PRK Educational Material
Laser Eye Surgery in Denver, Colorado
Photorefractive Keratectomy (PRK)
Introduction
How it works
Surgical procedure
Recovery
Results
Risks
Introduction to PRK
LASIK has become the treatment of choice for most people, but for individuals whose eye orbits are too deep or whose cornea is too flat, steep or thin, PRK may be the best alternative.
How PRK works
PRK, preceded LASIK and was the first modern operation using a laser to correct vision. About 15% of patients choose PRK for their laser vision correction, particularly if they have thin or irregular corneas.
Photorefractive Keratectomy (PRK) is a laser surgical procedure effective in correcting nearsightedness, farsightedness, and astigmatism. Much like LASIK, PRK uses an excimer laser to reshape the cornea, resulting in a reduction or elimination of glasses and contact lenses.
This reshaping is done on the outside surface of the cornea, rather than under a flap as in LASIK. It starts at Bowman's membrane and continues as necessary into the stroma, where the majority of laser vision correction takes place.
PRK Surgical Procedure
During the PRK procedure, Dr. Cutarelli does not create a flap, but instead removes the epithelium cells, the thin layer of cells on the surface of the cornea. Then, he uses the cool beam of the excimer laser to precisely reshape the cornea to its desired shape, in the same manner as LASIK with the same visual results, only at a slightly slower pace.
PRK eye surgery generally requires about twenty minutes of operating room time, but the actual duration may vary according to the type and amount of correction needed. A mild sedative, such as Valium or Ativan, may be given to help you relax. Eye drops will be administered to numb your eyes. You will be lying on the laser bed and your eyelids will be held open with a device called a lid speculum. You will be asked to focus on a special fixation light in a microscope. For a more detailed explanation see: LASIK surgery.
After PRK eye surgery, Dr. Cutarelli will place a soft contact lens on the cornea to protect the eye and reduce discomfort while healing. Until the contact lens is removed, your vision will be blurred. The blurriness may go away within a short time or may be that way for a number of months. You will be required to use medicated and lubricating eye drops to assist the healing process. It will generally take a few weeks for your vision to stabilize.
PRK Recovery
LASIK and PRK are very similar. In PRK and LASIK, you can usually read a clock across the room immediately after the procedure. PRK however, has a slightly longer recovery period, usually taking a week or so before a patient reaches optimal visual acuity. Immediate recovery time and time off from work is two to four days. During this healing period the patient continues to wear the soft contact lens. The contact lens acts like a Band-Aid to cover the cornea and to minimize discomfort.
You will be able to go home afterwards, but you will need to arrange for someone to drive you and bring you back the next day for your exam. Thereafter, you should not drive until Dr. Cutarelli has given you the go ahead.
For the first few days, you may experience discomfort, ranging from scratchiness, to actual pain; your vision may be blurry and/or may fluctuate between being clear and being blurry. In some cases, a patient's vision improves immediately afterwards, but later becomes blurry. These conditions affect various patients differently; some may not be bothered, other patients may be more intolerate to the discomfort or lack of visual acuity.
Functional vision typically recovers shortly thereafter. Several weeks or months may be required to attain final visual results.
PRK Results
The final outcomes of PRK eye surgery or LASIK eye surgery are often identical, especially in lower power corrections; the main difference is the healing time (for more information see LASIK).
You may need glasses or other corrective lenses after the procedure on a temporary or permanent basis. PRK eye surgery will not prevent presbyopia, and may actually reveal a need for reading glasses, particularly for patients over forty years of age.
PRK Risks
PRK includes the same risks as LASIK, plus some discomfort caused by the removal of the protective epithelium, or skin, of the cornea. This sometimes persists for 2 to 3 days until the epithelium grows back, during which time the patient continues to wear a protective contact lens and use pain relief medication. PRK is occasionally associated with some problems of regression of effect as well as haze in the stroma, both more common in higher powers of correction. The transient haze in the cornea typically is subtle and usually does not affect vision. Occasionally this haze is significant enough to slightly reduce vision, usually resolving itself within six months.
