Prior to LASIK, PRK surgery was the most commonly performed laser vision correction procedure. It was the first FDA-approved procedure changing the curvature of the cornea with the excimer laser.
PRK surgery is best suited for patients who are not candidates for LASIK, including those with thinner corneas, irregularly shaped corneas, corneal scars, or with vocational or sports-related limitations where a corneal flap is contraindicated.
In PRK, the topmost layer of the cornea, called the epithelium, is removed and allowed to grow back naturally over the course of 3-4 days. The surface of the cornea is reshaped using the excimer laser.
As a laser vision correction procedure with more than 25 years of clinical history, PRK is an excellent alternative to the more popular LASIK procedure. Like LASIK, PRK is both safe and effective. Visual outcomes with PRK are similar to LASIK, however the recovery process involves more discomfort as the eyes surface heals.
Although both procedures appear very similar, there are a few key differences between them. The main difference is where on the cornea the excimer laser is applied.
During a LASIK procedure, a corneal flap is first created with a femtosecond laser. This flap is then lifted, and an excimer laser is applied to the underlying corneal bed to reshape the cornea. The flap is then put back into its original position and allowed to heal naturally over the next several days. Antibiotic and steroid drops are used post-operative for a short period of time to aid in healing.
During a PRK procedure, the fine outer layer of the cornea, or epithelium, is removed to expose the underlying cornea instead of creating a hinged corneal flap as with LASIK. The same excimer laser is applied to the underlying cornea. A bandage contact lens is placed on the eye to promote healing of the corneal surface which normally occurs within a week. Antibiotic and steroid drops are also used post-operative for a longer period of time compared to LASIK.
Differences in Recovery
The difference between these two procedures is not found in the results. Studies have shown that LASIK and PRK provide similar vision correction. However, PRK patients are usually less comfortable and visual recovery is slower. The difference is in how long it takes to get the desired visual outcome. Given the success of LASIK, PRK is mostly used for patients who have thinner corneas, have high prescriptions, and have other reasons that make them poor candidates for LASIK.
With PRK, the initial discomfort, blurriness, and distorted vision can last for several days. Peak clarity from PRK laser eye surgery can take up to six months. The main advantage of PRK is, however, it leaves the integrity of your cornea stronger than LASIK since no flap is created.
In LASIK, the discomfort that follows is usually mild and short-lived. Many patients report that their visual acuity is dramatically improved within a few hours after surgery, although this continues to refine over the coming months. Peak clarity is normally achieved within 1-2 months.
For those who struggle with the issues related to reliance on corrective glasses and contact lenses for clear vision, and for whom LASIK is not an appropriate choice, PRK is an excellent choice. Unlike LASIK, the PRK procedure does not include creating a flap in the corneal tissue prior to performing the laser vision correction. By preserving more of the corneal tissue for treatment, PRK allows more people to take advantage of the benefits of laser vision correction.
With LASEK and Epi-LASEK, the epithelium is moved aside and then replaced after surgery.
Both PRK and LASIK have proven to be effective methods for laser vision correction. Each has its strengths, depending on the situation.
While the initial recovery is usually slower with PRK compared to LASIK, the final vision result is typically the same with either method.
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One of the first questions asked is always “What does it cost?” Which is why we provide you with all the information needed to make an informed financial decision. You can save thousands of dollars by ditching your glasses and contacts.
PRK should be affordable for everyone. With 24-month financing, you can make payments that work for you.
If you have a Flexible Spending Account (FSA) through your employer, you can save hundreds on PRK.
As with every surgery, the cost and the risks of PRK should be carefully considered beforehand.
After PRK surgery, the usual full recovery time is about 3 months, though patients heal at different rates.
Although it can take a few weeks to a few months for patients to fully reach their optimal vision, outcomes for PRK, LASEK, and Epi-LASIK are similar.
Patients usually experience some discomfort and blurred vision during the first few days. Halos and glare may be present from this time. Additionally, patients are normally placed on a regimen of steroid eye drops for a two-to-four-month window following the procedure.
Most patients can resume normal activities within a few days.
Most patients report improved vision by the end of the first week.
Many patients report that most of their side effects have subsided.
Most patients report that halos and glares subside at this time.
