When laser eye surgery comes to mind, LASIK is often the first thing people think of. However, there's another type of laser eye surgery called Photorefractive Keratectomy or PRK, which came before LASIK.

Photorefractive keratectomy (PRK) is a type of refractive surgery that utilizes laser technology to correct vision problems caused by refractive errors. Refractive errors happen when the eye fails to bend or refract light properly.

During PRK, an ophthalmologist uses a laser to reshape the cornea, which helps improve how light focuses on the retina. This procedure effectively treats myopia (nearsightedness), hyperopia (farsightedness), and astigmatism.

The goal of photorefractive keratectomy is to correct your refractive error and improve your vision.

Who can undergo photorefractive keratectomy (PRK)?

Certain criteria must be met to be eligible for PRK. Besides discussing with your ophthalmologist about the procedure, you need to:

• Have healthy corneas.
• Have overall healthy eyes.
• Maintain realistic expectations about the outcome of PRK, which will be discussed with your ophthalmologist.
• Be at least 18 years old.
• Have a stable eye prescription for at least a year prior.

You're unlikely to qualify for PRK if you:

• Have advanced glaucoma.
• Are pregnant or breastfeeding.
• Have cataracts.
• Suffer from eye infections, dry eye syndrome, or blepharitis.
• Have eye scars.
• Experience fluctuating refractive errors.
• Have corneal injuries or diseases.
• Have conditions affecting healing, allergies, or uncontrolled diabetes.

An ophthalmologist will conduct a thorough examination of your eyes to assess your candidacy for PRK. Here's what will typically be done:

• Your eye health will be evaluated comprehensively.
• Measurements of your cornea will be taken to assess its shape and thickness.
• The size of your pupils will be checked.
• Your refractive error, including nearsightedness, farsightedness, and astigmatism, will be measured to determine the extent of correction needed.

Surgery Procedure

The PRK surgical procedure typically lasts between 5 to 10 minutes per eye and does not require general anesthesia. Instead, you may receive local anesthesia or numbing eye drops.

During the procedure:

• Each eye will have an eyelid holder to keep you from blinking.
• The ophthalmologist will remove the outer layer of cells from the cornea, a process known as epithelium removal. This can be done using a gentle brush.
• A laser programmed with your eye's measurements will then reshape the cornea using a pulsing beam of ultraviolet light. You may hear a series of beeps during this step.
• To protect your eyes and aid in healing, a clear, non-prescription contact lens will be placed on each eye as a bandage. These contact lenses will remain in place for several days to one week. They help keep your eyes clean and prevent infection during the initial healing period.

Recovery

After having PRK surgery, it's important to relax at home for the rest of the day and avoid too much activity. Keeping your eyes shut can help them heal and feel more comfortable.

Your doctor might want to see you the day after surgery to check on your progress. If you notice any signs of an eye infection like redness, pus, swelling, or fever, be sure to call your doctor right away. If the bandage contact lens falls out or shifts, let your doctor know as soon as possible. You'll need to go back within a week to have the lenses removed.

• Avoid rubbing your eyes or getting makeup, soap, shampoo, or anything else in them for at least a week. Ask your doctor when it's safe to wash your face or use shampoo.
• They’ll also advise you on when it’s safe to drive, read, or use a computer again, which may be challenging initially. Avoid driving until your vision is clear, especially at night.
• Try to avoid sweating in your eyes for about a week to prevent irritation. Refrain from playing contact sports or doing anything that could potentially harm your eyes for at least a month. Wearing protective glasses for a few months is a wise precaution. Avoid swimming and water sports for a couple of weeks. Additionally, keep dust and dirt out of your eyes during this time.

It may take a few weeks for your vision to recover fully.

Wear sunglasses when outdoors to shield your eyes from bright sunlight.

PRK can help improve conditions like nearsightedness, farsightedness, or astigmatism. However, it’s important to have realistic expectations. Even after PRK, you might still need to wear glasses or contact lenses. If you have any concerns or notice issues with your eyes, be sure to talk to your eye doctor right away.