Photorefractive Keratectomy (PRK) uses a laser to sculpt the surface of the cornea. This contrasts with LASIK, which sculpts inside the cornea. PRK is useful for treating low to moderate levels of myopia or hyperopia with and without astigmatism. It is the procedure of choice if the patient has certain corneal dystrophies, certain corneal scars, or a condition called “recurrent corneal erosion”. PRK was FDA approved for myopia in 1995 and for hyperopia in 1998. PRK involves first removing the outer layer of the cornea, called the epithelium. A cool laser beam is then applied to the cornea, and a soft contact lens is placed over the eye as a bandage to help the outer layer to grow back. It usually takes 3-5 days for the outer layer to re-grow over the cornea. During that period, the patient may experience mild to marked discomfort with blurry vision. Unlike with LASIK, it takes longer to achieve the final result in PRK since a greater amount of tissue healing takes place. Because no corneal flap is created and manipulated during PRK, it is technically easier for a surgeon to perform PRK than LASIK.
In PRK, the surgeon may remove the outer layer either mechanically (with or without the aid of special chemicals) or with a laser. In mechanical removal, your surgeon uses a spatula or a rotating brush to cleanly remove the anesthetized epithelium. The epithelium may be “softened” by soaking it with certain anesthetic drops or diluted ethyl alcohol. Alternatively, the excimer laser can remove the outer layer in a process called “transepithelial ablation”. The laser removal of the outer layer is probably no better than mechanical removal.
An important note from Dr. Thompson:
See: Risks of Refractive Surgery. Remember surgery is surgery and all surgery has risks. This is not meant to discourage you but these are facts you should know if you plan to have surgery preformed. This office is extensively involved in refractive surgery and would be happy to meet with you and discuss your case. I have personally had refractive surgery. But, just because these risks were acceptable to me does not mean they will be acceptable to you. I strongly recommend you educate yourself prior to surgery and then consult a knowledgeable eye care provider to further guide you through the procedure and follow-up. Pre and post operative care is critical in maximizing your chance of a good outcome.
Our office policy is to educate our refractive surgery patients well enough that they have realistic expectations and know the risks before they commit to the surgery, we believe in informed consent. Once the decision is made, it is our goal to get that person to the best surgeon for the amount of money they want to spend.