PRK Surgery Explained: Pros, Cons, And What to Expect

PRK (Photorefractive Keratectomy) is the very first laser vision correction technique. The first time this technology was applied in Berlin in 1985. PRK eye surgery has a non-contact effect on the upper layers of the cornea, without affecting the internal structure of the eye. When using laser correction in this way, notching is not required, although the cornea is exposed. Its shape changes under the influence of a laser, which evaporates the tissue from the surface. Today, this surgical technique is chosen when other methods of laser correction are not possible. For example, if the patient has a very flat or thin cornea. During the operation itself, only 5-10 percent of the cornea is removed if a person has mild or moderate myopia. With a strong degree of myopia, up to 30% of the cornea can be removed. At the moment, this technique has already been perfectly developed, because it has been used for more than a decade. Ever since its inception, the high accuracy of such laser correction has made it possible to predict the result and significantly reduce the likelihood of side effects. But nevertheless, the recovery period for the patient was quite painful and unpleasant. Especially, in the first few days, when the surface layer of the cornea is restored. Complete adaptation was completed in 3-4 weeks. Also, PRK could not be done on both eyes at once. First, the operation was performed on one eye, and after a while on the other. Today, vision correction by the PRK method has already been modified and these unpleasant moments are excluded. For example, now a protective lens is used after laser exposure. This reduces the recovery period and makes it possible to correct both eyes at once.

Indications for PRK surgery:

• Myopia: up to -6D
• Hyperopia up to +3D
• Astigmatism: -0.5D to -3D

It should be noted that there are certain contraindications in which PRK should not be done:

• Cataract
• Glaucoma
• Pregnancy
• Autoimmune diseases
• Immunodeficiency state
• Diabetes
• Dystrophy or degeneration of the cornea
• Progressive myopia
• Certain infectious diseases
• The period up to 18 years, when the tissues of the eyes are not yet fully formed

Despite the fact that PRK is a safe and gentle method of laser correction, the operation still involves a surgical intervention in one of the most important organs of our body. Therefore, before the procedure, it is necessary to undergo a thorough diagnostic examination. This will help reduce risks and increase the likelihood of a better outcome. The doctor will definitely ask you about your diseases and about the condition of the eyes in the past and present. After that, he will determine the degree of visual impairment. Also, with the help of special devices, the doctor will receive all the necessary parameters of the curvature and thickness of the cornea. Plus, the doctor can measure eye pressure and examine the anterior segment of the eye and the fundus. After the diagnosis, you will be assigned a list of tests that you will need to pass. The doctor will also give you all the necessary recommendations to prepare for the operation.

For example, it will not be possible to drink alcohol three days before the operation or use cosmetics on the day of the procedure itself. The doctor will also give a list of drugs that cannot be taken before and after laser correction. One of the most important points is not to use hard contact lenses 3 weeks before the operation, and soft contact lenses 2 weeks before.

How is the operation going?

The duration of the procedure is approximately 15 minutes. PRK itself lasts about a minute in each eye. Therefore, you will not have to stay in the operating room for long. Before the intervention, the patient may be offered a sedative. After that, he lies down on the operating table in consciousness, in which he remains until the end of the operation. At the beginning of the procedure, the eye is covered with an eyelid speculum to keep it open until the end of the operation and to prevent blinking. Immediately before the start of the correction, an anesthetic is dripped into the eyes. Usually, patients do not experience any pain during laser exposure to the eye, because this effect does not last long. However, the higher the visual anomaly, the longer the laser exposure will last. Before turning on the laser, the patient will be asked to focus on a special mark and keep their eyes on it. Due to this, the cornea is centered and the accuracy of the impact is increased. After that, the laser beam is activated. Its power and duration of stay at each point are strictly defined. Thanks to the beam, surgeons act on the upper layer of the cornea and form its new appearance. If the patient looks away from the mark, the laser will immediately turn off or the point of application of the beam will be automatically corrected. The doctor monitors the entire process in a special microscope and controls the progress of the procedure. 

After the operation is completed, the doctor will examine you again and give further recommendations. It is good if someone will accompany you after the procedure. So it will be easier for you to get home and not forget anything in the hospital. After the end of the laser correction, it will be necessary to follow all the instructions of the ophthalmologist. The first few days you will experience some discomfort, but they will pass quickly. During this period, you can not touch your eyes and it is not recommended to resort to physical activity. Full recovery will be over in a few weeks. After this time, you can fully return to your rhythm of everyday life.

  PRK Advantages:

• Minimal eye trauma, as microsurgical instruments are not used
• Lack of restriction on physical activity and return to a normal lifestyle after the recovery period
• High predictability of results
• Most often, the effect after surgery lasts until the end of life
• The operation is performed quite quickly, only 10-15 minutes
• As a rule, the body copes with tissue regeneration without complications
• The strength of the eyeball remains virtually unchanged as a very thin layer of tissue is removed
• The PRK method can be used for thin corneas

Flaws:

• There is a small chance of clouding of the cornea
• The functions of the eye will be fully restored only after a month, during which certain restrictions will need to be observed
• It is required to instill special drops up to 30 days
• Discomfort may be felt in the first 2-4 days after surgery

Today, PRK treatment is not used as often as other modern options for laser vision correction, such as LASIK eye surgery. However, this method is still relevant, effective and safe, and in some situations is best suited for surgery. If your cornea is too thin or your pupil is too wide, this type of surgery suits you best. Keep this in mind as you consider options to improve your vision.