My account of Wavefront TransPRK at London Moorfields – June 2022

At the age of nine or ten years old, I remember a school friend telling me that she “liked my new glasses”, which were are large pair of rectangular gold metal spectacles, picked perfectly to match my bright ginger hair! I suspected she might have had a crush on me; however, that turned out to be short-sighted.

I don’t recall what my first ever prescription was back then, but it was enough to need them to help me read the blackboard from the back of the classroom. Since those blury days, my eyes seemed to get worse at every eye check up resulting in wearing -8.00 spectacles at my mid-life crisis point of 45.

During primary school and my early secondary school years, I could get away with only wearing spectacles to watch TV or support my studies but by the time I was sixteen I had become fully dependent on them. At eighteen I switched to soft contact lenses, which I wore for 12 hours a day (way beyond the recommended wear time).

At the age of twenty four, laser eye surgery was pretty common among TV adverts, so I decided to go for a suitability consultation with a company called Maxivision. I attended the appointment in Reading where I was assessed by a young lady who represented the company. I had eye drops to dilate my pupils and went through a number of visual inspections of my eyes and remember returning to the office that afternoon looking like a cat, with huge pupils. The result was that I was a perfect candidate for LASIK and I was booked in to attend surgery at their Harley Street facility a few weeks later where something bizzare happened… On the day, what appeared to be junior doctors conducted my pre-surgery checks where they raised the alarm to the eye-surgeon that they were worried that I had “steep corneas”. The surgeon spent about ten seconds looking at my eyes and backed up their concerns! I was told that I had steep corneas and suspected Keratoconus. The team told me that they could confirm or discount those concerns a week later as they were installing an “orb scanner” – a new piece of technology or could simply cancel and receive a refund.

As far as I was concerned, the outcome I got from my first attempt at laser eye surgery was the right one, because if in doubt – don’t take a risk with your eyes. A far better result than “having a go” and “cocking it up”, so I decided not to proceed. Isn’t it odd that a one hour in-depth assessment with machines was completely overridden by a a visual inspection on the day of surgery?

Twenty years later I decided to get a second opinion leaving two decades for advancement in technology. After careful research and some recommendations from friends I decided to go for a consultation at Moorfields Private, deliberately avoiding Laser Eye Surgery advertisements on the TV and Internet and choosing the best eye hospital in the country.

Consultation Appointment

On the 3rd of May 2022, I arrived at Moorfields OutPatients department in London to meet Dr Bruce Allan. Before I had my consultation with him, I was taken from room to room in their private suite to have a number of tests and measurements taken. I had a standard eye test as well as having my eyes scanned by different machines, which was a very high tech experience mapping out my eyes and providing a detailed topography.

The result of the consultation was that I am the perfect candidate for laser eye surgery and no signs of abnormal corneas or Keratoconus. I had gone to see Dr Bruce believing that I would not be suitable or alternate treatments such as implantable contact lense might be the only option, but this turned out to not be the case. Note to the people reading this from Maxivision twenty years ago; go and get your eyes tested!

Given my age and -8.00 prescription, Dr Bruce recommended Wavefront TranksPRK as this was the lowest risk option and also the one that would yield the best result and I booked in for surgery there and then as I was so keen to get my vision corrected.

Surgery Day (Day 0)

I travelled to the main Moorfields eye hospital in London on the 7th June after arriving back from holiday in Spain at 2am that same morning. My appointment was at 11:30 and by 13:00 I was out and on my way home under the care and “supervision” of my wife.

After checking in at reception and a brief wait, I was greeted by a nurse who took my wife and I through the after care instructions. She pulled out a carrier bag full of drops and oral medication, which was daunting and a little bit confusing in the moment.

In a nutshell, I was given the following medication:

• Pain relief drops in the form of aneasthetic drops (Proxymetacaine), which would be taken as required, but not more often than hourly.
• Anti-inflammatory drops (Dexamethasone), which would be taken hourly.
• Anibiotic drops (Moxifloxacin), which would be taken four times a day for seven days.
• Dilating / relaxation drops (Cyclopentolate), which would be taken once on Day 0 and then twice on Day 1.
• Tear supplement to keep the eyes moist (Hyabak)
• Oral medication:
  • Chewable vitamin c to aid healing
  • Paracetamol to provide pain relief
  • Naproxen anti-inflamatory / pain relief
  • A sleeping tablet for the first two nights (Zopiclone)

After the after-care brief, I was greeted by Dr Bruce who took me to the laser suite where he was assisted by two other members of staff (I guess they were nurses). I was asked to lie down on the ‘bed’ face up, I put on a hair net and had my COVID face mask taped down.

The laser machine was then brought over my face – here we go!