To find out if PRK is right for your eyes, you will need a thorough vision consultation. If you have been told in the past you were not a candidate for vision correction like LASIK, you should consider having a second opinion. Many patients we see at LaserVue who have been told before that they cannot have their vision corrected, but are actually good candidates for the PRK laser vision correction procedure. That is why it is important to see a vision correction provider who specializes in all the latest vision correction techniques.
PRK, along with other forms of laser vision correction, can be an effective treatment for those suffering from contact lens intolerance (CLI). CLI is a painful and progressive condition associated with the eye’s rejection of contact lenses. This can lead to irritated eyes and may bring discomfort when wearing contacts for long periods of time. PRK can treat CLI by eliminating the need for contact lenses altogether. If you are concerned that you may be suffering from CLI, please give us a call or schedule an appointment.
The PRK procedure itself is not painful. Before your PRK procedure begins, your eye will be numbed with anesthetic drops. You may feel a slight sensation of pressure, but LaserVue surgeons will talk you through each step. As part of your PRK procedure, your vision correction surgeon will apply a protective, temporary contact lens to the eye to reduce the post-operative discomfort which usually lasts 4-5 days. This special contact lens functions as a type of bandage for the eye, keeping the surface safe and more comfortable in the first days after PRK eye surgery.
Absolutely! When having PRK for both eyes, it can be done in one surgery day. When having PRK on both eyes at the same time, there is only one recovery period, one drop schedule to follow, and the brain is able to adapt to the corrected vision all at once. However, we are happy to treat one eye at a time also based on your preference.
Both LASIK and PRK are performed with an excimer laser, which reshapes the front of the eye (the cornea). Both PRK and LASIK are excellent procedures that deliver similar long-term results.
PRK eye surgery achieves improved vision by using an excimer laser to reshape the very front surface of the eye (cornea). In LASIK, the same laser makes changes to the cornea but under a flap made by a second laser. Not having to create a corneal flap is the primary difference between LASIK and PRK.
The process of healing from PRK eye surgery is different for each person, and is closely tied to how well you follow post-operative instructions. After PRK, vision will improve daily. Functional vision (seeing pretty clearly for day to day tasks like driving) will generally occur five days after your PRK procedure. However, full clarity can take several weeks or months to achieve. By attending your scheduled post-operative checkups, your vision correction team can track your results and healing and answer any questions you may have.
Typically the eye will take three to six months to be healed and stabilized. After this occurs the vision correction procedure to your cornea is permanent. Any changes to your vision will be the result of normal aging processes of the eye.
While protecting your eyes from the sun and it's harmful UV rays is critical for all aspects of eye health, it 's particularly important after having any eye surgery, including PRK. It is important to wear sunglasses while spending time outside to reduce the harmful effects of UV exposure. This will help your healing process, as well as stabilize long-term eye sight.
You should not rub your eyes in general. It is a habit that can reduce eye health. It is particularly important to not touch or rub your eyes after a laser vision correction procedure to encourage healing. We understand that many people have a tendency to rub their eyes, especially if they are irritated. For this we can provide you with an eye shield to wear when you sleep, to reduce eye rubbing damage.
Directly after your procedure you should have a designated driver as you will be offered a sedative like Valium to help you relax and will have blurred vision for 4-5 days after the procedure, as well as sensitivity to light. Most people can return to normal driving habits within 1 week after the surgery.
Just like driving, it is most important for you to feel comfortable before returning to work. Many people will return to work after 4-5 days of receiving the surgery. It is recommended if possible, to reduce screen time to maintain comfort and to reduce dry eyes. Try using the 20:20:20 rule, every 20 minutes look at an object 20 feet away for 20 seconds. This as well as blinking often will help keep your eyes more comfortable.
There are medical conditions that may make surface ablation procedures like PRK more suitable than LASIK.
LaserVue will evaluate and determine which procedure is best for you. We will inform you of the benefits and risks of each procedure, and answer all of your questions regarding the procedures.
If you’re interested in PRK, give us a call at 1-800-LASER-45 (1-800-527-3745) to schedule a free consultation to determine if you are a good candidate for PRK, LASIK, or another refractive surgery treatment.