PRK: Male, 46

August 17, 1999
Web posted at: 11:44 a.m. EDT (1544 GMT)

Name: Anonymous Male (He spoke to us on condition he not be identified, because he's seeking legal recourse.)

Age: 46

Residence: New England

Procedure: PRK

Which eyes: He had the procedure in his right eye only. He had PRK shortly after it was approved by the Food and Drug Administration. It was customary at that time to only do one eye at a time.

Because the results of the procedure on his right eye were poor, he said he felt he couldn't "risk" his left eye.

Cost: At the time, the cost was $2,000 per eye. He went to a specialized clinic that handled all the pre- and post-operative care. He only stayed under the clinic's care for six months. After that time, his dissatisfaction led him to consult different doctors.

He ended up at a second clinic, which attempted a procedure to correct his vision. Insurance covered this second procedure because it was deemed an attempt to correct medical damage.

When done: Early 1996

Why did you do it?

He said it was the first time in his life that he was out of debt and had discretionary income. That and his strong belief in what he had read about the procedure led him to believe it would be good for him.

He loves swimming and it that's something with which he can't wear contacts or glasses. He hoped that this procedure would allow him the freedom to see and do such activities he enjoys.

Would you call it successful?

"Absolutely not."

What was your vision before the procedure?

He was nearsighted, -7 or -8 in each eye.

After:

Following PRK, he was 20/40 in his right eye. But he was quick to say the 20/40 measurement is misleading. The "Big E" chart, he said, is an outdated measurement of the types of vision loss people may suffer following refractive surgery.

He is critical of doctors who use this traditional eye chart as a measure of the safety and success of refractive surgery.

"It can't measure any of the distortions that come with my distanced acuity," he said. He said he can see farther now, but his vision is blurred. "If I read the truth before the procedure, it would have said, 'See further, but worse.'"

Did this procedure meet your expectations?

"No."

Going into the surgery he said he believed that if his vision needed correction following PRK he could wear eyeglasses. He learned later that the loss of a smooth surface on the eye causes an irregular astigmatism, which is not eyeglass-correctable.

"I have highly distorted vision in my treated eye," he said, "which is profoundly worse in anything but full lighting."

He said he experiences glare, starbursts, halos and double vision all the time. The distorted vision also gives him frequent headaches.

"If I look at a light itself," he said, "a pilot light on an oven or a traffic light, I see it as very smeared."

He said he sees not only the object, but several secondary images. He compared it to looking through a greased windshield or underwater. The more shiny the object, the worse the distortion.

He does not wear any corrective lens on his treated eye and he said he has to adjust the prescription on his left eye so he can use his eyes together. The lens on his left eye is slightly underpowered so that it matches his right eye better. This helps to reduce things like heads. He said he simply has to live with the distortion in his right eye.

"I use my two eyes independently to a large extent," he said.

When he returned to his PRK surgeon with his problems, he said the doctor was "very low-key," but the other examiners with the group were hostile. He said he was personally attacked and told his vision was good and not bad. "I was told I was a phony," he said, "making things up, and so on."

His original surgeon told him all he needed was more time to heal -- and that with PRK, long healing periods are not usual, sometimes as much as one to two years.

He said that he's now read a lot of medical journal articles about PRK. Sometimes patients experience a "haze" following the procedure.

For awhile, he said, he was told that he had this haze condition. But since then, he said more than one doctor has said he had received an off-center treatment with his original PRK, causing many visual aberrations. But no doctor has been willing to put that into writing.

Would you do it again?

"No. I wish I could undo the one I did."

He has a job that requires close vision all day. The poor results of the surgery have impacted his work and made it a strain to get through his daily work routine.

In an attempt to improve his vision, he has had a second procedure at a different clinic. The second process is called PTK, or photo-therapeutic keratotomy.

He said he ended up over-corrected after the second surgery and is now a bit farsighted in his treated eye.

Any pain?

He experienced no pain from the procedure because he had narcotic eyedrops, but he said the days following were uncomfortable. He took pain killers for a couple of days to combat the sharp pains he felt in his eye during the healing process.

He said he wouldn't have cared about pain if he'd ended up with good vision, but feels he went through the pain and ended up losing, not gaining.

How would you describe the experience?

His experience, he said, was driven more by marketing strategy than by medical safety. He said the volume of people having the surgery appeared to be a consideration to the doctors.

He said doctors performing refractive surgery can make substantial sums of money in a very short period of time, more than most people will ever save in a lifetime.

"If they shared the dangers as they really are, they would lose business," he said.

He said refractive surgery success is usually measured by a person's ability to see 20/40 or 20/20. That means, he said, that many of the statistical successes are also clinical failures.

"I now know that your eye can do what a fly's does and you can be 20/20 -- and your eye can do what a fun house mirror does, and still be 20/20," he said.

What risks were you made aware of ahead of time?

He said that at the time of the surgery, he was given a fairly technical written briefing compiled by the laser company. It did mention the possibility of irregular astigmatism.

But he said he also read that over 90 percent of the people who had the procedure ended up with 20/40 or better. He said he didn't know then what he knows now about vision quality.

Did you seek out the treatment, or was it suggested to you by a doctor?

He said he sought out his treatment. He saw many advertisements as well as news articles that only had positive things to say about the procedure. "They never had people like me in them," he said.

Based on what he read, he believed it would be a low-risk procedure. He said that belief and the lure of seeing without assistance were very strong.

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