Eye Surgery Prk

If you are thinking about getting corrective eye surgery, you have a number of options, depending on the current state of your vision and your budget. While many people are familiar with LASIK as one of their surgical options, photorefractive keratectomy (PRK) is another procedure that you can get.

Read on to learn about PRK eye surgery, including information about the surgery itself, PRK recovery, side effects and associated PRK risks. Jump in to the LASIK versus PRK debate, and decide if PRK vision correction is right for you.

What is PRK?

Surgeons perform PRK eye surgery with an excimer laser that uses an ultraviolet light beam to precisely remove extremely small pieces of tissue from the cornea’s surface. The point of PRK is to reshape the cornea. If reshaped correctly, the cornea focuses light better into the retina, making vision much clearer after the procedure. While some who get PRK don’t need to wear contacts or glasses after having the procedure, others still need to use this eyewear, though they need a milder prescription.

While PRK was invented in the early 1980s, the American FDA didn’t approve this procedure until the mid-nineties. Prior to FDA approval, some Americans sought PRK eye surgery in Canada.

Am I a good candidate for PRK?

Before seeking any surgery, it is a good idea to understand whether the procedure is the right choice for you. Here are some of the basic criteria that will help determine if you are eligible for PRK. You should:

  • be aged 19 years or older
  • be in normal health
  • between -1.50 to -7.00 diopters of myopia
  • have a pupil size that is 6-mm in normal room light
  • have no noticeable change in vision within the last year (called “stable refraction error”)
  • not be pregnant
  • not have pre-existing conditions that can possibly complicate or preclude treatment (Some of these conditions that can affect the success of PRK include collagen vascular diseases, such as corneal ulceration or melting, ocular disease, such as dry eye or glaucoma, or systemic disorders, such as diabetes or rheumatoid arthritis.)
  • vision correctable to 20/40 or better.

The PRK’s excimer laser can be used to correct astigmatism, nearsightedness and farsightedness.

Photorefractive Keratectomy PRK

The Advantages of PRK

The most obvious advantage of PRK is having corrected vision. Depending on your situation, surgeons may perform PRK on one eye at a time to get better results. Another advantage to having PRK done on one eye at a time is that patients will still have functional vision during the healing process.

Drawbacks of PRK Surgery

Any surgery, including PRK, contains risks and possible complications. As a result, make sure that you fully understand the potential PRK side effects and risks before pursuing this surgery. Possible PRK side effects include:

  • a recurrence of myopia
  • corneal haze
  • long healing period
  • pain
  • reduced best corrected visual clarity
  • reduced clarity of vision in low light
  • scarring
  • under-correction or over-correction of your current vision problems
  • vision complications such as glare, halos, or starbursts.

What to Expect from PRK Surgery

Here is an outline of what to expect when you go through the process of PRK surgery:

  • Beginning steps: First, you’ll want to choose a surgeon. After your surgeon examines your eyes, he will determine what kind of vision correction you need, as well as how much laser ablation (reduction of the tissue) you need to correct your vision. Your eye surgeon will use a corneal topographer to photograph your eye. The topographer will precisely map each irregularity of your cornea, informing the surgeon about which areas need to be reshaped.
  • Surgery day: PRK eye surgery is an ambulatory procedure, meaning that you can walk yourself into the surgery center, undergo PRK vision correction and go home immediately after the procedure is done. The surgery itself takes less than one minute. Although some surgeons administer a mild sedative prior to the surgery, you’ll be awake and alert the whole time. For the procedure, the surgeon will have you lie down with your eye directly beneath the laser. Your eye is held open with a comfortable, painless retainer. The retainer’s suction ring keeps your eye perfectly pressurized and immobile. A computer system tracks the position of your eye at an amazing rate of 60 to 4,000 times per second so that the laser pulses are directed exactly where they need to be in order to correct your vision. In fact, most modern equipment is programmed to stop ablation instantly if the eye moves out of its range.
  • Associated pain from PRK: Most people say they don’t feel pain from PRK eye surgery. Special drops anesthetize your eyes during the surgery itself. In the few days following the surgery, your eyes may experience some pain as the epithelium heals. To minimize associated pain, surgeons recommend using eye drops, pain medication and protective contact lenses as your eyes heal.

PRK versus LASIK

PRK and LASIK both belong to the same “laser eye surgery” family tree. However, because these procedures are different, they each have their own distinct pros and cons that make either one more or less ideal for you, depending on your unique situation. Consult the table below to identify the differences between PRK and LASIK.

PRK LASIK

PROS

Most surgeons prefer PRK for patients who have larger pupils or thinner corneas. With PRK surgery, a surgeon will remove the cornea’s thin outer layer, called the epithelium, entirely. As a result, even the outer surface of the cornea can be ablated. Sometimes people who are not candidates for LASIK eye surgery are candidates for PRK eye surgery. Patients who select LASIK generally suffer less discomfort than PRK patients. They also obtain improved vision more quickly than PRK patients, as LASIK has a faster recovery time.
CONS Recovery time is longer than it is with LASIK. In fact, improvement is gradual and can span several days to more than one month. Since the LASIK procedure actually creates a flap in the outer cornea, the cornea is more physically altered. A surgeon uses a microkeratome blade or a laser to create this corneal flap. The flap is folded back, which exposes the inner cornea, so that treatment can take place. After surgery, the flap is repositioned back in to place. The tiny flap of tissue can possibly detract from some of the improvements in vision and can infrequently become dislocated years after the surgery is completed.