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Post Info TOPIC: CXL + PRK Experience - New York


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Date: Tue Jan 6 3:22 AM, 2015
CXL + PRK Experience - New York
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Hi everyone, reading everyone's experiences on this board has been very helpful in preparation for my CXL + PRK procedure next week. I decided to write about my upcoming experience as I go through it in case someone is in a similar situation as I am.

I was diagnosed with form fruste keratoconus back in march 2014 at 26 when I went for a LASIK consultation. It's very mild and limited to my left eye. The LASIK doctor recommended Dr. Donnenfeld in Long Island, NY.

After a consultation with Donnenfeld he suggested CXL and PRK to stop the spread of kc while its still early and PRK to improve my vision. After doing all sorts of tests and taking measurements we set a date for the surgery, Jan 16, 2015.

My vision is -4.75 in each eye. To function, I wear glasses and have near-perfect or perfect vision when I'm wearing them without any problems.

I'm a little nervous before the procedure since I currently don't really have any issues with my vision and am worried about haze or ghosting after the surgery. Also I'm relatively young at 27 and still need my eyes for a while longer.

My next post will be next Friday after the procedure, assuming I'm in any condition to think or write.



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Executive

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Date: Tue Jan 6 3:27 PM, 2015
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Dima, Your in good hands, Dr. Donnenfeld is well respected. Do keep to his advice on the pre and post after care. It is the case of the earlier the batter with most of the treatments and CXL is the only one thats proven to treat progression.

Best of luck



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Date: Tue Jan 6 4:44 PM, 2015
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Remo, thanks for the encouragement! I'm really nervous about the surgery and constantly having second thoughts. We'll see how it goes...

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Date: Sun Feb 1 6:08 PM, 2015
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Hi all,

It's been slightly over 2 weeks since I got CXL + PRK and I wanted to share my experience thus far now that I can somewhat see the computer screen.

Short summary:
I had PRK first, there was no pain or discomfort at all and it must've taken about 5-10 minutes- flew by in a flash. I went into another room for CXL and received riboflavin drops in my eyes for 20 minutes at 2 minute intervals. Next the UV light was shone in each eye for 2 minutes each. Shortly after the surgery there was significant burning pain which extra-strength advil PM helped. The next day my vision was pretty good, not perfect though. The doctor told me my epithelium has grown back on Day 3 and removed the bandage contact lens. Over the next week my vision gradually got worse before beginning to improve day by day after the first week. Currently my vision is still recovering. Night vision is pretty good (not perfect) aside from starbursts (slowly going away) and ghosting(unfortunately no sign of going away yet).


Long Story:

Surgery Day:

I was given my instruction sheet and plenty of wetting drops before I went into the operating room. The techs dropped anesthetic drops into my eyes every few minutes while the Laser machine was being prepped. After about 5 minutes of waiting I went into the laser room and laid down. It's chilly in there but not too bad if you wear layers. I was given a few more drops of anesthesia and the doctor came in. He put a patch over one eye and placed a clamp so I couldn't blink over the other eye. Surprisingly, it wasn't uncomfortable at all. He began to remove the epithelium with what looked like a thin wire. There was no discomfort at all and I couldn't feel a thing. He removed it fairly quickly and told me to look into the blinking light of the laser machine right above me. The machine made some loud noise and i smelled a faint smell of burning flesh - it wasn't overwhelming or that bad. It reminded me of the smell of the dentist's drill during a tooth cleaning except fainter. Overall, not bad. The techs placed wetting drops into the eye and removed the clamp. He placed a patch over the operated eye and began to do the same to the other eye. Again, there was no pain or any discomfort. The operation must have taken about 5-10 minutes - it was very quick.

Next, I got up and went to a nearby room for the CXL. The doctor told the tech to do 20 minutes of drops with 2 minutes of UV in each eye. The tech put in more anasthetic drops and began to administer the riboflavin drops every 2 minutes for 20 minutes in both eyes. The drops didn't sting or hurt at all. They make everything yellow- sort of like wearing yellow sunglasses. After 20 minutes, the tech turned the UV light onto each eye for 2 minutes. It's like staring at a bright light blue light. It doesn't hurt or feel uncomfortable at all.

After, she put in contact lenses, taped eye shields on my eyes and put bulky sunglasses on my face. I was free to go. I stopped by the front desk and made an appointment for the next day and got into the car and was driven home. After about 10 minutes in the car, I noticed a burning sensation in my eyes. Still didn't feel too bad yet. After a few more minutes, the burning got much worse and I couldn't keep my eyes open. They began to tear heavily and everything around me became too bright for my eyes to handle (it was a sunny day unfortunatly). The pain began to get worse and worse as my eyes felt like they were on fire. They clamped down shut like a vault and streams of tears began rolling out from them. As soon as i got home i took an advil PM and went to bed. My room had the blinds drawn and barely any sunlight peeked through the blinds but it was still too bright for me. I had to get under the covers as i was extremely light sensitive. I went in and out of sleep and the pain partially subsided. I had to take pred forte(anti-inflammatory) and ofloxacin(anti-biotic) 4 times a day. I could barely open my eyes wide enough to get the drops in and had to force my eyes open by pulling my eyelids back. Luckily, by the time evening rolled around i fell asleep and woke around 8am the next day.

