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PRK Laser Eye Surgery

Photorefractive keratectomy, or PRK, is a type of laser eye surgery used to correct mild to moderate nearsightedness, farsightedness, and/or astigmatism.

All laser vision correction surgeries work by reshaping the cornea, which is the clear front “windshield” part of the eye, so that light traveling through it is properly focused onto the retina located in the back of the eye. There are a number of different surgical techniques used to reshape the cornea. During PRK, an eye surgeon uses a laser to reshape the cornea. This laser, which delivers a cool pulsing beam of ultraviolet light, is used on the surface of the cornea, not underneath the cornea, as in LASIK.

What Are the Advantages of PRK Eye Surgery?

PRK eye surgery is highly accurate in correcting many cases of nearsightedness. Approximately 80% to 90% of PRK patients have 20/20 vision without glasses or contact lenses one year after the surgery; 95% to 98% have 20/40 or better without glasses or contacts.

What Are the Disadvantages of PRK Eye Surgery?

Disadvantages of PRK eye surgery include:

  • Mild discomfort, including minor eye irritation and watering, for one to three days following the procedure
  • Somewhat longer time than LASIK for vision to improve to obtain maximum vision improvement; typically, patients are 80% at one month after surgery, and 95%-100% by three months after surgery. LASIK, in contrast, corrects vision much faster.
  • Some patients may still require glasses after PRK, just like with LASIK.

What Are the Potential Side Effects of PRK Eye Surgery?

PRK patients typically experience mild discomfort in the first 24 to 72 hours after surgery and many experience temporary sensitivity to light. Within the first six months after surgery, other potential side effects may include:

  • Loss of best vision with or without glasses
  • Mild glare that may be permanent
  • Mild halos around images

photorefractive keratectomy

How Do I Prepare for PRK Eye Surgery?

Before your PRK eye surgery you will meet with an eye surgeon or a coordinator who will discuss with you what you should expect during and after the surgery. During this session your medical history will be evaluated and your eyes will be tested. Likely tests include measuring corneal thickness, refraction, corneal mapping, and eye pressure. Once you have gone through your evaluation, your surgeon will answer any questions you may have. Afterwards, you can schedule an appointment for the PRK procedure.

If you wear rigid gas permeable contact lenses, you should not wear them starting three weeks before your evaluation. Other types of contact lenses shouldn’t be worn for at least three days prior to the evaluation, as well.

On the day of your surgery, eat a light meal before coming and take all of your prescribed medications. Do not wear eye makeup or have any bulky accessories in your hair that will interfere with positioning your head under the laser. If you are not feeling well that morning, call the doctor’s office to determine whether the procedure needs to be postponed.

What Happens During PRK Eye Surgery?

PRK eye surgery is done under topical anesthesia put directly into the eye, and the procedure generally takes a maximum of about 10 minutes to do both eyes. The eye surgeon will carefully remove an area of surface epithelium, “skin,” to access the top layer of the cornea before the laser treatment. The eye surgeon then uses a laser to reshape the cornea to treat your prescription. This laser, which delivers a cool pulsing beam of ultraviolet light, is used on the surface of the cornea, not underneath a layer of the cornea, as in LASIK.

What Should I Expect After PRK Eye Surgery?

Most of the time, a bandage contact lens will be applied immediately after PRK eye surgery. This contact lens is usually worn for the first five to seven days to allow the surface of the eye to heal. You should expect to visit your eye doctor at least a few times during the first six months after surgery, with the first visit being one to three days after surgery. Once the surface of the eye is healed, the bandage contact lens is removed.

Your vision may fluctuate between clear and blurry for the first few weeks following eye surgery and you may need to wear glasses for night driving or reading until your vision stabilizes. Your eyes will be dry, even if they do not feel that way. Your doctor will give you prescription eye drops to prevent infection and keep your eyes moist. These drops may cause a slight burn or momentary blurring of your vision upon using them. Do not use any drops not approved by your eye doctor.

Your vision will gradually improve, and should be good enough to allow you to drive a car within one to three weeks following surgery. Keep in mind, however, that your best vision may not be obtained for up to six weeks to six months following surgery.

Will I Still Need Reading Glasses to Correct Presbyopia After I Have Had PRK?

Presbyopia (blurred reading vision in the presence of excellent distance vision) happens in vitrually everyone, typically around ages 40 to 45. It can be corrected with reading glasses or by allowing one eye to focus at close distances and the other eye focused far away. This is called monovision and can be achieved with laser refractive surgery, or contact lenses. With monovision, the non-dominant eye is corrected for reading and the dominant eye is corrected for distance. Like LASIK and contact lenses, PRK can be used to create a monovision result for patients in their 40’s and older who would like the ability to read without reading glasses. Whether to target monovision should be part of your preoperative discussion with your eye surgeon.

Posted by: Dr.Health

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