PRK stands for ‘Photorefractive Keratectomy.’ It is a type of laser vision correction that is an alternative to LASIK for the treatment of near-sightedness, far-sightedness, and astigmatism.

Like LASIK, PRK changes the shape of the cornea. The cornea, the clear front window of the eye, is the primary determinant of an eye’s prescription. By changing the shape of the cornea, PRK can eliminate the eye’s need for a prescription.

Unlike LASIK, PRK does not create a flap in the outer layer of the cornea. Rather, the outer layer (epithelium) of the cornea is brushed away using a chemical solution and/or a gentle sweeping instrument. The excimer laser is then used to precisely reshape the now-exposed deeper layers of the cornea (just like with LASIK). Lastly, a contact lens is placed on the eye to serve as a bandage while the epithelium naturally heals back over the surface of the cornea.

The outcome/success rate of PRK is identical to LASIK, but there are several important differences between these two procedures.

  • Because no flap is created in PRK, patients are not at risk for any of the complications related to having a flap (such as wrinkles/folds, flap dislocation, having cells from the surface of the eye get trapped under the flap, etc.)
  • Some patients who are not eligible for LASIK –because of their prescription, the thickness of their cornea, the shape of their cornea, scarring, or several other factors – may still be eligible for PRK.
  • Compared to LASIK, the recovery from PRK is more uncomfortable. For approximately 3 days after PRK, while the epithelium is healing over the surface of the cornea, the eye can feel scratchy, irritated, sensitive to light, and achy. You will receive eye drops and oral medications to help with this pain, but several days of discomfort are expected nonetheless.
  • Compared to LASIK, the rate of visual recovery after PRK is slower. It often takes 2-3 months to achieve your best vision. During this time, your vision will gradually improve, but fluctuations are common until your eyes are fully healed.

As with LASIK, to determine if you are a PRK candidate, the first step is to schedule a free screening. At this screening, multiple measurements are taken of your eyes to determine if your eyes qualify for refractive surgery. If your eyes are suitable, the next step is to have a thorough eye exam with Dr. Larson. She will further evaluate you to ensure that your eyes are healthy enough for the PRK procedure.

On the day of surgery, you will be given medicine to help you to relax. You will then be brought into our state-of-the-art laser suite and reclined flat on your back. Numbing drops are placed in your eyes, your eyelashes and eyelids are cleaned with a medical soap, and your eyelids are gently separated. A combination of a chemical solution and/or a blunt sweeping instrument is used to brush away the top layer of the cornea. You will then be positioned under the excimer laser and asked to focus on the blinking orange light.

The laser will confirm your eye, and you will hear the clicks of the laser pulses working to reshape your cornea. Once this is complete, a sponge soaked in the medication Mitomycin-C is then placed on the surface of the cornea for several seconds in order to reduce scarring. This is followed by a copious rinse of the eye with a cold saline solution. Lastly, a bandage contact lens is placed on the surface of the eye. Dr. Larson does one final check to make sure that everything looks good, and then the procedure is complete!

Immediately following your PRK surgery, it is normal for the vision to be blurry or to feel like you have something in your eye. The best thing to do for your eyes is to take a nap, and then to start using your eye drops when you wake up. The first 3 days after PRK surgery can be uncomfortable, but you will receive instructions on how to prevent and manage your pain.

Approximately 5 days after your PRK procedure, you will return to see Dr. Larson to have your bandage contact lens removed and to check on the progress of your healing. At this visit, the doctor will also review directions regarding the use of eye drops and activity restrictions. Remember that your vision will still be blurry at this appointment, as it takes 2-3 months before you achieve your best vision. However, after the contact lens is removed, most patients are able to resume driving within a few days.

PRK is a life-changing procedure, and the surgeons at Vermont Eye Laser are committed to helping you achieve your best vision possible! Schedule a PRK consultation today.

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