Photorefractive Keratectomy (PRK) Eye Surgery: Pros, Cons, and What to Expect

Photorefractive keratectomy or PRK eye surgery can often help individuals with poor vision, who would like to be less dependent on glasses or contact lenses. Photorefractive keratectomy is a type of outpatient refractive eye surgery that improves nearsightedness, farsightedness, and astigmatism. 80% of patients who have PRK see improved vision one month after surgery, and 95% see significant improvement after three months.  

What Is Photorefractive Keratectomy (PRK) Eye Surgery?

The PRK procedure is a type of eye surgery used to correct refractive errors. Refractive errors occur when the shape of your eyes causes light to improperly focus on the retina of the eye, resulting in images that appear blurry. Following the PRK procedure, there’s a high probability that you will no longer require glasses or contact lenses to see clearly. 

Why Is PRK Performed?

The photorefractive keratectomy procedure is used to treat refractive errors that have developed in the eye. The surgeon will use a laser to alter the shape of your cornea improving the way light rays are focused on your retina. You might need a PRK if you’ve been diagnosed with one of the following eye conditions:

• Myopia (nearsightedness)
• Hyperopia (farsightedness)
• Astigmatism (irregular shape of the eye).

Who Is a Candidate for PRK?

PRK procedure candidates often have dry or thin corneas. Other types of refractive surgery such as LASIK are not ideal for those who have these conditions. Individuals with very active jobs or overall active lifestyles are often better candidates for PRK since the procedure doesn’t require cutting a flap in the cornea as it does with LASIK. If you’re particularly active, you could accidentally dislodge the flap of the cornea and cause issues. 

In order to move forward with your PRK procedure, you’ll need to meet specific requirements:

• You should be at least 18 years old (ideally patients will be over 21)
• Your eye prescription should be stable
• If you have a refractive error, it must fall within the parameters to safely treat you
• Your eyes should be healthy and you must have overall good health
• You have realistic expectations about what PRK can and cannot do for you.

 Some people may not be ideal candidates for PRK. These people have:

• Advanced Glaucoma
• An unstable refractive error
• Skin diseases that can impact healing
• Uncontrolled diabetes
• Pregnant or nursing women
• History of specific eye infections
• A cataract that impacts vision

Your ophthalmologist will discuss your specific situation and determine if you’re a good candidate for PRK. 

Advantages of PRK

There are pros and cons of PRK eye surgery, here are some advantages:

• Approximately 90-95 percent of those who undergo PRK surgery achieve at least 20/40 vision or better without the need to wear contacts or glasses
• PRK can achieve the same long-term benefits as LASIK
• PRK is an alternative for those who aren’t good LASIK candidates, including those who have thin corneas
• Athletes might be better candidates for PRK, the flap made on the cornea during LASIK can become dislocated by injury or contact.

Disadvantages of PRK

As with any medical procedure, there is a chance of complications. Although minimal they can include:

• Infection, scarring, cloudiness of the cornea, and a “halo effect” that appears around lights
• Over or under correction of your vision. In this case, glasses, contacts, or additional surgery can remedy the problem
• Although extremely rare, it’s possible for vision to worsen after PRK
• The initial recovery time is longer than LASIK, visual stability can take several weeks.

What to Expect During Photorefractive Keratectomy (PRK)

Knowing what to expect can help ease any anxiety you might be feeling.

Before PRK Surgery

Before your surgery occurs, you’ll meet with your healthcare provider to go over what you can expect during each stage of the surgery. During this time, you will discuss your medical history, and have comprehensive tests to determine the following:

• The size of your pupil
• Your refractive error
• Your corneal thickness
• Your general eye health.

If you currently wear rigid gas permeable contact lenses, it’s important that you stop wearing them at least three weeks before your pre-op testing. Soft contact lens use should be avoided for at least one week before your pre-op. If you have glasses, make sure to bring them so your doctor can evaluate your prescription and determine if your eyes are stable. During this time, your doctor will discuss any concerns, and answer any questions you may have. You will then be clear to set up an appointment for your procedure. 

On the day of your surgery, eat a light meal before your visit, and you can take any medications as usual. Don’t wear eye makeup or bulky hair accessories. If you’re feeling under the weather, call the doctor's office to see if you should reschedule your appointment to a later date.  

During PRK

So how does PRK work, exactly? The PRK eye surgery procedure typically takes place in an outpatient surgery center,  the entire procedure takes around 15 minutes. Here are additional details about what you can expect.

• Your doctor will numb your eye with eye drops.
• Your surgeon will then place an eyelid holder in your eye to  prevent you from blinking during the procedure.
• Your ophthalmologist will then remove the surface cells of your cornea, called the epithelium. To do this, they will use a brush to gently remove the cells. 
• You’ll be asked to look at a target light so your eyes don’t move during the procedure. The ophthalmologist will then reshape your cornea with the laser. The laser will have been specially programmed with measurements for your eye. While the laser is being used, you’ll hear a clicking noise.
• A soft bandage contact lens will be used to help with healing and aid in your comfort for the first few days.

After PRK

You’re likely wondering what you can expect after PRK eye surgery. Here’s additional information to help you prepare for PRK recovery. 

• You’ll want to ask a family member or friend to drive you home from surgery.
• Make sure to closely follow the aftercare instructions from your doctor. 
• Use your eye drops as prescribed to prevent infection and improve the healing process.
• Any time you are outside, make sure you are wearing sunglasses. Light sensitivity is common following PRK.
• It’s possible to experience mild pain during the first 24-36 hours, your doctor will provide you with medication to help manage any pain you may have.
• Make sure to schedule follow-up visits as recommended by your doctor.

Conclusion

If you’re interested in learning more about PRK eye surgery in Chicago, our team at the Kraff Eye Institute is here to help you! Our team is passionate about helping you improve your vision and quality of life, we will guide you every step of the way on your journey to a better vision. Contact us today to get started.