had perfect vision but the other was still a little blurry. I knew it wasn’t a guarantee that I would be able to see perfectly when things were all done, but it seemed like my eyes wouldn’t be quite perfect. Luckily it was only noticeable when I was using the computer, although between being a doctor and a blogger I spend absurd amount of times sitting in front of a screen.
Then one day I woke up and the blurriness was gone. At my month check up, my eye sight was almost 20/15. Better than perfect. I owe it all to the UCSF Lasik surgery center and Dr. Hwang. Even though I’m four months out, I still occasionally reach for my glasses when I wake up in the morning. It just doesn’t seem real. The redness and eye dryness that I had before this journey is gone. I just went camping and didn’t have to worry about putting in contacts! It’s amazing.
The private practice offices I visited felt very shiny and glamorous. The consultation procedure was streamlined, everything ran on time and the clinics were very comfortable. UCSF, an academic center, was the opposite. Typically appointments ran 15-30 minute behind, the clinic is brown and old-fashioned and the process of making appointments is challenging at best.
Those things are not why you should choose your eye surgeon. You should choose them based on skill and operating record. Dr. Hwang is an expert in extreme eye surgery corrections. He’s organized large trials and done thousands of these procedures. At the end of the day I’ll take skill over customer experience any day. At the end of the day, you want the guy.
Any questions about my experience? Feel free to reach out and I’ll try my best to answer!
Are Lasik & PRK Worth It?
For me, having Lasik & PRK eye surgery was 100% worth it. Given the low risk of each procedure and relatively low recovery time, coupled with the high success it was a no brainer. The fact that my extremely bad eyesight put me at risk in the setting of an accident or natural disaster was also a big factor in this decision. The biggest consideration is cost which is obviously something very personal.
Disclaimer: I’m a doctor but I’m not your doctor! This story is my experience as a patient and should not be taken as medical advice. For questions about these procedures, you should contact your own doctor.