What is Photo Refractive Keratectomy (PRK)? Benefits and Procedure Overview

Quick answer: PRK (photorefractive keratectomy) is laser eye surgery that removes the thin surface layer of the cornea and reshapes it with an excimer laser, without a flap. It can suit thinner corneas or people at risk of eye injury. Final vision is similar to LASIK, but the first few days are more uncomfortable and vision takes longer to settle.

Photo Refractive Keratectomy, similar to LASIK is a laser eye surgery. While LASIK involves lifting a cornea flap, PRK eradicates your cornea so that it grows back more naturally and healthier. This makes it a better choice for laser eye surgery for some people who can not go for LASIK or other types of refractive surgeries. 

PRK is used to treat various visual issues like nearsightedness, farsightedness, and astigmatism. It reshapes the cornea with the help of an excimer laser to improve how light focuses on the retina. Vision Concern explains more about this treatment below so you can ultimately decide whether or not you’re eligible for this treatment.

What is Photorefractive Keratectomy (PRK)?

Photorefractive Keratectomy is a laser eye surgery that improves eyesight. The laser slightly changes the shape of the cornea which is the clear and protective layer at the eye’s front. Reshaping the cornea will change the way the eye bends light and how a person sees everything around it.

PRK is a predecessor to LASIK. Approved by the FDA in 1996, PRK has since become the most commonly done laser surgery for correcting vision. In 1999, the FDA officially approved LASIK as more popular than PRK, owing to its certain advantages. 

However, there is no denying that PRK is also an extremely helpful and common treatment. There are also certain situations where it does things that LASIK can not.

What does PRK treat?

The cornea is perhaps the most important part of the eye concerning focusing light to the retina within. The refraction (bending) of light rays emanates from the cornea and lens to converge precisely upon the retina. A refractive error occurs when the light rays do not converge on the retina at the correct point.

Corrective lenses, glasses, or contact lenses bend light rays more than the eye alone could ordinarily do. Corrective lenses thus help with a refractive error. That said, in some cases, a person could want stronger vision correction than glasses or contacts can provide, or a person may have issues with or decline to wear corrective glasses.

In cases like these, vision-correcting surgeries like PRK come into play. PRK can reduce dependence on corrective lenses or even eliminate it altogether.

PRK is used to treat various refractive errors, like:

Nearsightedness (Myopia): If a person has vision problems where close objects are seen clearly but faraway objects seem blurry, PRK can be the treatment.

Farsightedness (Hyperopia): It also helps treat vision for those who can see distant objects more clearly than the near ones.

Astigmatism: Because of the irregularly shaped cornea, this condition causes blurred vision at all times and distances. PRK helps to reshape the cornea to improve this condition.

PRK procedure details 

How to prepare for PRK?

Much of what will go into preparations for PRK will be worked through with the help of your eye care specialist:

•  An eye exam: The eye exam checks your vision and overall eye health to ensure there are not any reasons why you should not have PRK. 
• Eye surface measurements: These involve precisely mapping your eye surface, especially the surface of your cornea.

Being clear on what to expect is necessary for the satisfaction of the outcome. Your eye care specialist at Vision Concern will value your understanding of realistic expectations, as PRK is not a magical fix.

They will talk to you about what to expect with PRK, ensuring that you understand that even if it does not completely correct your sight, it can still improve it.

What happens during the procedure?

PRK is an outpatient surgical procedure, meaning that you can leave shortly after finishing the job. The whole procedure lasts about five to fifteen minutes. You are awake during the procedure and won’t feel any pain since your doctor will apply numbing drops.

During the PRK procedure, the following steps occur:

1. Preparation 

• Patients are to stop wearing contact lenses for a couple of weeks before undergoing this procedure.
• Do not apply makeup or other cosmetics on the surgery day as it increases the risk of infection. 

2. Numbing and eye stabilization

• Doctors use topical anaesthetic drops around the eyes to numb them, minimizing discomfort during the surgery.
• A lid holder is used to prevent blinking and to stabilize the eye.

3. Removing Epithelium

• Diluted alcohol is applied to the epithelial layer to loosen it. It is then removed with a laser which then exposes the primary corneal tissue.

4. Laser treatment 

• The patient sits under an excimer laser and looks at a target light while the laser reshapes the cornea based on pre-measured specifications. 
• Modern lasers are equipped with eye-tracking technology to assure accuracy and safety during the stock.

5. Post-surgery care 

• After the surgery ends, a bandage contact lens is put over each eye for protection while they heal for several days or weeks. Eye drops are given for healing and comfort.
•  Some of these medications (eye drops) need refrigeration.
• Bandage contact lenses are just like disposable soft contact lenses. The eye care specialist will tell you how to use them.

How to take care of myself after going home?

