Photorefractive Keratectomy (PRK)
Photorefractive keratectomy, or PRK, has been approved by the Food and Drug Administration in the United States since 1996. The PRK procedure corrects vision by reshaping the cornea. It is used to treat low to high levels of nearsightedness, farsightedness, and astigmatism. PRK differs from LASIK in that the epithelium, or the outer layer of the cornea, is removed entirely during the procedure in order to access the stroma, or inner layer of the cornea. It is often recommended to those who cannot undergo LASIK due to having thin corneas that cannot accommodate a tissue flap.
For nearsighted patients, the goal of the PRK procedure is to flatten a steep cornea. To improve vision in farsighted patients, PRK is used to increase the curvature of a cornea that is too flat. To treat astigmatism, the procedure reshapes the cornea, making it more spherical. Dr. Andrew Holzman can assess your PRK candidacy during a consultation at one of his five Washington, D.C.-area offices.
The Day of Your Procedure
After arriving at your scheduled time, a friendly member of our staff will give you a sedative to help you relax. We will then prepare you for surgery. We will clean the area around your eyes and then apply anesthetic eye drops to your eyes to keep you comfortable during the procedure. There is no need for any needles or injections. Once your eyes are completely numb, we will place an instrument called a speculum to hold your eyelids open and prevent you from blinking during the procedure.
In general, more than 90 percent of patients achieve at least 20/40 vision after PRK, and more than 70 percent achieve 20/20 vision.
Once you have been prepped, Dr. Holzman will remove the epithelium, which is the thin outer layer the cornea. This tissue is discarded, but regenerates on its own in about a week. He will ask you to look directly at a target light while he uses the laser to reshape your cornea. The laser is programmed according to the information about your refractive error gathered during your pre-operative exam. The laser treatment takes less than a minute per eye to complete.
After PRK Surgery
Following your PRK procedure, Dr. Holzman will examine your eyes with a slit lamp. He will then shield them with soft clear contact lenses that act like bandages. You will wear these for three to five days after surgery as they foster the healing process. You may experience blurred or hazy vision for one to five days. As the epithelium heals, you may notice some discomfort. To minimize any pain, we can provide you with eye drops and pain medication. In most cases, you can return to normal activities within one to three days. Your vision may continue to fluctuate for up to six months following the procedure.
PRK Recovery Timeline
The recovery timeline for PRK is a bit longer than LASIK, but can result in comparable enhancement. During the PRK recovery period, patients may also experience a glare or halo effect and light sensitivity. The typical recovery is complete within six months:
- One to Three Days: Over the first few days of your recovery, you may experience some irritation and discomfort. You may also notice some sensitivity to light. The medications and eye drops Dr. Holzman provides can help minimize these side effects. It is usually best to take these days off work or school so you can rest your eyes and allow the epithelium to regenerate.
- Three to Five Days: You will return to our office three to five days after your surgery. Dr. Holzman will remove the bandage contact lenses at this time since most, if not all, of your epithelium will have grown back. You may have blurry vision temporarily but you can usually return to your regular activities at this point.
- One to Three Months: Your vision should continue to sharpen and stabilize during this time. Fluctuations should become less frequent.
- Three to Six Months: By this time, your vision should be stabilized completely and you can fully enjoy a reduced or eliminated need for glasses or contacts.
Risks and Benefits
PRK candidates can expect to achieve results similar to LASIK. Although it typically takes longer to fully recover and achieve optimal results following PRK, the procedure remains the vision correction method of choice for patients with especially thin corneas or scars that prevent them from being suitable candidates for LASIK. As with all laser vision correction techniques, there is a very small risk of scarring or infection as a result of the procedure. Dr. Holzman and TLC Laser Eye Centers use special protocols and medications to specifically minimize all risks and adverse side effects.
PRK Safety Data and Statistics
PRK surgery is minimally invasive and is performed on an outpatient basis, meaning patients can return home the day of surgery. There are few serious risks involved, making it one of the safest vision correction procedures available. Patients are often at a greater risk of an allergic reaction to the sedative or their prescription pain medications than any complications related to the surgery itself.
The steroidal eye drops prescribed following PRK surgery also carry some risks. Minor risks include irritation and itching, as well as redness and inflammation. More severe risks may include a rise in intraocular pressure, which can result in glaucoma, as well as damage to the optic nerve and the development of cataracts.
Patients who undergo PRK surgery should take extra precautions when driving, as vision and depth perception may fluctuate. In general, more than 90 percent of patients achieve at least 20/40 vision after PRK, and more than 70 percent achieve 20/20 vision. As few as one percent of patients require a touch-up procedure following their initial surgery. Just five percent of patients need to continue wearing glasses or contacts (usually at a much lower prescription) after PRK.
Learn More about PRK
If you are tired of relying on contacts or glasses to correct your vision, contact our office to schedule a laser vision correction consultation with Dr. Holzman. He will evaluate your current vision, ocular health, and goals to determine whether PRK or another procedure is right for you.
“Dr. Holzman is the best - very honest, very professional yet very friendly and personable.” Ben E.