ODs pleased after undergoing PRK

Issue: January 1997

ByBob Kronemyer

A satisfied customer: Cheri L. Vincent, OD, was so pleased with the results on her first eye that she asked surgeon Ray M. Stein, MD, to immediately treat her other eye.

EAST LANSING, Mich. — Before undergoing photorefractive keratectomy (PRK), Cheri L. Vincent, OD, who enjoys wind surfing, was becoming contact lens intolerant, experiencing dryness in her right eye. "The freedom I gained since the procedure has been a real joy," said the 35-year-old practitioner in private group practice here.

Vincent was surprised at the lack of pain after the procedure. Her preoperative refraction was -3.75 -0.75 x 155 OD and -3.75 -0.75 x 160 OS. Her postoperative refraction is +0.25 in the right eye and +0.50 in the left eye. Preoperative vision was 20/15 in each eye with correction; postoperatively it is 20/15 in each eye uncorrected. Ray M. Stein, MD, a surgeon with Beacon Eye Institute in Toronto, Canada, performed the procedures in June 1995.

Although a strong believer in PRK, Vincent feels practitioners must consider the effect on near vision. "If a patient is used to removing eye glasses to read and do fine tasks, this changes that," she said. "Patients must understand that PRK will not eliminate their need for glasses.They will eventually need reading glasses and possibly a slight distance prescription."

Continuing education patient

James E. Powers, OD [photo] --- James E. Powers, OD

James E. Powers, OD, an avid swimmer and sailor with mild contact lens intolerance, is the center director of Capital Eye Consultants in Fairfax, Va., a subsidiary of Omega Health Systems Inc. His first eye was treated in October by the medical director of Capital Eye Consultants, John C. Baldinger, MD, at the 20/20 Laser Services center in Fairfax, as part of a PRK continuing education course where Powers lectured.

Three weeks after undergoing PRK in his left eye (which was -4.00 -0.75 x 75), the 42-year-old Powers had his right eye (which was -4.50 -0.50 x 130) treated. His preoperative visual acuity was 20/15 corrected in each eye. Presently, his left eye is +0.50 -0.25 x 75 and his right eye is +0.25 -0.50 x 130.

Powers was surprised at how quickly he recovered his vision in the first eye. "Four days after surgery I removed the bandage lens and my vision was about 20/50, then 2 days later it was 20/20 and it hasn't varied since then."

His right eye was a different story. "It's only about 20/30 with a double image," he says. "But when I use both eyes together I don't notice it." He expects the eye to recover to 20/20 within the year.

Unlike Vincent, Powers experienced severe, deep pain, although he admits he made the mistake of continuing to work after both procedures. He used topical proparacaine to relieve the discomfort.

Results better than expected

Stephen M. Prince, OD, in private group practice in Mt. Pleasant, Mich., is a jet-ski and downhill-ski enthusiast. He was contact lens intolerant and wore very thick glasses, with a preoperative refraction of -5.25-1.50 x 175 in the right eye and -6.25 -1.50 x 168 in the left eye. His goal was merely to have a minimal prescription. "I didn't expect it to get as close as it did," he said.

As with Vincent, Stein also performed Prince's PRK in June 1995. Today, Prince is 20/20 uncorrected in the right eye and approximately 20/25 uncorrected in the left eye. However, he has early presbyopia, requiring reading glasses a total of about an hour a day.

Prince also had some haze that began increasing nearly a year after PRK. The haze was nearly unnoticeable except by slit lamp exam, and it has largely resolved itself. His postoperative refraction is +0.25 -0.25 x 180 in the right eye and +0.50 -0.75 x 180 in the left eye.

"While not perfect, the outcomes are close enough for most people to be very happy," he said. "But it's important that you don't sell the procedure as 'never having to wear glasses again.'"

For Your Information:
Cheri L. Vincent, OD, can be reached at 310 West Lake Lansing Road, MI 48823; (517) 337-8182; fax: (517) 332-0038; e-mail: visioncare@voyager.net.
James E. Powers, OD, can be reached at Capital Eye Consultants, 3025 Hamaker Court, Suite 101, Suite 101, Fairfax, VA 22031; (703) 876-9633; fax: (703) 876-0163.
Stephen M. Prince, OD, can be reached at 1535 East Broomfield Road, Suite B, Mt. Pleasant, MI 48858; (517) 772-2020; fax: (517) 772-5319.