Photorefractive Keratectomy is an extremely well-established laser eye surgery used to correct refractive errors in vision, such as myopia, hyperopia, and astigmatism. As a refractive surgery, PRK aims to reduce or eliminate dependence on corrective lenses by reshaping the cornea—the transparent, frontal portion of the eye—to enhance visual acuity. This blog explains the purpose of PRK, possible complications, and some aftercare tips to make recovery smooth.

Photorefractive Keratectomy (PRK Eye Surgery) is a well-established laser eye surgery used for the treatment of refractive errors in vision, such as myopia (nearsightedness), hyperopia (farsightedness), and astigmatism.

As a refractive surgery, photorefractive keratectomy aims to eliminate or reduce the dependency on corrective lenses by reshaping the cornea (the transparent, front part of the eye) to enhance vision acuity. In this blog post, we will explain the purpose of PRK Eye Surgery, its possible complications, and some aftercare tips to make a smooth recovery after surgery.

PRK Eye Surgery Purpose

Photorefractive Keratectomy was the first type of laser eye surgery before LASIK (laser-assisted in situ keratomileusis) was developed to correct refractive errors. LASIK has become more common due to its quick recovery time, and PRK remains a viable option for many patients. The PRK eye surgery purpose is to correct common vision problems by changing the corneal surface, which directly affects how light is focused on the retina at the back of the eye.

• Myopia (Near Vision): PRK reduces myopia by flattening the cornea, and improving distant vision.
• Hyperopia (Far Vision): To correct far-sightedness, PRK steepens the cornea to improve near and intermediate vision.
• Astigmatism: In astigmatism, PRK smoothes out irregularities on the corneal surface and leads to clearer vision.

PRK is a surgical process that involves the excimer laser for shaving off micro-thin layers of corneal tissue so that light can be properly focused on the retina. While LASIK only opens a flap in the cornea, PRK removes the outer layer of the cornea called epithelium entirely and then reshapes it.

Complications of PRK Eye Surgery

PRK is generally effective and safe but also holds, some potential risks and complications like any other surgical procedure. Understanding these can help patients make informed decisions and prepare for the post-operative phase.

• Discomfort and Pain: patients may experience discomfort and pain during the initial healing period. Because PRK Eye Surgery is a procedure that involves the removal of the corneal epithelium, with this surgery, there is likely to be more pain or discomfort during the first days to a week of healing.
• Visual Fluctuations: Some fluctuation in vision may occur during the recovery process. It can consist of blurred vision or halos about lights, especially at night. It usually settles within several weeks to months.
• Delayed Healing: PRK takes a little longer time for recovery after surgery, in comparison to LASIK. Whereas in the case of LASIK, it may take a few days. PRK may even take several weeks for the vision to get fully stabilized. Fluctuating vision is common during this period.
• Infection: like other surgical procedures on the eye, there is a risk of infection associated with PRK, so aftercare instructions should be taken very seriously to reduce the chances of infection.
• Under or Over-Correction: There is a possibility that the vision correction achieved might be less than optimal. Some patients may require enhancement procedures to reach their desired vision level.
• Haze: Corneal haze may develop during the healing period, which is typically temporary and resolves on its own. More serious cases may require additional treatment.

PRK Procedure Steps

Here are some general steps of the PRK procedure

1. Pre-Procedure Assessment:

– Detailed eye examination to determine the candidate’s suitability.
– Measurement of corneal thickness, eye shape, and refractive error.

2. Preparation:

– The pupils are dilated to get a good view of the eye.

3. Anesthesia:

– Local anesthesia in the form of eye drops that will numb your eyes so that no pain is felt.

4. Removal of the Surface Layer:

-This could be done by scraping off the epithelium with a brush, rinsing it away with an alcohol solution, or lasering it away.

5. Laser Reshaping:

– The excimer laser reshapes the corneal stroma to correct one’s vision.
– The way lasers work on reshaping the cornea is custom-designed from the pre-surgery measurements of the eye.

6. After the Procedure:

– If the patient uses a contact lens, a bandage contact lens will be applied to the eye, to promote healing.
– Prescription of antibiotic and anti-inflammatory eye drops.

7. Recovery:

– A few days to one week is required for the corneal surface layer to heal.
– The vision is a little blurry initially but gets better over time.

8. Follow Up:

– The eye doctor should be visited regularly for follow-up about the healing process and visual improvement.

9. Long-Term Care:

– Following post-operative instructions regarding restriction of activities and taking prescribed medications.

PRK Surgery Aftercare

Proper aftercare will speed up your recovery and help reduce possible complications. The following are some of the essential aftercare instructions:

1. Follow-up Appointments: It is very critical to visit your eye surgeon for regular follow-up visits. These visits will check on your healing process and treat any possible complications that may appear.
2. Medication Adherence: Patients are prescribed antibiotics and anti-inflammatory eye drops to avoid an infection or inflammation at the surgery site. It’s important to use these medications as directed.
3. Do not Rub Your Eyes: Touching and rubbing the eyes may further irritate the cornea and slow down the healing process. Be especially conscious about this during the healing time.
4. Protective Eyewear: You may use sunglasses or protective goggles to shield your eyes from UV light and other potential irritants. This also helps prevent accidental rubbing.
5. No Contact Lenses: If you use contact lenses prior. you’ll need to avoid them until your eye doctor confirms that your cornea has fully healed.
6. Restricted Screen Time: Reduce the screen time and give yourself many breaks to relieve the eyes while recovering. Use this 20-20-20 rule: every 20 minutes, for at least 20 seconds, look at something 20 feet away.
7. Swimming and Hot Tubs: Swimming and using hot water tubs should be avoided for several weeks after surgery to reduce the risk of infection.
8. Good Hygiene: Wash your hands frequently and avoid touching your face. Your surgeon will guide you through eye makeup and facial cleansers to prevent any possible irritation or infection on your face.

PRK Surgery Benefits

PRK Eye Surgery (Photorefractive Keratectomy) offers several benefits as a vision correction procedure. Here are some of the key advantages:

• No corneal flap
• Effective for thin corneas
• Lower risk of dry eyes
• Long-term stability
• Predictable outcomes
• Suitable for higher refractive errors
• Less risk of complications
• Good for active lifestyles

Conclusion:

PRK eye surgery is an excellent solution that minimizes or eliminates reliance on corrective lenses. It is generally safe and effective but also includes some complications to which awareness and proper aftercare can make a huge difference in overall outcome and recovery. The cost of PRK eye surgery depends on the patient’s requirements. By following the recommendations provided by your surgeon and maintaining good habits in the care of your eyes, you can ensure optimal vision correction.

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Written and Verified by:

DR. GAURI SINGH

MBBS, MD (OPHTHALMOLOGY)

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