What is PRK surgery?

Laser eye surgery
PRK has several advantages over LASIK for some patients but it takes longer to recover from PRK than LASIK. It can take up to three months for the vision to be completely clear, sharp, and stable. Most patients achieve 20/20 vision.

PRK (photorefractive keratectomy) is a type of laser surgery used to correct refractive errors such as myopia, hyperopia, and astigmatism. PRK was the first type of laser eye surgery for vision correction. LASIK was introduced after PRK and became more popular than PRK. PRK has several advantages over LASIK for some patients but it takes longer to recover from PRK than LASIK.

The cornea and natural lens of the eye bend and focus light on the retina and create images on the retina for vision. This bending and focusing of light are also known as refraction. Refraction is affected in refractive errors, causing blurred or distorted vision. PRK replaces the need to use eyeglasses or contact lenses.

PRK surgery may be done to correct one of these refractive errors:

How is PRK surgery performed?

The procedure is done under local anesthesia using anesthetic eye drops and a mild sedative may be administered. The procedure is short and takes around 15 minutes for both eyes. The surgeon uses a programmed excimer laser beam over the eye. The laser energy removes small microscopic amounts of tissue from the top layers of the cornea is ablated (removed) and the cornea is reshaped. There is no pain or discomfort during the procedure except a feeling of pressure in the eye. The treated cornea is covered with a bandage contact lens for a few days till the cornea heals. 

How long after PRK does vision improve?

It can take up to three months for the vision to be completely clear, sharp, and stable. Most patients achieve 20/20 vision.

Recovery after PRK surgery:

  • Immediately after the procedure:
  • Patients can go home soon after the procedure, once the sedation wears off, but should not drive.  
  • Antibiotic and anti-inflammatory eye drops are prescribed.
  • Pain killers may be prescribed. 
  • The patient is advised to rest the eyes for a few hours at home. They may also take a nap.  Watching television or reading should be avoided
  • Makeup and skincare products should be avoided over the skin around the eyes
  • Patients may take a shower 24 hours after surgery. The doctor may suggest a special shield to be worn to protect the eyes 

Two to four days after surgery:

  • Patients may continue to experience pain and discomfort which can be relieved by over-the-counter painkillers.
  • Patients continue wearing the bandage contact lens to protect your cornea as it heals. 
  • Patients should avoid exercising and excessive sweating, as sweat may enter the eye. Even mild exercise can delay healing.
  • Patients begin to experience side effects of the procedure:

Five days after surgery: 

  • The bandage contact lens would be removed by the doctor if healing is satisfactory
  • Once the bandage contact lens is removed, patients notice an obvious improvement in the vision, depending on the severity of refractive error before surgery. Vision continues to improve over the next several weeks.

One to four  weeks after surgery: 

  • Patients may resume work depending on their comfort level and nature of the job, after consulting with the surgeon.
  • Patients can resume driving again if comfortable,
  • Patients may experience glares (difficulty in seeing in the presence of bright light), halos (bright circles around a light source), starbursts, haziness, and difficulty seeing in the dark. These usually resolve seven to 10 days after surgery. 
  • Patients can use wear makeup and other skincare products 10 days after surgery. 
  • Patients should avoid strenuous, high-impact, or contact sports, like running, soccer, football, basketball  or wrestling because they increase the risk of injury to the eye, infection, and delay healing. 
  • Patients should avoid using a jacuzzi, swimming or any activity other than showering that might get water and chemicals like chlorine in the eye. 
  • The eyes should be protected from dust and pollutants. Activities that increase the risk of pollutants in the eye should be avoided like gardening, cleaning, construction sites, etc. 

Four to six weeks after surgery: 

  • Vision continues to improve. 
  • The doctor may prescribe eye drops to be used in the first month to reduce the risk of corneal haze, a common side effect from PRK 
  • The eyes may still feel dry, but most other side effects, resolve by this time.

Three to six months after surgery: 

A vision reaches 20/40 or better during this time in most patients.

One year after surgery: 

Patients are advised to wear anti-glare sunglasses for at least a year after surgery when exposed to bright light and outdoors during the day. 

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Medically Reviewed on 9/23/2020
References
References:

https://www.aao.org/eye-health/treatments/photorefractive-keratectomy-prk

https://emedicine.medscape.com/article/1220845-overview
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