Your eyesight is vital for your best quality of life. Poor vision can be helped by a PRK (photorefractive keratectomy), which is a type of outpatient, refractive laser eye surgery that helps with nearsightedness, farsightedness and astigmatism. About 80% of patients see improved vision one month after surgery and 95% after three months.
Photorefractive keratectomy (PRK) is a laser eye surgery — specifically a type of refractive surgery. A refractive problem is where your eyes don’t bend light properly, which keeps you from seeing your best. There’s a chance that after your PRK you might not need your glasses or contact lenses anymore, or at least only for certain activities like reading or driving at night.
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A photorefractive keratectomy is performed to treat refractive errors in your eyes. By using a laser to change the shape of your cornea, this procedure improves the way rays of light are focused on your retina. You may need a PRK if you’ve been diagnosed with the following eye issues:
You have to meet certain requirements in order to have a PRK. In addition to having a conversation with your ophthalmologist (eye doctor) about what to expect, you need to:
You’re not likely to qualify for a PRK if you:
Your photorefractive keratectomy will take place in an outpatient eye surgery center.
You may work with a whole team for your photorefractive keratectomy:
LASIK (situ keratomileusis) is also a type of laser eye surgery that works on your cornea. Unlike LASIK, a PRK doesn’t involve cutting a flap in your cornea. It’s best to have a PRK if you have dry eyes, thin corneas or if you have a very active lifestyle. The corneal flap could move from the activity.
All laser vision correction surgeries work by reshaping the cornea, or clear front part of your eye, so that light traveling through it is properly focused onto the retina located in the back of your eye. During PRK, an eye surgeon uses a laser to reshape your cornea. This laser, which delivers a pulsing beam of ultraviolet light, is used on the surface of the cornea, not underneath a corneal flap as in LASIK.
LASIK has a shorter recovery period and less pain after the procedure. If you have a PRK you’re more likely to have hazy eyesight for a short time. Usually, the quality of vision long-term from a PRK is as good as LASIK.
You might choose a PRK over LASIK for the following reasons:
Before your PRK surgery, you will meet with a healthcare provider who will discuss what you should expect before, during and after your surgery. During this session, your medical history will be evaluated and you’ll have your eyes tested to measure the following:
Your eye surgeon will answer any further questions you may have. Afterwards, you can schedule an appointment for the PRK procedure.
If you wear rigid gas permeable contact lenses, you should stop wearing them at least three weeks before the date of your screening visit. Other types of contact lenses shouldn't be worn for at least three days prior to evaluation. Be sure to bring your current glasses so your prescription can be reviewed.
On the day of your surgery, eat a light meal before coming and take all of your usual prescribed medications. Don’t wear eye makeup or have any bulky accessories in your hair that will interfere with positioning your head under the laser. If you’re not feeling well that morning, call your ophthalmologist’s office to determine if the procedure needs to be postponed.
It’s not necessary to bring anything to your procedure, although you might want to wear glasses instead of contact lenses, just for the convenience.
Your PRK will happen in six steps:
The PRK procedure only takes about 10 to 15 minutes.
You will be awake during the PRK procedure. Your surgeon will use drops to numb your eyes.
You’ll be able to go home right away after the PRK. However, you should have someone drive you.
After the PRK, you should:
You may have some eye pain for two or three days, so take an over-the-counter pain reliever or get a prescription for eye drop pain relievers. You may also be prescribed other medications. Be sure to wear sunglasses outside (for as long as you’re instructed) to prevent scarring on your corneas.
Your vision will improve after three to five days, but meanwhile, it may be blurry. It may take a month of more before you see big improvements with your vision.
Talk with your healthcare providers about the risks and benefits of a PRK (photorefractive eye surgery) before your procedure. Advantages include:
All surgeries include risks, and a photorefractive keratectomy is no different. After the procedure you may have:
Very, very rarely, patients have experienced worse vision or even blindness.
The outcome is not completely predictable due to variations in individual wound healing, and a small number of patients may still require glasses or additional surgery to achieve their best vision.
The prognosis is very positive after PRK. Typically, vision is about 80% improved at one month after surgery and about 95% by three months after surgery.
No. Your eyes will be numbed so that you don’t feel anything. After the procedure you may feel some pain for a few days.
There are no restrictions on what you can eat or drink after a photorefractive keratectomy.
The bandage contact lens is usually worn for the first several days to allow the surface of your eye to heal. You should expect to visit your ophthalmologist two or three times during the first three months after surgery, with the first visit being one to three days after surgery. Once the surface of your eye is healed, the bandage contact lens is removed.
Presbyopia (loss of focus on nearby objects) eventually affects all patients over the age of 40 and can be managed with reading glasses or with a blended approach to laser refractive surgery called monovision. Monovision can be simulated before surgery by using a pair of trial glasses or contact lenses. In monovision, the non-dominant eye is corrected for computer or reading distances (slightly nearsighted) and the dominant eye is corrected for distance.
Presbyopia is not actually reversed by monovision PRK, but your dependence on reading glasses can be reduced by incorporating monovision into the treatment plan. An in-office trial of monovision during your screening exam can help you assess the benefits and compromises associated with a monovision approach.
Some people take a few days off work/school while others take a whole week. Don’t return until you feel comfortable with your vision.
Contact your surgeon if the pain doesn’t go away after a few days.
See your optometrist or ophthalmologist for a follow-up appointments as recommended. Let them know if you have any more concerns about your vision.
This depends on the type of insurance you have and how much they cover. Contact your insurance company before the procedure to find out the details.
A note from Cleveland Clinic
A photorefractive keratectomy (PRK) is a short procedure with a short recovery time. It can improve your nearsightedness, farsightedness or astigmatism. Remember to have appropriate expectations for your PRK. You may still need your glasses or contact lenses after the surgery. Talk to your optometrist and ophthalmologist about your concerns and options as soon as you notice problems with your eyes.
Last reviewed by a Cleveland Clinic medical professional on 06/07/2021.
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