One eye was covered up and after head and neck alignment with the machine, I had aneasthetic drops placed into my eye and when Bruce was happy, he turned on the laser. All I had to do was stare at a green light and experience the smell of hair burning, which was the smell of the laser performing its task on my eye (ablation). After 10 to 20 seconds, the laser stopped, he wiped my eye with a soft implement, rinsed with saline and then popped in the bandage contact lens, which was basically a normal zero prescription, highly breathable lens.

He covered up my eye and then repeated the procedure on the other eye and the procedure was finished. I sat up from the laser and was reaquainted with my wife and with my carrier bag of drugs was told to go home.

Absolutely nothing to it; quick and simple. Just look at the green light and relax!

I felt fine, my eyes were hazy and blurry but bye-bye glasses and we made our way home.

Now the terrible part (all my fault of course). By the time we got to Paddington station, the anisthaetic had worn off and I could feel pain, my eyes were watering and I couldn’t open them for the floods of tears and burning sensation in my eyes. I put up with this discomfort all the way home to Gloucestershire and after a panic stricken moment, I called Dr Bruce on his personal mobile. He told me to calm down and to take the anaesthetic drops, which removed all of the pain, stopped the tears and returned me to being a panic free human being again.

What was to come was three days of pain management, discomfort and a continuous wave of eye drops.

Day 1

Not much to say, other than I couldn’t see distance or close up, so there was very little I could do, other than listen to my audio book or the radio.

I took my sequence of drops and medication and relied carefully on the anaesthetic drops to get me through the day, taking care not to over use them. I think I took this magic drop every 1.5 to 2 hours whilst I was awake.

Day 2

Same as day 1; however, I started to worry.

Why isn’t my eye sight improving?

What if my eyes don’t heal?

What if I don’t get the result I’m looking for?

What if I can’t get back to work next week?

Panic! Panic! Anxiety! Was this the right thing to do?

Continued with my drops…

Day 3

Same as Day 2; but the pain was much more maneagable and I could see light at the end of the proverbial tunnel.

The anxiety persisted and with my short term vision coming back, I started googling every combination of the question ‘how long does it take to recovery from TransPRK?’

What did I find out? TransPRK is not a 7 day recovery as I somehow understood it to be; it was in fact going to take several weeks and more like 3 months.

Increased PANIC! How will I work? How will I drive? What will I do with myself? What if it hasn’t worked? Was this the right thing to do?

Continued with my drops…

Day 4

The pain was over and my near term vision was great, but I still couldn’t read a number plate at twenty yards and I struggled to watch TV or use my computer.

Still panicking and Googling more and more to find a different answer to the three months I was getting back.

Continued with my drops…

Day 5

No pain.

Anxiety, panic management!

Still couldn’t read a number plate at twenty yards and I struggled to watch TV or use my computer.

When am I going to get to see Maverick at the cinema? Will I miss it at the cinema? When will I see again?

Now the bloody bandage contact lense has clouded over and my vision is getting worse and I don’t feel good about the contact lense. I texted Dr Bruce who returned my text telling me if I was comfortable to remove the contact lense myself, he would be happy with that.

With a cloudy contact lens, I thought I may as well sleep on it, so I went to bed.

Day 6

No pain.

I removed my own bandage contact lense.

Still taking the various drops.

Still worried about not being able to drive the next day.

Day 7 – Consultation Day

I cycled 10km to my local station, because I still couldn’t drive; but I was pain free and contact lense free.

I arrived at the Moorfields OutPatient department just as I had on my first consultation and after brief wait, I was greeted by Dr Bruce. His only objective was to look at my eyes using his high magnifiation microscope thing (same as you have at the optician) to check that the surface skin had healed and he said “everything looks perfect, you can go! see you in 3 months”.

? Where was the eye test and a repeat of all the earlier scans to see if it had worked ? Ah, we’re going to do all that in 3 months as Day 7 is far too early.

I explained to Dr Bruce that I was a bad patient, that I had set and managed my expectations incorrectly and that I was panicking and anxious. He simply said from his side of the table, the procedure went incredibly well and than on visiual inspection of my eyes, everything was “perfect”. And he repeated that the healing process for TransPRK is weeks and months and that over the next 2-3 weeks and longer I will see gradual improvement.

So, I need to suck it up and wait it out…

At the end of Day 7, I’m pain free, contact lense free and on a reduced set of drops with time as my healer going forward.

I did manage to cycle 10km on the roads to the station and make it across London by Tube on my own and read my phone for 1.5 hours on the train; but still panicked by not being able to drive or watch TV without sitting on top of the T.V.

Week 2

As I enter my second week post surgery, I have no pain or discomfort and as I described in my post op consultation with Dr Bruce, I’m patiently waiting for my vision to get back to at least driving standard.