DAY 1:

The pain was gone and I woke up to surprisingly sharp vision. I could see almost perfectly but felt like there was a shower curtain over my eyes as not everything was in focus. I went to my post op that morning and the doctor said my cornea is healing well. She checked my vision and I was about 20/40 overall. The rest of the day was spent in bed listening to audio books and podcasts, taking vitamin C, fish oil, eating carrots, and drinking plenty of water. There was no pain or discomfort. I could see some ghosting, halos, and starbursts from electronic lights.


Day 2-6:
It seems like my vision gradually became worse over these few days. On Day 3 I had a post op. The doctor said my epithelium was healed and removed the contact lenses and told me I'm healing well. I made a post op appointment in 2 weeks and left. During this period, at night, i could see significant starbursts from vehicles and street lamps. In light, everything appeared blurry and washed out- like someone set the contrast too high. Everything looked like it was behind plastic wrap with no focus. Interestingly, whenever I drop the wetting drops everything becomes sharp and in focus for a second before i blink and everything looked blurry and smeared.

Day 7-16:
After 1 week, I discontinued the anti-biotic drops and reduced the anti-inflammatory drops to 1 time each day. At day 14, I'll stop taking the anti-inflammatory as well. Although my eyes don't feel dry I continue to take the wetting drops (Refresh preservative-free) about every 30 minutes just in case.
Over the next week and a half my vision became slightly better as my eyes recovered. However, I do notice that my right eye (good eye before surgery) is blurrier and has ghosting whereas my left eye is sharp and has no ghosting- strange. Some focus returned as now i'm able to see big letters and store signs. My night vision is pretty good aside from the starbursts and ghosting- but at least the starburst and halos are getting smaller each day whereas the ghosting is the same.

My job involves typing on a computer for 8 hours a day and it's pretty hard to work with the ghosting. I magnify the screen size but the ghosting makes reading even big letter difficult. Overall, I'm optimistic and it appears like my vision is getting slightly better each day, although its so slight that it's hard to tell day by day. My main concern is the ghosting in my right eye as it doesn't seem to be getting any better. I'm still taking plenty of fish oil, vitamin c, and drinking lots of water each day. My post op with Dr. Donnenfeld is this Wednesday (3 days away) and this would be the first time he's examining me, since he was away at a conference and other doctors saw me instead. I'll update everyone after the post-op. If you have any questions or want to find out something, feel free to ask.

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Deb


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Date: Sun Feb 1 6:53 PM, 2015
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Hi Dima,

I'm glad you are over the the worst part! If it can be called that!

There will be swelling of the cornea as it heals which sometimes helps early on with vision post op. The vision does drop before coming back round again and improving.

Do you have haze ? ask the Dr when you see him (its like if the vision feeling milky?) be sure to know on this, that this is something common and part of the healing process until it fades away.

Debby



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Date: Mon Feb 2 9:12 PM, 2015
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Thanks for the write up, it does really help to know from another.

Would you say you can do most things now whilst your are still recovering ? can you watch TV ? what about driving ?

Are you using vitamin C, fish oil, eating carrots, and drinking plenty of water as it was suggested by te Dr ?

I hope you can call your self a past patient soon enough.

Bobby



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Date: Mon Feb 2 10:26 PM, 2015
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Deb - I'm not sure if I have haze. The 'washed out' effect in lit rooms could be the haze. I'll definitely ask about it during my appointment, thanks for the advice.

Bobby- Yes, I can do the majority of things. Reading small text on books/screens is difficult and I definitely find myself either using a magnifying glass or zooming in on the text.
I can watch TV from about 10 feet away and see very well. The issue with TV is that certain things on the TV have ghosting (people, text, etc) which gets in the way.

I haven't tried driving yet but daytime driving should be fine. At night it probably is possible but would require a higher degree of caution with the starbursts and ghosting from traffic lights, street lamps and car lights. I would probably be able to see speed limit signs and large text on signs. At this point to be safe I would avoid driving for about another week (the 3 week period).

I'm taking those supplements not on the orders of my doctor but from what I read on here and figured it's part of a healthy diet anyway.

Thanks for your encouragement!

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Date: Wed Feb 4 11:18 PM, 2015
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DAY 19:

Went to the doctor today for a checkup. He told me there is no haze and my eyes are healing perfectly, even ahead of where he thought I would be at this point.
Not sure I'm doing that well, but its good to hear that.
I'm pretty sure I heard him mention an abrasion on my right eye (the eye that is blurry and has ghosting) but he didn't seem worried. He said it the ghosting and blurriness will go away very soon and appeared confident I'll be able to achieve perfect vision.
He told me in about 2 months my vision will reach its peak, with the ghosting going away and the blurriness going away.

Aside from this visit, it appears that the starbursts are almost gone- they appear to be very slight compared to a week ago.
I'm able to drive during the day, even being able to perfectly see the 5'' Garmin GPS screen. Haven't tried driving at night yet.

Hopefully the ghosting and blurriness in the right eye go away soon. Other than that, it seems there's some slight progress every day.

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