While LASIK is the most well-known laser eye surgery, there are alternative procedures available for patients who aren’t good candidates. One such option is PRK, an overall similar procedure which is as effective at correcting vision. Before you schedule your consultation, here are some of the basics about PRK surgery.
What is PRK?
PRK, or photorefractive keratectomy, is a type of laser eye surgery that is an alternative for patients who may not be good candidates for LASIK. Like LASIK, PRK is designed to correct refractive vision errors, meaning that it reshapes the cornea to ensure that light is correctly directed towards the center of the retina. PRK is a treatment option for patients with myopia (nearsightedness), hyperopia (farsightedness) and astigmatism.
PRK predates LASIK by several years, and was the first laser refractive surgery available. It is a safe and effective option to restore vision so patients no longer need to wear glasses or contact lenses.
PRK Candidates and Criteria
PRK is most often recommended for patients who have very thin corneal tissue or dry eyes. This is because LASIK and other laser eye surgery methods utilize a flap method, in which a small flap of corneal tissue is folded back before being replaced when the surgery is complete. This can make dry eye symptoms worse as the patient heals following the procedure. PRK removes this small amount of corneal tissue entirely, avoiding these dry eye symptoms.
The procedure is also sometimes chosen for patients who are at a higher risk of an eye injury. For example, those who have dangerous or very physical jobs or who play certain sports may be better suited to PRK. This is because there is a small risk of a flap moving out of place even after healing is complete. In PRK, the tissue that is removed grows back, removing this risk.
Before having any type of laser eye surgery, patients must have good overall eye health and a stable prescription. If a patient’s lens prescription changes within a year prior to their surgery, it’s more likely that their vision will regress after having PRK or LASIK.
Finally, patients should be aware that PRK is not a suitable option to correct presbyopia, or age-related loss of near vision. Whether patients develop presbyopia before or after they have PRK, it’s best to wear reading glasses while reading or performing other close-up tasks.
How is PRK Performed?
The first step in PRK is applying numbing drops to the eye so the patient is comfortable throughout the procedure. Mild sedatives are also available for patients who are nervous about the surgery. Once the numbing has taken effect, a speculum is placed over the eyes to prevent the patient from blinking. Then, a thin layer of corneal cells known as the epithelium is removed.
With these steps complete, the patient is asked to focus on a target light. At this stage, the surgeon will then use an excimer laser controlled by a computer to accurately and precisely reshape the cornea. This step takes just ten minutes per eye at most.
Once the surgery is complete, soft contact lenses are placed over the cornea to act as a bandage. Patients will have blurry vision following PRK, so it’s important that they have someone to drive them home after the surgery.
After a PRK procedure, patients should sleep for several hours. When the numbing effect of the drops has subsided, patients will feel some soreness, a slight burning or stinging, and a sensation that there is a foreign body in the eye.
The epithelium grows back within about a week, at which time the ophthalmologist will remove the bandage contact lens. Light sensitivity and blurry vision are typical during the first one to two weeks after PRK.
During the recovery period, patients should use prescription anti-inflammatory and antibiotic eye drops. Dry eye symptoms in the first several months after the procedure can also be treated using lubricating eye drops. Following the first day, most patients can manage discomfort using over-the-counter pain medication.
Most patients can see well enough to perform routine activities and drive within two weeks of their PRK surgery. However, complete healing generally takes three to six months. During this time, it’s normal to experience halos or glare, light sensitivity, reduced night vision, or fluctuations in your vision before healing is complete. Your ophthalmologist will monitor your healing process during regular follow-up appointments.
PRK Side Effects, Risks, and Results
Complications are rare with PRK and other forms of laser eye surgery. Some risks include under- or over-correction, corneal scarring, decreased night vision, corneal haze, and decreased vision overall. Most of these issues can often be addressed with a new corrective lens prescription or a second PRK or LASIK procedure.
Schedule a Consultation
To learn more about PRK and see if you are a candidate, schedule a consultation at Boston Laser – Boston Eye Group by calling (617) 566-0062 or requesting your appointment online.