I can confirm that second day of week two I can see the number plate of the car parked opposite, although still a little blurry. I could drive today, but there is no immediate need, so I’ll wait a bit longer but I feel confident that by the time I need to drive my son on Sunday (3-4 days from now), I believe I’ll be at the driving standard. Result!

Month 3

During the last several weeks, I got on with life, but I knew my vision was not perfect and I also knew that my left eye was far worse than my right. Whilst my vision got better in the first couple of weeks, it got a bit worse as time went on.

I phoned Dr Bruce and told him I was worried about my left eye and he insisted that we wait until the 3 month appointment.

On the 14th of September 2022, I returned to Moorfields for my three month check up where I had all the exact same tests and opticians appointment and the exact same people that I met on day one.

The result is that I’m -1.75 in my left eye (as suspected) and -1.00 in my right eye.

After the tests, I had an appointment with Dr Bruce where I received what had become pretty normal by now; a very complacent response with no remorse, apology, sympathy or empathy.

“so it seems you are a little under corrected in both eyes”…

No explanation why, no commentary at all on why I had this result and a response from him that this was pretty normal.

What he failed to “see” was that I had lived for 3 months without spectacles in a worse position than I had when I first went to the clinic and had to struggle with long distance.

My short distance, computer and reading was absolutely fine, but I couldn’t recognise people 5 meters away.

So the option I’ve been left with is stay as I am or have my right eye done again to get an improvement in my long distance; i.e. target 0 in my right eye.

So I left happy’ish that I spent £5,000 on getting from -8.00 to -1.75 L / -1.00 R, but it’s left me in a peculiar position.

As I left the surgery I booked a 6 month appointment to see if my vision is stable and have a conversation about repeating the surgery in my right eye.

That same week on the Friday, I went to my own optician who charged me another £40 for an eye test and £190 for new lenses for my old spectacles. Wonderful! At least I can now see again. but!……….

My peculiar position that I mentioned above is that I don’t need glasses to write this blog, but I do need to put them on to watch TV, take the dog for a walk, drive, go to the pub. And I find myself one of those people having to take my glasses on and off; so in a way, I’m worse off than before because I just wore my glasses for everything before surgery.

My local optician said my result is actually very good and warned that I don’t get the right eye corrected down to zero, because having eyes more than 2 diopters apart is a bad result because the brain struggles with that size of gap.

So where am I now? I’ll be visiting Moorfields again in January 2023 to have my eyes tested again and if my vision is stable, make a decision whether to have my eye or eyes treated again. My current thinking is having one eye done creates a bigger gap between both eyes, so I’ll see if there is any benefit to having both done again, because ultimately I’m not satisfied with the result!

FAQ

• Why did you choose Moorfields?
  • My plan was to avoid internet or TV advertised companies and basically went to the best private clinic in the UK, with the best doctors.
• Why did you have TransPRK rather than LASIK?
  • Good question, I’m not sure I completely know.
  • Basically it is less risky thank LASIK.
  • Because my high prescription, it’s better to do TransPRK than LASIK as it provides more room to have another go should I need a second round of treatment.
• What is it about wearing glasses that led you to laser corrective surgery?
  • Walking into a shop and your glasses steam up.
  • When it rains and you can’t see through your glasses.
  • When you break or lose your glasses and you can’t see.
  • The cost of new spectacles.
  • The cost of contact lenses.
  • The frequency and cost of check ups.
  • When you need to work upsdie down on something when you do DIY and your glasses fall off and you can’t see.
  • When you swim and can’t see.
  • When you swim with contact lenses and they come out.
  • When you swim with contact lenses and risk getting an eye infection.
  • No matter how much I cleaned my specs, they were always dirty.
  • Certain sports can’t be done with glasses.
• Does the laser hurt?
  • Your eyes are numb from anaesthetic drops. You don’t feel a thing. It’s a bit noisy and you can smell hair burning.
  • The laser is not thermal (hot), it’s a cool blue laser that etches the eye cells from your eye.
  • I had a wisdom tooth removed last year that took 90 minutes and was the worse pain in my life. Laser is easier and quicker than having your hair cut.
• How bad is the pain during Day 0 to Day 3?
  • Firstly, it is manageable using the anaesthetic drops.
  • Without the drops, you get eye ache and an irritating, gritty feeling in the eye.
• How much does it cost?
  • £5,000 basically.
• Are you happy with the result?
  • No, not yet. Obviously I’m happy I can see without glasses but -1.75 and -1.00 isn’t really what I hoped for. If my result was -0.75 and 0 or even -1.00 and -0.25 then that would be super.
• What is Moorfields like?
  • Their private suite(s) are great, just as you would expect.
• What did you think of your consultant?
  • Great, friendly, obviously knows what he’s doing, but a bit complacent, a bit blasé, little empathy, very transactional.