COMMONLY ASKED QUESTIONS ABOUT PRK

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Questions About the Procedure

What is PRK?

Photorefractive keratectomy is a means of reducing or eliminating nearsightedness that uses an ultraviolet excimer laser to sculpt the cornea to a new shape. The procedure has been in development for about 10 years and on October 20, 1995, the FDA (link to FDA pg) approved the procedure.

How effective is PRK?

For most patients, there is about a 90% chance of achieving normal or near-normal vision (20/40 or better, allowing you to pass the driver's vision test) and carry on most of your daily activities with less dependence on corrective eyewear. Thin glasses that sharpen up your vision for certain activities, such as driving at night, are often needed.

Does it hurt?

The surgery is painless and is performed under anesthetic eye drops. After the surgery, your eye will be a bit sore and some pain medication will most likely be required. After the third day, you will be comfortable. Your vision will be blurry for several weeks until the surface of the eye heals. Some patients (10%) have severe pain after surgery, and require narcotic pain killers.

What is the difference between LASIK and PRK?

Both procedures use the excimer laser to reshape the cornea and correct nearsightedness. The difference is that in PRK, the laser is used on the surface of the cornea and in LASIK, the laser is performed under a protective flap of tissue. WFU surgeons believe that the use of the laser under a protective flap produces faster viaual recovery, less pain, and less scarring. In PRK, the laser is used on the surface of the eye, and it takes several weeks for the surface to heal and become smooth, allowing good vision. Steroid drops are necessary (usually for about two months) to help regulate healing, and it is not as easy to repeat PRK, because of scarring and lack of predictability. For these reasons, LASIK has become the refractive surgical procedure of choice at Wake Forest University Eye Center. There are some circumstances, which make PRK preferably to LASIK, if this is your case your physician will discuss this with you during consultation.

Is PRK better than RK?

Both techniques are safe and effective for low to moderate amounts of myopia. For patients with very low myopia, both techniques offer about a 90% chance of attaining 20/40 or better vision without glasses. For younger patients with more than 3.0 diopters of myopia, the laser may offer a slightly better chance for optimum vision.

Is PRK safe?

Any surgical procedure should be undertaken only after careful consideration of the likelihood of success and consequences of any possible risks or side effects. Thorough professional advice from a qualified eye surgeon or surgeons is required before any eye treatment is undertaken. Predictability can be defined in several ways- a percentage approach to achievement of visual goals, with 20/20 uncorrected vision being ideal and 20/40 uncorrected vision being okay or acceptable. Uncorrected vision of 20/40 still allows driving without glasses. Most PRK facilities and machines report that 65-70% of patients with correction up to -6.00 diopters can expect 20/20 uncorrected vision post operatively. The percentage with 20/40 uncorrected acuity is 90-95%. Corrections less than -6.00 diopters will have better odds and corrections greater than -6.00 will have lower odds. The safety of the procedure is judged on the basis of the chance of a possible complication. Serious complications are extremely rare. Infection is the most worrisome complication and fortunately it can usually be eliminated with antibiotic medications. Other possible problems include delayed surface healing, corneal haze and or scarring, over or undercorrection, and the development of astigmatism. Some individuals can have a poor or excessive healing response. Again most complications remain treatable with medications or further surgery.

Is PRK the same procedure as RK?

No. RK is an older procedure, pioneered in Russia, which uses a handheld scalpel to make 4 - 8 cuts 95% deep into the cornea. Unlike the laser, RK weakens the eye. The predictability and results may vary greatly depending on the skill of the surgeon.

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Questions About Your Recovery

What is Healing Haze?

With PRK, almost everyone develops trace degrees of haze. It is not a fog or blur. Most patients are not even aware of it. It is a normal part of the healing process and usually clears within the first year.

How long will it take before I see better?

Usually vision is immediately improved but may fluctuate for several weeks. For a week a shield is worn over the eye at night until complete healing occurs. The eyes and lids cannot be rubbed to protect the flap.

Will my activities be limited after laser vision correction?

Once your eye heals after PRK, you will be able to participate in all sports and activities that you enjoyed before surgery. It is recommend that you wear eye protection such as sports goggles for any contact or racket sports where your eye may be likely to come in contact with fingers, dirt, balls, etc.

Will I have to still wear glasses?

Glasses, if necessary, for reading and distance are prescribed in two weeks. Retreatment occasionally is necessary and is performed as soon as the eye is stable but usually no sooner than two months.

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