PRK

PRK (or photorefractive keratectomy) is a laser eye surgery that is very similar to LASIK. The primary difference between the two is that in PRK, no flap is created on the cornea prior to reshaping the eye with an excimer laser.

Though you may not be familiar with PRK, it has been around longer than LASIK and once was the most common laser vision correction procedure.

Like LASIK, PRK can correct a wide range of nearsightedness, farsightedness and astigmatism, and many studies indicate PRK provides virtually the same long-term visual outcomes and success rates as LASIK.

Advantages of PRK

PRK (or photorefractive keratectomy) is a form of laser eye surgery that is closely related to LASIK. Here in Fort Collins, Loveland and Greeley the main difference between the two is that in PRK, no flap is created on the cornea prior to reshaping the eye with an excimer laser.

PRK has been in practice in the US for much longer than LASIK and was once was the most common laser vision correction surgery.

Similar to LASIK, PRK has the ability to correct a wide range of nearsightedness, farsightedness and astigmatism. Many studies have shown that PRK can provide the same long-term visual successful outcomes as compared to LASIK.

Advantages of PRK

The main advantage that PRK has over LASIK is that because no flap of tissue is formed there is then is no risk of flap problems during or after PRK procedure. Many people in Northern Colorado find PRK as a better option if they have a vocation that puts them at a higher risk of eye injury. (Examples include: military personnel, policemen and professional or amateur sports players.)

Yet another advantage of PRK is that the very laser reshaping of the eye is performed closer to the surface of the cornea as compared to a LASIK surgery. Because of these reasons, PRK may be able to be safely performed on eyes that have corneas which are too thin for LASIK.

Disadvantages of PRK

One of the disadvantages of  PRK is that a person’s vision recovery generally takes longer after PRK than after LASIK. There is also more discomfort during the first few days after the procedure. Some people in Fort Collins, Loveland and Greeley who have had PRK have found that they cannot see well enough to drive safely or perform their normal workday tasks for several days post procedure.

Also, because there is no flap of tissue (like LASIK has) to cover over the eye, until a new layer of surface cells (called epithelial cells) grows back over the laser-treated portion of the cornea, PRK patients may have a higher risk of eye infections as compared to LASIK patients during the first few days post procedure.

There is a higher risk of mild or moderate haze that can develop in the cornea from a PRK procedure. This corneal haze could last a few months or it could be permanent, and it may or may not noticeably affect vision.

There are some cases where it may take anywhere from three to six months to achieve optimum vision after PRK.

Before PRK Surgery

If you are considering PRK, your first step is to choose an experienced refractive surgeon and schedule a pre-operative exam and consultation. During this visit, your PRK surgeon or another eye doctor will examine your eyes to determine if you are a good candidate for laser vision correction.

Be sure to discuss any medical conditions that you have and any history of previous eye surgery or injuries during this visit. There are some conditions or injuries may disqualify you altogether as a PRK candidate; while others may mean a postponement of the procedure or the need for special care post procedure.

During PRK Surgery

PRK is an ambulatory procedure in Northern Colorado which simply means that you will walk into the surgery center, have the procedure, and walk out again. The entire surgery usually takes less than 15 minutes and you will awake the entire surgery. Please allow for at least an hour at the surgery center due to wait times and recovery times.

Below we have listed the general format for a PRK surgery:

• Your eye is first anesthetized with numbing eye drops.
• A retainer is then put under your eyelids to help keep your eye open during the surgery.
• After the surgeon is sure that the surface of your eye is completely numb, the surgeon will remove the thin outer layer of the cornea (called the epithelium).
• After the epithelium is removed, the excimer laser is positioned directly over your eye.
• You will be asked to look at a small light located within the housing of the laser for a short while during which time your surgeon will be watching your eye through the operating microscope.
• Then the laser is activated and begins the job of reshaping your eye’s cornea. You will likely hear a loud clicking sound at this point, and there might be a faint odor.
• After the laser treatment is complete, medicated eye drops and a bandage contact lens will be applied to your eyes.

The actual laser treatment for a PRK procedure is usually less than a minute in Fort Collins, Loveland and Greeley.The less powerful your prescription is the less time it will take but the whole surgery is considerably short.

If you are having both eyes treated the same day, the surgeon will most likely proceed immediately to the second eye after the laser treatment of the first eye is completed. You do have the option of having the PRK surgery performed on your second eye a week or two later, allowing for the recovery of the first eye before the procedure of the second eye. This is done at personal preference.

After PRK Surgery

What to expect after PRK:  

• You will need to use medicated eye drops multiple times a day for a period of time to reduce the risk of infection and inflammation.
• You will most likely be given a prescription pain reliever to control pain during the first few days post procedure.
• As with any kind of eye surgery, it is very important that you do everything that your eye surgeon instructs to the letter after a PRK surgery.
• Plan to get proper rest, make sure you use your medications as directed, and please call your eye doctor or surgeon’s office immediately if you suspect there is a problem.

Most people in Northern Colorado are able to achieve 20/20 or better vision after PRK, but please keep in mind that outcomes are different for each person. It is a possibility that you might need to wear eyeglasses after PRK for certain work like reading and driving at night. Occasionally, a second PRK surgery (called an enhancement) might be necessary for you to have enough visual acuity to be able to without glasses or contact lenses.

PRK Risks and Complications

Below we have list the risks and potential complications of a PRK procedure which are similar to those associated with LASIK, and include:

• Dry eyes
• Vision problems, such as poor night vision, glare, halos and haze
• Incomplete or inaccurate vision correction
• Infection or inflammation following surgery

Corneal haze may also be an issue following a PRK surgery. This reduces the sharpness of vision and some people in Northern Colorado find that corneal haze detected shortly after surgery gradually decreases as time goes on and usually disappears completely after six months. Your eye doctor or refractive surgeon is well equipped to provide you with additional information about the risks associated and the potential complications of PRK.

For additional information or to schedule an appointment, please call 970-204-4020 or click on the link on the side of the page.