What Is PRK: Pros and Cons, PRK vs. LASIK Surgery

PRK (photorefractive keratectomy) is a kind of refractive surgery to correct myopia (nearsightedness), hyperopia (farsightedness) and astigmatism.

What Is PRK?

PRK was the first type of laser eye surgery for vision correction and is the predecessor to the popular LASIK procedure. Though PRK recovery takes a bit longer than recovery from LASIK eye surgery, PRK is still typically carried out and offers advantages over LASIK for some patients.

Like LASIK and other types of laser eye surgery, PRK works by reshaping the cornea utilizing an excimer laser, enabling light getting in the eye to be properly focused onto the retina for clear vision.

PRK ADVANTAGES AND DISADVANTAGES
Pros Cons
Less depth of laser treatment than LASIK Slower recovery than LASIK
Suitable for patients with a thin cornea Best vision takes longer to obtain
No risk of corneal flap complications Increased risk of post-surgery infection, inflammation and haze
Reduced risk of compromised corneal thickness More eye discomfort during early PRK recovery, compared with recovery after LASIK surgery

The primary difference between PRK and LASIK is the first action/step of the procedures.

In LASIK, a thin flap is produced on the cornea with a microkeratome or a femtosecond laser. This flap is raised to expose the underlying corneal tissue and is replaced after the cornea is improved with an excimer laser.

In PRK, the thin external layer of the cornea (epithelium) is gotten rid of and disposed of prior to improving the underlying corneal tissue with an excimer laser. The epithelium repair works itself (grows back over the corneal surface) within a couple of days after surgery.

A variation of PRK, called LASEK, also is available. Rather of getting rid of the outer epithelial layer of the cornea similar to PRK, LASEK involves lifting the epithelial layer (using a surgical instrument called a trephine), protecting it during surgery and after that changing it on the eye’s surface area at the end of the procedure.

LASEK has reduced in appeal due to the slower recovery of vision compared with PRK, as the changed epithelial layer takes longer to recuperate in LASEK than the development of a new epithelial layer in PRK.

Difference Between PRK and LASIK Eye Surgery

The outcomes of PRK surgery are similar to LASIK results, but initial PRK recovery is slower since it takes a couple of days for new epithelial cells to restore and cover the surface area of the eye.

There also is a somewhat increased risk of eye infection and haziness of vision in the first couple of days after surgery. LASIK patients generally have less discomfort, and their vision stabilizes faster, whereas vision improvement with photorefractive keratectomy is progressive and the final result can take several weeks.

PRK does, however, offer some unique benefits. Because PRK surgery does not produce a corneal flap (which consists of both epithelial and the deeper stromal tissues), the whole thickness of the underlying stroma is readily available for treatment.

This is of specific benefit if the cornea is too thin for LASIK or if you have undergone LASIK formerly and therefore have a thinner recurring cornea. There also is no risk of flap complications, and the risk of eliminating excessive of the cornea with the excimer laser is reduced.

How Is PRK Performed?

First, your eye cosmetic surgeon removes a main area of corneal epithelium with an alcohol service, a “buffing” device or a blunt surgical instrument.

Next, an excimer laser is used to exactly improve the curvature of your cornea’s surface. This computer-controlled, extremely specialized laser provides pulses of cool ultraviolet light that remove microscopic quantities of tissue in a precise pattern.

A soft contact lens “plaster” is then placed on the cornea to assist secure your eye. Brand-new epithelial cells grow back in about four or 5 days, after which the plaster contact lens is gotten rid of by your optometrist.

What To Expect From PRK Surgery

Before. You need to first select an eye cosmetic surgeon experienced in PRK surgery. You will then go through a thorough eye examination to ensure your suitability for laser eye surgery. This will consist of an examination of:

  • The size of your pupils.
  • The moistness of your eyes, to assess the risk of establishing dry eyes after laser eye surgery and treat appropriately.
  • Corneal curvature, using a corneal mapping device to specifically measure the contours of the front surface area of your eye.
  • Corneal thickness.

Your eye doctor likewise will assess your general health and medical background, as well as any medications you are taking, to identify if you are a suitable candidate. If you wear contact lenses, you might have to stop wearing them for a time period before your eye exam, as contacts can alter the natural shape of your cornea. (Ask your optometrist for specific recommendations about this.)

During PRK eye surgery is an ambulatory procedure, implying it is carried out on a walk-in, walk-out basis. In fact, the actual surgery usually takes just 15 minutes. You will be awake during the procedure, however your eye surgeon may give you a mild oral sedative to help you unwind.

Numbing eye drops are used to your eyes, and an instrument called a cover speculum is used to keep your eyelids open. Your cosmetic surgeon then directs the excimer laser over your eye, which is programmed for your precise prescription.

You will be asked to take a look at a target light for a brief time while your surgeon sees your eye through a microscopic lense as the laser sends out pulses of light to your cornea.

The laser energy gets rid of microscopic quantities of tissue and improves the cornea. Many people do not feel any pain, although you might feel some pressure on your eye. Your cosmetic surgeon has full control of the laser and can turn it off at any time.

PRK is carried out on each eye independently (frequently one after the other on the exact same day), with each procedure taking only about 5 minutes. While some patients have actually both eyes dealt with on the same day, others choose to have the surgery on their second eye a week or 2 later on.

Your surgeon covers the treated cornea with a bandage contact lens. Within days, brand-new epithelial cells grow back, and the plaster contact is removed.

Right away After. You will be asked to rest for a short period after your surgery, after which you can return home (another person should own you).

Your cosmetic surgeon will prescribe topical antibiotics as well as anti-inflammatory and pain medications to minimize post-operative discomfort, lessen any swelling and speed up healing. As with any other surgery, it is vital that you follow your doctor’s guidelines to assist ensure maximum results. You will have to go to regular follow-up consultations with your doctor over the next numerous weeks to monitor the recovery procedure.

PRK recovery takes longer than recovery from LASIK surgery. It may be days or a couple of weeks before your eyesight enhances, as well as longer for your vision to support. The majority of PRK patients generally can resume driving a car one to three weeks after surgery, but it can take 3 to six months before vision is entirely clear and stable.

Long-Term Results Of PRK

PRK laser eye surgery has been carried out overseas considering that the 1980s and in the United States since 1995 and has a really high success rate. It has gone through significant improvements during this time and remains the treatment of option in certain scenarios.

PRK and LASIK results are comparable. Most people achieve 20/20 vision after PRK surgery, and almost all patients achieve 20/40 visual skill or better. Some patients might still have to use glasses or contact lenses, but the prescription will be substantially lower than prior to the procedure.

Post-operative PRK and LASIK complications are uncommon and can consist of infection and glare (starbursts or halos that are most noticeable when you’re viewing lights at night, such as while owning).

While unlikely, you may require extra or enhancement surgery to enhance your vision further or to remedy a steady worsening of your vision in time. Checking out glasses likewise might still be required after PRK surgery as soon as you hit your 40s, due to an age-related loss of near vision called presbyopia. The FDA currently is keeping an eye on scientific trials for a long-term surgical correction of presbyopia.

While LASIK is by far the most popular laser eye procedure today, it’s crucial to follow the guidance and judgment of your eye cosmetic surgeon to figure out whether PRK or LASIK is best for your specific circumstances.

Reyus Mammadli (Eyexan Team Leader) / author of the article
Bachelor in biomedical and electrical apparatus and systems. For more than 20 years he has been studying methods to improve health using affordable and safe methods. Collaborates with eye care charity organization of the CCP. Specialization is a vision correction by laser surgery, including LASIK.
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