PRK (Standard and Wavefront-guided)

Photorefractive keratectomy, or PRK, is a laser vision correction procedure that reshapes the cornea to correct mild to moderate conditions of:

• Nearsightedness, or myopia
• Farsightedness, or hyperopia
• Astigmatism

PRK uses an excimer laser to reshape and remove a small amount of the front of the cornea to correct your prescription. Unlike the LASIK procedure, where a flap is created to access the area to be reshaped, during PRK the surface is prepared with a rotating brush to remove the thin epithelial layer first. The area to be reshaped is now ready for treatment with the excimer laser, which will correct the vision.

Advantages of the Photorefractive Keratectomy Procedure

The PRK procedure provides the surgeon with greater control over the location and amount of tissue being removed, which allows patients to enjoy excellent results. The PRK method involves gently sculpting the full-thickness cornea, rather than the residual thinner bed after cutting the LASIK flap, allowing the surgeon to treat greater degrees of nearsightedness, farsightedness, and astigmatism. This procedure is preferred for individuals at increased risk of flap dislocation due to facial or ocular injuries, e.g. athletes involved in contact sports, soldiers, and pilots.

Up to 95 percent of patients with a correction of up to -6.00 diopters achieved a vision of 20/40 or better after PRK, with up to 70 percent achieving 20/20.

Some of the advantages of the PRK procedure include:

• Less depth of laser treatment
• Patients with thin corneas may be eligible for PRK
• No corneal flap complications

Candidates for the Photorefractive Keratectomy Procedure

Before LASIK was available, PRK was the most commonly performed refractive surgery procedure. LASIK has several advantages over PRK, including:less discomfort, faster results and quicker recovery. However, PRK is preferred for patients with larger pupils or thinner corneas which are poor LASIK candidates. Over-thinned corneal bulging, called ectasia, a rare and dreaded complication of LASIK is avoided with PRK.

The Photorefractive Keratectomy Procedure

Before the PRK procedure begins, the eyes are numbed with anesthetic eye drops. The surgeon uses the targeted laser energy to shape the cornea. The entire procedure takes only a few minutes to perform.

After the procedure, a soft contact lens will be placed so that the cornea is protected. The contact lens will be removed only by the surgeon in a follow up examination.

Recovery from the Photorefractive Keratectomy Procedure

After the PRK procedure is completed rest and prudence is needed until vision has stabilized. The surgeon will prescribe topical antibiotics and anti-inflammatory drops to prevent infection, control pain, and minimize inflammation.

While vision may seem to have improved initially, it may take several days or even weeks to see complete improvement. Patients may be able to return to work the next day, unless otherwise advised. Strenuous exercise should be avoided for at least a week, as this can affect the healing process. You will likely be able to see well enough to drive after a few days.

Results of the Photorefractive Keratectomy Procedure

The results of PRK are the same as LASIK therefore, in  rare circumstances some may need glasses or contact lenses after their procedure. PRK or LASIK do not correct presbyopia, a natural and progressive lens-related change in the eyes that affects everyone over the age of 40, so patients that need reading glasses may continue to need them after surgery. It is important for patients to maintain realistic expectations in order to be satisfied with the results of corneal refractive surgeries like PRK or LASIK.

Risks of Photorefractive Keratectomy

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