Medical training traditionally dictates that one doesn’t operate on a family member. When my husband needed a touch up on his refractive surgery I thought I would ignore that credo and take matters into my own hands- both an as exercise in self-awareness as a surgeon and an opportunity to empathize with my patient’s family members.
My husband’s original prescription was about a -6.00 meaning his was so nearsighted the alarm clock was out of focus in the morning. After PRK was performed by the Army hospital he enjoyed 20/20 vision for a long time. Ten years after his surgery and now married to an Ophthalmologist, my husband noticed he couldn’t see street signs as quickly as I could. I brought him in for an exam and he was a bit nearsighted again, about a -0.75. He could still see to drive and certainly, the alarm clock was well in focus, the world just wasn’t as sharp as he had remembered.
PRK (photorefractive keratectomy) is commonly known as “LASIK without the flap.” Instead of making a thin flap in the cornea as is done in LASIK, the laser treatment in PRK is applied to the surface of the cornea, eliminating all potential complications of a LASIK flap. Though LASIK is approved by the military, PRK is still commonly preferred. One disadvantage of PRK is the longer healing time. Instead of a LASIK flap which heals overnight, the surface treatment of PRK takes about five days to fill in. Both surgeries can have vision fluctuations for over a month with glare and halos. Both surgeries can also be “touched-up” if needed, which is what I decided to do for my husband.
The day of the surgery came. I have counseled patients dozens of times about PRK surgery expectations and post-op healing times. Now I was about to experience it from the family member point-of-view. During the surgery, I was very proud of my husband as a patient. He was a little “loopy” from the pre-op Valium but held perfectly still during the procedure. He told me it was sometimes hard to keep the eyes focused on the red light but nothing about the surgery hurt. He said he was comforted by the count-down we gave so he knew how much time was left in the procedure. After the treatment, I put a clear bandage contact lens in each eye to help the healing. I checked his eyes with the microscope and put on his clear goggles for protection.
After the surgery was over I expected that he would want to go home and sleep. He was off of work, had just had Valium and laser eye surgery so a nap seemed like a reasonable choice. He wanted pizza instead. We got a few funny looks sitting down to order at Pizza Perfect with him wearing taped goggles and sunglasses. He said he felt fine and could already see better, even though his eyes were watering. He put in two sets of drops before taking a sleeping pill and going to bed for the night.
The next morning was his first post-op exam. At that point, he was fairly uncomfortable with watery eyes and a lot of light sensitivity. I woke up thinking, “I’ve made a mistake!!” He considers himself “tough” and elected not to take a pain pill and only used his “rescue drop” a few times. He wore his sunglasses inside all day and slept a lot. I woke him up to use his drops but he preferred to stay in bed. I wondered if he was staying in bed just to avoid me. The next day was a little better with the light sensitivity and irritation but his vision was worse. I reassured him that this was a sign that the surface was healing. Meanwhile, I was definitely questioning whether it was a good idea to do surgery on a family member… any discomfort he was feeling was because of me! I was wondering if he regretted it too. However, the third day he felt much better and said his eyes only felt scratchy like he had a dirty contact. He was able to drive himself to my office for an exam even though the vision was a bit “double”. His eyes were almost healed so I left the clear bandage contact lenses in. They were ready to come out the next day and he only had minor irritation of both eyes.
Inside I had a huge sigh of relief. His post-operative course was just like how I counsel patients but each day seems so much longer when the patient lives with you! He experienced nighttime glare for a few months but he is now 20/20 and we are both happy we went through the experience together. We even met one of our best friends while at Climb Nashville a few days after surgery because, turns out, climbing in goggles is an excellent conversation starter. I’m grateful I can confidently counsel patients on the PRK experience and have complete trust in the procedure, enough to live through it with my family member.
