PRK: A LASIK Alternative

PRK (photorefractive keratectomy) was actually the first type of vision correction surgery approved by the FDA in 1995 to reshape the cornea (even before LASIK). Since then, millions of PRK surgeries have been performed to correct nearsightedness, farsightedness and astigmatism, helping most patients see more clearly without glasses or contacts. Patients who are not good candidates for LASIK due to thin corneas or other conditions may be good candidates for PRK and end up with clear vision like most LASIK patients. 

How PRK Differs from LASIK

At the heart of the surgery, both LASIK and PRK involve the use of an excimer laser to remove tiny amounts of corneal tissue to create a more ideal shape and correct a refractive error. This allows light to focus on the retina for clear vision.

How your doctor accesses this corneal tissue is where the two surgeries differ:  

  • LASIK: your doctor creates a hinged corneal flap that is folded back for excimer laser treatment and then replaced on the cornea where it begins to heal immediately. There is a risk of flap complications with LASIK. 
  • PRK: your doctor removes a thin layer of tissue on the cornea (the epithelium). After the excimer laser treatment is complete, the epithelium needs time to grow back, which typically takes 5 or more days. 

What to Expect on PRK Surgery Day

Like LASIK, PRK (photorefractive keratectomy) is an outpatient surgery that is performed in our office. Please expect to be at our office for approximately 1 hour even though your time in our surgical suite will only take about 15 minutes.  This extra time is necessary to have you complete last-minute paperwork and rest before and after the surgery. 

Relaxation medication can also be administered if you are feeling especially anxious before the surgery.  

Here is what you can expect during the PRK process: 

  • Numbing anesthetic eye drops will be placed into your eyes. 
  • Dr. Colin E. Brown will perform one last check on your vision.
  • A device will be placed into your eyes to keep your lids open and prevent blinking. 
  • Dr. Brown gently removes your cornea’s outer (epithelial) layer to allow access to the underlying tissue. 
  • Dr. Brown then uses the Wavelight® EX500 excimer laser to reshape the cornea by removing small amounts of corneal tissue according to your unique refractive error. This laser provides accurate outcomes and Dr. Brown trusts this laser to be the safest for his patients. PerfectPulse Technology®compensates for any involuntary eye movements which halt the process entirely until the eye is in the correct position. This step takes just minutes to accomplish. 
  • A contact lens is temporarily placed on the cornea to protect the eye as the epithelial cells regenerate. 
  • You will then rest in our post-op suite and Dr. Brown will perform one final check of your eyes. 
  • When Dr. Brown gives the ok, you will be free to have a friend drive you home so you can rest. 

PRK Recovery 

PRK recovery takes longer than LASIK because the epithelial cells need time to regenerate. This process may take 5 or more days. After that time the temporary contact lens can be removed by your doctor. Your final vision results may take a couple of weeks or months as your vision stabilizes. 

Some patients experience temporary eye discomfort after PRK surgery including: 

  • Mild pain
  • Inflammation
  • Itching or burning
  • Hazy vision
  • Watering 
  • Light sensitivity
  • Dry eyes

It is important to avoid rubbing your eyes during the healing process to avoid infection or other complications. Discuss any of these conditions at your post-op appointment and contact us if they continue. 

Common Questions About PRK

Does PRK hurt? 

Prior to the PRK surgery, Dr. Colin E. Brown applies numbing eye drops to block the feeling of pain. While every person has their own unique threshold for discomfort, most patients do not report that the process is painful. The PRK recovery process may bring you temporary discomfort as the epithelial cells regenerate on your eye. These discomforts can include pain, throbbing, a foreign substance feeling, etc. This can be managed with pain medications outlined by your doctor. 

How long does PRK take? 

The full PRK surgery takes 15 minutes, from the time you enter our surgical suite until you go into the recovery area. The excimer laser treatment where we reshape your cornea takes just a few minutes! Plan to spend 1 hour with us on your surgery day.

What are the risks of PRK? 

Although considered a relatively safe surgery, PRK carries some element of risk. Complications of PRK can include: 

  • Starbursts, glare or halos in low light environments
  • Sensitivity to bright light
  • Overcorrection or undercorrection
  • Infection
  • Pain
  • Double vision 
  • Clouded vision

How long will I need to be off work?  

Because your eyes need time to recover an intact outer layer on the cornea, expect to take a few days off from work to recover from PRK in Rapid City. Your best vision results will probably take longer to achieve, but most patients are able to return to non-strenuous activities after 1-2 weeks. It is important to keep your follow-up visits so Dr. Brown can monitor your progress. 

Will I ever need glasses after PRK? 

Your vision is constantly changing. While PRK is performed to correct a refractive error, other vision conditions can develop that may require you to need glasses in the future. Most people over age 40 develop a condition called presbyopia. This is a gradual stiffening of the eye lenses that makes it difficult to focus on things up close like reading material. Even if you had a successful PRK surgery, you may need over-the-counter reading glasses as you grow older. There are also different surgical methods to correct presbyopia. If you are experiencing this condition and are frustrated with reading glasses, contact us to learn about your treatment options. 

What are the requirements for PRK? 

There are several conditions that must be met to be considered for PRK: 

  • 18 years or older
  • Stable vision prescription for at least one year
  • Free of eye disease or other interfering vision conditions
  • Proper corneal thickness
  • Good overall health
  • Realistic expectations 
  • Full understanding of the potential risks

The only way to know if you meet these requirements is by having a comprehensive Consultation with us. It’s free and will let you know for sure if this is a safe option for vision correction for you.  

Will the cost of PRK go down?  

It is not likely that the cost of PRK will go down in the future. In fact, as technology changes the costs may actually rise over time. While the price of PRK is a definite concern for many people, you don’t want to shop for the lowest price if it means sacrificing quality. When you are researching PRK centers, be sure to weigh the cost against:

  • The surgeon’s training, experience and results
  • The type of technology being used 
  • Whether or not a low advertised price will apply to your vision prescription
  • Additional hidden fees that will apply
  • Inclusion or exclusion of enhancement surgeries and follow-up care

You only have one set of eyes, so make sure you put your vision care into a doctor and center you trust – a center like Great Plains Eye Specialists.

Can I have PRK on both eyes at the same time? 

Yes. You can choose to have the surgery on both eyes or just one eye at a time. 

When can I wear makeup after PRK?  

Patients should wait at least 2 weeks before wearing makeup. We recommend that patients purchase new eye makeup to avoid infection.

If you have more questions about PRK, contact us to schedule a free Consultation. Call (605) 519-5071 or click here.

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