Blog . Eli Duke . Com

this past monday, meredith and i drove downtown to the Swedish Medical Center where i went under the “knife” for my very first photorefractive keratectomy (PRK), which wikipedia defines as:

[a] laser eye surgery procedure intended to correct a person’s vision and reduce their dependency on glasses or contact lenses… [by] … permanently change[ing] the shape of the anterior central cornea using an excimer laser to ablate (burn off) a small amount of tissue from the corneal stroma at the front of the eye, just under the corneal epithelium.

it continues, describing the different layers of the cornea:

The outer layer of the cornea, or epithelium, is a soft, rapidly regrowing layer in contact with the air that can completely replace itself from limbal stem cells within a few days with no loss of clarity. The deeper layers of the cornea, as opposed to the outer epithelium, are laid down early in life and have very limited regenerative capacity. The deeper layers, if reshaped by a laser or cut by a microkeratome, will remain that way permanently with only limited healing or remodelling.

and briefly explains the difference between LASEK and PRK:

In LASEK the corneal epithelium is preserved with a chemical solution, peeled off, and replaced after the laser ablation is complete. With PRK the epithelium removed is discarded and allowed to regenerate. … Because PRK does not involve a permanent flap in the deeper corneal layers, the cornea’s structural integrity is less altered… [and] …does not run the risk of dislocated corneal flaps, which may occur infrequently with trauma even years after LASIK.

wow! that was a lot of blockquotes. now it’s me time!

i can honestly say, without hyperbole, that it was absolutely the most surreal experience of my entire life. no joke. it was a lot like any other kind of surgery, but it was on my freaking eyes. i could see the entire time, but i couldn’t feel anything, except for the eery sensation that this is what an alien abduction must be like!

first i was loaded up with the normal surgery gear: hair and shoe covers; i was given a whole range of antibiotic eye drops and disinfectant to prepare my eyes. the doctor sat me down, explained what was going to happen, then we headed into the surgery room. it wasn’t much more than a glorified closet, only about 10ft by 10ft with not much more than the laser and a sink.

i sat down in a dentist-like chair next to the laser, the back was lowered and the legs raised until i was lying completely flat. they put a pillow under my knees and a big teddy bear on my chest to hold.

a plastic patch was taped to my left eye while my right eye was prepped for the laser; they put in the numbing drops (which took affect immediately), taped back my eye lashes, and put in the lid spreader (think: clockwork orange).

it was at this point that the surreality kicked in. the laser itself was a huge beige box with a laser arm sticking out one side, perpendicular to the wall. the chair i was sitting in was attached to the side of the big box and could swing in such a way that would bring the patient’s eye directly under the arm of the laser.

i was now face to face with a laser, literally. picture a white circle on a black background with a blinking red dot in the middle. that’s what i stared at for about 5 minutes while they prepped my eye and then for 16 seconds while the laser chugged away, burning the flesh off my eyeballs.

but before the laser could kick into high gear, they had to clean and prep my eye. first they set up the “bucket of water” used to cool the surface of the eye. it was a tube placed directly on the eye and filled with cold water. the red light kept blinking. after that they brought out the rotating scrubbers (think street sweeper / electric toothbrush) and next came the squeegees. keep in mind that during all of this i could clearly see what was happening, but i couldn’t feel a single thing. the red light kept blinking and finally it was time.

the doctor braced my head and the laser started up, accompanied by an ominous clicking noise. “keep staring straight ahead,” he said, while the red light kept blinking. the surgery technician started counting down from “16… 15… 10… 5, 4, 3, 2, 1, and the laser is off.” i smelled burning hair. they immediately flushed my eye with cold water, put more antibiotic drops in, and covered it all with a protective contact lense. one eye down, one more to go.

i was literally in and out of the hospital in about 90 minutes. amazing. meredith drove home and i could actually see pretty well. i wasn’t experiencing any pain and i didn’t really feel any sort of discomfort until late on wednesday. even then, it didn’t feel much worse than an allergic reaction or light sensitivity with lots of tearing.

the up-keep hasn’t been bad at all. i just have to be careful not to rub or scratch my eyes to hard (and where “sport-specs” goggles while i sleep), and i have to put in 3 different kinds of drops about 4 times a day.

i woke up this morning (friday) and all the discomfort was gone. i had a doctor’s appointment today at 4pm and the contacts were removed. my vision is pretty good right now (about 20/30, down from 20/80), but there have been moments where one or both of my eyes has been at 20/20 or better. these are all good and normal signs. my vision should be at 20/20 within a couple weeks and will continue to get crisper and cleaner over the next couple months.