What Is Photorefractive Keratectomy (PRK)?

A PRK procedure fixes refractive errors by using an excimer laser to reshape the cornea. First, your surgeon will gently remove the surface cells (epithelium) of the cornea. Then, using a cool excimer laser, your surgeon reshapes your cornea to correct your vision.

This type of refractive surgery has identical outcomes to LASIK. The vast majority of patients who receive PRK get 20/20 vision without glasses or contacts. PRK is a better alternative to LASIK for many patients who have thin or irregularly shaped corneas, who have pre-existing chronic dry eye, or those who perform sports with a lot of direct contact to the eyes (ex: Boxers, Ultimate Fighting Champions, etc).

PRK can treat low and moderate degrees of nearsightedness, farsightedness, and astigmatism. The main downside of PRK compared to LASIK is that vision remains blurred for longer after surgery and there is potential for some discomfort after treatment.  After a PRK procedure, it takes up to a week for the surface cells to grow back and cover the surface of the cornea. It takes anywhere from two to six weeks for the cells to smooth and allow for clear vision. It can take up to three months for maximum vision after PRK.

PRK patients have the option of having both eyes treated on the same day. However, if you have both eyes treated on the same day, you will typically be out of work and unable to drive for a week while your eyes heal.  For those unable to take this recovery time, you have the option of treating one eye at a time, so that you can get back to work earlier using the vision from the other eye. If you elect to have one eye done at a time, the second eye surgery will be performed two to four weeks later (depending on how quickly you recover vision).

Before the Surgery

When you meet with Dr. Kubota and your surgeon to discuss your options, there are several factors that they will consider. Dr. Kubota will first conduct a thorough comprehensive eye health exam and review your medical and family history to make sure that you are eligible for surgery. Make sure that you bring a list of your medications and previous operations. Then you will see your surgeon to do a few more tests to identify any possible concerns about your suitability and discuss the finances. Once surgery is scheduled, you will return to Dr. Kubota to do a dilated fundus exam and refraction and you will need a driver to take you home.  Finally, you will be required to stop wearing contact lenses for a period of time before the operation. This will allow your corneas to return to their natural shape before the operation.

The Surgery

The actual PRK surgery is a short procedure that will only take about 15 minutes. The patient will not be sedated during the operation but may be given an oral sedative if needed to relax the patient. Numbing drops are applied to the eyes and a small speculum is used to hold the eyelids open for the procedure. The surgeon will gently remove the surface cells (epithelium) of the cornea and the excimer laser is programmed for the patient's exact prescription. Patients are instructed to look at a certain object or target while the laser is operating. The surgeon will watch the procedure through a microscope and can stop the procedure at any time.  Most patients do not report discomfort, although there may be some pressure.  At the conclusion of the procedure, a bandage contact lens will be applied.  Do not remove this contact lens on your own.  Once the surface of your eye has healed then Dr. Kubota will remove the contact lens in her office at one of your follow up visits.

Recovery

You will be observed for a short time after your operation to make sure that you don’t have any severe immediate reactions. After this observation, you will be sent home. It is important to have someone else drive you home since your vision will still be blurry and it will impact your ability to drive safely. You should make sure to follow all of the surgeon’s recommendations to facilitate a speedy recovery. You should also expect several follow up appointments with Dr. Kubota to make sure that the operation was successful and that there are no additional concerns. There is potential for some discomfort after treatment and over the counter Tylenol is usually adequate.  Unlike LASIK, after a PRK procedure, it takes up to a week for the surface cells to grow back on the surface of the cornea at which time Dr. Kubota will remove the bandage contact lens. It takes anywhere from two to six weeks for the cells to smooth and allow for clear vision. It can take up to three months for maximum vision after PRK.