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Understanding PRK: Is It Right for You?

PRK or photoreactive kerectomy is a surgical procedure that was the precursor for the surgery known as Lasik. The biggest difference between the two procedures is how the first portion of the operation is conducted. Additional variability between the two procedures includes recovery, risk factors, and the patient’s overall needs. Understanding these differences can help you decide if PRK is an appropriate solution for your vision issues.
 

How it Works

PRK utilizes a laser to correct farsightedness (hyperopia), nearsightedness (myopia), and astigmatism. During a PRK operation, a laser is used to remove the exterior epithelial cells from the cornea. This procedure uses an excimer laser to remove the cells which are then discarded. A contact “bandage” is placed over the eye, and the cells can heal over the course of a few days. Your doctor will then remove the contact lens when the eye has healed enough to be exposed.

While the results are like that of Lasik, PRK does take some additional healing time. This is due to the time that must be allowed for the epithelial cells to heal and regrow on the eye. Additionally, Lasik patients generally experience less discomfort and faster results. PRK results can take a few weeks to fully materialize.

This isn’t to say that PRK doesn’t have its own benefits too. This procedure is well-suited for patients that have had previous eye surgeries and may have thin corneas. Because PRK does not make an incision into the cornea and only removes the epithelial cells, it leaves more of the stromal tissues which underly the epithelial tissue. PRK does not run the risk of “flap” issues that can arise from Lasik, and the risk of removing too much of the cornea is reduced. However, if you are considering PRK, you should consult with your medical professional to identify the right procedure for your specific case.
 

Before the Surgery

When you meet with your eye specialist to discuss your options, there are several factors that they will consider. Your potential surgeon should conduct a thorough eye exam during which they will measure your eye moistness, pupil size, corneal thickness, and corneal curvature. Your doctor should also review your medical and family history to identify any possible concerns about your suitability. Make sure that you bring a list of your medications and previous operations. Finally, you may be required to stop wearing contact lenses for a period before the operation. This can allow your cornea to return to its natural shape before the operation.

LASIK (laser-assisted in situ keratomileusis) is the most popular refractive surgical procedure. In this procedure, a laser is used to permanently change the shape of the cornea (the clear covering on the front of the eye) to correct common vision problems such as nearsightedness, farsightedness, astigmatism, and presbyopia. This improves vision and reduces a person's need for glasses or contact lenses.

LASIK uses an excimer laser (an ultraviolet laser) to remove a thin layer of corneal tissue, giving the cornea a new shape, so that light rays are focused clearly on the retina. In the case of a nearsighted person, the goal of LASIK is to flatten the too-steep cornea; with farsighted people, a steeper cornea is desired. LASIK can also correct astigmatism by smoothing an irregular cornea into a more normal shape.

LASIK is an outpatient surgical procedure with no need to stay at the surgery center overnight, as it will take 10 to 15 minutes to perform for each eye. The procedure is done while the patient is awake, but the patient may request mild sedation. The only anesthetic used is eye drops that numb the surface of the eye. LASIK can be done on one or both eyes during the same session.
 

How to Prepare for LASIK Eye Surgery?

Before LASIK eye surgery, the eye surgeon will evaluate the patient’s medical history and perform a full eye examination, including measuring corneal thickness, refraction, corneal mapping, eye pressure, and pupil dilation. Afterward, the surgeon will discuss what to expect during and after the procedure.

On the day of the surgery, eat a light meal before going to the doctor and take all prescribed medications, if any. Do not wear eye makeup, creams, perfumes, or lotions on the day before and the day of surgery, or have any bulky hair accessories that will interfere with positioning the head under the laser.

Contact lenses shouldn't be worn for at least three days prior to the evaluation. In the case of rigid gas permeable contact lenses, they should not be worn for at least three weeks before. Patients should arrange for a ride home from the place of surgery, as their vision might be blurry.