Photorefractive Keratectomy: Overview, Preparation, Procedure, Recovery, Risks, and Aftercare
PRK is a laser eye surgery technique used to correct refractive errors such as nearsightedness (myopia), farsightedness (hyperopia), and astigmatism. By reshaping the cornea, the eye's clear front surface, PRK improves vision and reduces the need for contact lenses or glasses. PRK does not involve creating a flap in the cornea but instead removes the outer layer (epithelium) before reshaping it with a laser.
Preparation
PRK patients typically undergo the following preparations before the procedure:
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Comprehensive eye examinations are performed to determine the extent of refractive error and assess the overall health of the eyes.
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PRK is an appropriate treatment option after patients discuss their visual goals and expectations with their eye surgeon.
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During the medical history review, the eye surgeon identifies any preexisting conditions or medications that may affect the outcome.
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In order to allow the cornea to return to its natural shape, patients who wear contact lenses are typically instructed to discontinue their use for a specified period prior to PRK.
Procedure
Following are the steps involved in PRK:
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For the patient's comfort, numbing eye drops are applied before the procedure begins.
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Using a specialized instrument or solution, the outer layer of the cornea (epithelium) is gently removed, exposing the underlying corneal tissue.
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An excimer laser is used to precisely reshape the cornea based on the patient's refractive error using a computer-controlled excimer laser. By delivering pulses of ultraviolet light, the laser removes microscopic amounts of corneal tissue, improving vision by sculpting the cornea.
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After laser reshaping, a bandage contact lens may be placed on the eye to promote epithelial healing and provide comfort.
Recovery
Patients can expect the following recovery process after PRK:
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After PRK, patients may experience mild discomfort, tearing, and sensitivity to light as the epithelium regenerates.
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As the cornea heals and stabilizes, visual improvement typically begins within a few days to weeks after PRK.
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Regular follow-up visits with the eye surgeon are scheduled to assess visual acuity, monitor healing progress, and address any concerns.
Risks
There are potential risks and complications associated with PRK, including:
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An infection of the cornea or surrounding tissues may occur after PRK, and antibiotics should be taken as soon as possible.
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Some patients may develop corneal haze, a cloudy or blurry appearance of the cornea that can impair vision. Corneal haze is usually temporary but may require additional treatment in severe cases.
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Occasionally, the desired refractive correction may not be fully achieved, resulting in residual refractive error requiring further enhancement.
Aftercare
After PRK, patients should follow the following aftercare instructions:
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To promote healing and reduce infection risk, patients are instructed to use prescribed eye drops, including lubricating drops and anti-inflammatory medications.
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To protect the eyes from harmful ultraviolet rays during healing, patients should wear sunglasses with UV protection when outdoors.
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To prevent dislodging the bandage contact lens and reduce the risk of infection or corneal damage, patients should avoid rubbing or touching their eyes.
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During the initial recovery period, patients may be advised to avoid strenuous activities, swimming, or dusty environments.
It is possible for patients to achieve optimal vision without the use of glasses or contact lenses if they understand the PRK procedure, follow aftercare instructions, and attend follow-up appointments. In order to monitor progress and address any post-operative concerns, it is essential to maintain regular communication with the eye surgeon.
