Monday, December 15, 2008

Ow, My Eyes!

Thursday I'm taking the plunge. Laser eye surgery.

I spent the weekend debating the merits of PRK vs. Lasik. With Lasik, they cut a flap in your cornea, fold it back, and correct the lens underneath. With PRK, they remove a thin layer on top of your cornea (epithelium) and then apply the corrections directly to your cornea.

So what's the difference to the patient? There's very little healing associated with Lasik...once the flap is back on top of your eye, it's pretty much 24 hours until you're able to see clearly. But that flap never heals 100%, for the rest of your life the flap could detach if there's direct trauma to your eye, or greater-than-hurricane-force-wind-shear. PRK has an affectionately named "48-hour agony period" during which you take extra painkillers, extra eyedrops, and wear an implanted contact lens to protect the eye while it heals. Vision generally takes weeks or months to gradually improve to the corrected level. But when you're done, your eye is whole again, perfectly healed.

So I'm naturally leaning toward PRK. I hate the idea of having a weakness like the flap, even though after 90 days the chance that it might detach is excessively remote. Plus I have this strange desire to test myself against the "agony period." But lots of internet research, and a useless conversation with my eye doctor, didn't produce any proof that PRK was better long-term. The odds of a flap detaching, epithelial regrowth, or other general "flap complications" are actually less than the chance you might develop corneal haze from scarring (only possible with PRK) although neither chance is high (1/500 vs. 1/100.)

So should I really risk being laid up a few weeks, possibly unable to drive, watch TV, or work on the computer, for only a psychological benefit? The potential boredom is absolutely terrifying, much more so than two days of searing pain. After all, what are the chances that I'll ever be ejected from a fighter jet or be hit in the eye with a crowbar while defending my family from a pack of thugs? As I approach 40 in my comfortable suburbia lifestyle, I'm struggling to see these as realistic possibilities.

So Lasik it is. I can't wait until Thursday, when I can stop wondering if I made the right choice and just start dealing with the consequences.


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