PRK (photorefractive keratectomy) is a type of refractive procedure performed to correct nearsightedness, farsightedness and astigmatism – just like LASIK vision correction does. At the heart of the procedure, your doctor uses laser energy to reshape your cornea to allow light to properly focus on your retina (the back of your eye). A cornea that is not ideally shaped will cause blurry vision at varying distances.
PRK is often recommended for patients who have thin corneas. At Mountain Eye Associates, we prefer PRK over LASIK to help our patients achieve clearer vision – 20/20 vision or better for most patients. PRK has the longest track record of the excimer based refractive procedures, and the lowest chance of long-term complications because there is no flap to deal with.
We’ve assembled comprehensive PRK information on this page to help you understand this procedure:
- PRK vs. LASIK
- What to Expect During PRK Surgery
- What Happens During a PRK Consultation?
- Common Questions About PRK
- Affording PRK
PRK vs. LASIK
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 (nearsightedness, farsightedness and astigmatism). This allows light to focus on the retina for clear vision. How your doctor accesses this corneal tissue is where the two procedures 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 3-5 days.
What to Expect During PRK Surgery
PRK is an outpatient procedure. Please expect to be at our office for approximately 1.5 hours even though your time in our surgical suite will usually only take 30 minutes or less. This extra time is necessary to have you complete last-minute paperwork and have anesthetic and antiseptic drops applied. Relaxation medication can also be administered if you are feeling especially anxious before the procedure.
Here is what you can expect during the PRK process:
- Numbing anesthetic eye drops will be placed into your eyes.
- A device will be placed into your eyes to keep your lids open and prevent blinking.
- Your doctor gently removes your cornea’s outer (epithelial) layer to allow access to the underlying tissue.
- An excimer laser (the VISX STAR S4 IR® laser) is used to reshape the cornea by removing small amounts of corneal tissue according to your unique refractive error. This step takes just minutes to accomplish. Eye tracking technology will detect the slightest eye movement and stop the laser until the eye is in perfect position again.
- 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 your doctor will perform one final check of your eyes.
- When your doctor gives the ok, you will be free to have a friend drive you home so you can rest.
After PRK Surgery
PRK recovery takes longer than LASIK because the epithelial cells need time to regenerate. This process may take 5 days or more. After that time the temporary contact lens can be removed by your doctor. It may take a couple of weeks or months until your vision stabilizes to give you your final vision results.
Some patients experience temporary eye discomfort after PRK surgery including:
- Mild pain
- Itching or burning
- Hazy vision
- 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 your doctor if they continue.
What Happens at a PRK Consultation?
Our PRK consultation is designed to set your mind at ease and let you know if the procedure is recommended for your eyes. For best testing results it is recommended that you be out of soft contact lenses for 1 week, and out of hard contact lenses for at least 2 weeks before your full consultation exam. Testing will include:
- Multiple scans of your eye
- Testing of your corneal thickness
- Identification of any eye diseases or other conditions
- Overview of your medical history
The consultation is also a time for you to get information about:
- Costs and financing
- PRK technologies
- Our doctors’ experience
- Vision results for our past patients
- Potential risks and complications of PRK
- Any other questions or concerns you have
Equipped with the knowledge you receive during the consultation, you will know for sure if PRK is a feasible option – no more wondering! You may want to talk things over with a loved one or think about your budget before deciding to proceed – and that’s fine. We will not pressure you into scheduling the procedure on-the-spot. We simply want you to know your options.
Common Questions About PRK
- Does PRK hurt?
Prior to the PRK procedure, your doctor 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 procedure usually takes less than 30 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 usually takes less than 2 minutes!
- What are the risks of PRK?
Although considered a safe medical procedure, PRK carries some element of risk. Complications of PRK can include:
- Starbursts, glare or halos in low light environments
- Sensitivity to bright light
- Over-correction or under-correction
- 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 2-4 days off from work to recover from PRK. 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 your doctor 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 procedure, 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 PRK consultation with us. We also offer a free PRK screening exam which will be able to give you a very good idea of your eligibility for the procedure.
- 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 Mountain Eye Associates.
- 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 want better vision, we don’t want cost to stand in your way. We have several recommendations to help make PRK an attainable goal for your budget:
- PRK financing: We offer financing through CareCredit®. If you qualify, you can have your PRK procedure with no money down and pay for it over time with low monthly payments.
- Flexible Spending Account (FSA): If you have access to a Flexible Spending Account or Health Savings Account, you may be able to set aside pre-tax earnings to save for your procedure and ultimately end up spending less on the overall cost. There are restrictions with these plans regarding the timeframe when the money must be used, so make sure you know all of the specific rules of your plan before enrolling.
- Credit cards: We accept Visa and Mastercard.
We also accept cash and personal checks.
If you are tired of wearing glasses or contacts, schedule a PRK consultation with us today. We will take time to fully assess your eye health and let you know if PRK would be a good option for vision improvement. Call (828) 452-5816 to schedule a PRK appointment in our Clyde office.