Photorefractive Keratectomy (PRK)

Photorefractive keratectomy, or PRK, is a laser vision correction procedure that reshapes the cornea to correct mild to moderate conditions of myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. It is the second most common type of laser eye surgery after LASIK. Unlike LASIK, there is no flap created. During PRK a portion of the epithelium, or outer layer of the cornea is removed and later grows back on its own.

• Less depth of laser treatment
• No corneal flap complications
• Ability to be performed on thin corneas

The PRK procedure offers distinct benefits to individuals whose activities put them at elevated risk of eye injury (boxers, for example) and for patients whose corneas are too thin, to permit LASIK.

While PRK may be a preferable to LASIK surgery for some patients, there may be disadvantages to the procedure as well, including:

• More discomfort for the first few days after surgery
• Longer recovery period
• Greater risk of postsurgical eye infection
• Greater risk of temporary or permanent haziness of the cornea

Both LASIK and PRK have comparable rates of vision improvement and carry some of the same risks, so a serious consultation with the ophthalmologist is necessary to determine which surgery will be most beneficial to the individual patient.

Before the PRK procedure begins, the eyes are numbed with anesthetic eye drops. Next, the epithelium is removed most commonly using an Amoils Brush, but there are other methods. Then, the surgeon uses targeted laser energy, to reshape the cornea. The surgeon has complete control over the laser throughout the procedure, for a highly precise and customized result, designed to give each patient the best vision possible. The entire procedure takes only a few minutes to perform.

After the procedure, the eyes are bandaged with a soft contact lens to protect the cornea. New cells will grow back over the next few days to replace the cells that were removed. The contact lens will be removed by your eye doctor in a follow-up examination.

After the PRK procedure is completed, patients are instructed to rest before returning home. The surgeon prescribes eye drops to prevent infection and keep the eyes moistened. You should plan on 5-7 days of recovery time.

While vision may improve immediately after the PRK procedure, full results may take several days or weeks to become apparent. Patients will likely be able to see well enough to drive a car after 2 to 3 weeks.

The results of PRK are considered comparable to those of LASIK. PRK does not correct presbyopia, a natural change in the eyes that affects people over the age of 40. Patients who require glasses for reading will continue to need them after surgery. It is important for patients to maintain realistic expectations of the results of any laser surgery if they are to be satisfied with the results.

As with any type of surgery, there are certain risks associated with the PRK procedure, including:

• Postsurgical infection
• Sensitivity to light
• Problems with night vision, such as halos
• Hazy vision
• Dry eyes

Many of the complications that may arise after PRK are similar to those that may occur after any type of refractive surgery.