After the procedure, you can go home. There are some things that you need to bear in mind once you go back home. These include:

• Take it easy: For the first few days, rest is your primary concern. Physical activity may hamper your eyes so make sure you’re not doing it unless your provider says otherwise. It would be wise for you to take some time off work or school for a few days.
• No driving: As a rule, good practice is to abstain from driving for at least a few days following PRK.
• Strictly follow medication and care instructions: If your condition calls for medications and the use of bandage contact lenses, follow the prescription instructions as instructed. If you stick to the prescriptions, the likely outcome is good.
• Wear sunglasses as directed: Wearing sunglasses protects against corneal scarring and other post-op damage from possible UV rays. You must continue to do this anytime you go outside during the day if recommended by an eye care professional.

Benefits of PRK 

For decades, PRK has had a successful history. It is because: 

1. Suitable for thin corneas

PRK is an excellent choice for patients who have thin corneas, as there is no flap-altering action that could cause complications. Thus, it increases the chance of proffering a better outcome than LASIK.

2. No flap complications

Flap-related complications like displacement or wrinkling are eliminated with PRK, unlike LASIK.

3. Effective refractive correction

High success rates for effective correction of nearsightedness, farsightedness, and astigmatism at a rate of 20/40 vision or better without prescription lenses after a year is around 95%.

4. Long-term stability and cost-effective

PRK’s more gradual healing may lead to more stable long-term results than that of LASIK. Also, the cheaper cost compared to LASIK due to relatively high-technology placement and fewer risks of complications.

5. Reduced possibility of dry eye syndrome

There is a lower risk of dry eyes syndrome post-surgery after a PRK procedure in comparison to LASIK because they did not create a flap.

6. Compatibility with an active lifestyle

They are safer for people with active lifestyles involving contact sports because no corneal flap, which could be dislodged physically, is made.

When to choose PRK over LASIK?

LASIK is a popular surgery because it recovers faster and gives you less pain. But, PRK is better for some people than LASIK if:

1. You have dry eyes

As we mentioned earlier, it is necessary to mention that creating a flap for LASIK may disrupt the nerve connections in the corneas responsible for preparing moisture in the eyes. Avoiding flap-related LASIK minimizes issues concerning dry eyes.

2. You have thin corneas

Thin corneas would make creating corneal flaps riskier. If the flap cuts into the cornea too deeply, it might trigger possible harm to deeper layers of the cornea and yield undesirable complications.

3. You’re athletic 

Being involved in various athletic activities can cause a flap of dislodge, later to exercise LASIK. Eye injuries are less likely to happen after PRK than after LASIK as the flap can reopen and come loose even after healing, under some circumstances.

However, there are some cases when LASIK is more convenient than PRK:

• It is more comfortable with a quicker recovery.
• It is usually less painful.
• PRK requires medications for several weeks to lower the risk of certain complications. For instance, steroids.

Because so many parameters go into play concerning these procedures, there can never be one choice that is better for all patients. The eye care specialist is best positioned to advise you on what possibly best approach relates to your condition. 

Risks or complications of PRK

After PRK, you may experience some side effects or complications which usually result in a variation in your vision through the affected eye. They may include:

• Halos around lights
• Light glare or lights that produce ghost-life effects
• Cloudy cornea (corneal haze)
• Corneal scarring that can affect the vision 

Many of these issues may be minor or temporary even if they seem severe at first. Others may need further treatment to resolve the issues. Your eye care specialist will update you about what would work best and what is expected of you afterward. Just like LASIK, PRK may also damage your eye and worsen your vision. Thankfully, that case is extremely rare.

When should I contact my eye doctor?

In case you have the following issues, you must immediately call your eye care specialist:

• Sudden vision loss.
• Eye pain that the medications can not treat or if it keeps getting worse day by day.
• Eye infection symptoms like discharge, excessive watering, swelling, etc.

Conclusion 

PRK is the best vision treatment option for some people who have greater risks from LASIK. PRK has been a laser correction surgery for more than 25 years. With the improvement of technology, PRK has been modernized and is more effective than ever. This is not a magical cure but offers a pretty good shot at improving your vision. And, having realistic expectations is a must. In case you’re having any issues, and want to go through PRK, contact Vision Concern today.

FAQs

1. Will insurance cover PRK?

Ans: Normally, insurance companies do not cover laser vision correction surgery because they are usually deemed cosmetic. Because of that, you may be expected to pay for the whole surgery out of your pocket. That said, some optical/vision insurance carriers may afford discounts to those specialists who perform the procedure. 

2. When can I go back to school/work after the procedure?

Ans: Most people return to work about a week after PRK (perhaps even sooner). Your eye care doctor will tell you whether and when to return to your normal routine. They might, however, tell you to avoid some activities at first. You should discuss this with them and find out what activities you should avoid and for how long.

Turn this information into a personal eye-care plan

If this topic relates to your symptoms or vision, book an eye assessment at Vision Concern. Share your main concern when booking so the team can confirm the appropriate appointment or referral.

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