How Does PRK Surgery Work?

Are you having difficulty seeing near or far objects, having double vision, difficulty focusing on objects, blurring of vision, halos around the light, headaches, eye fatigue, irritation, and dry eyes? If yes, then you may be having a type of refractive error. 

Your eyes are a gateway for your vision, and different parts of your eyes work in conjunction to pass the light that enters your eye to the brain. Light enters your eye and passed through the cornea (the white clear part of the eye). The cornea then passes the light through the lens (this is like a camera, which helps to focus and transmits the light) onto the retina (layer of nerve cells at the back of the eyeball). The nerve cells present in the retina then convert the light into electric signals. These signals are sent to the brain via the optic nerve in the eye. The brain processes these signals and converts them into an image. Refractive errors develop when the light is unable to focus directly on the retina due to the change in the shape of the cornea, eyeball, or lens leading to the above symptoms. 

What is PRK Surgery?

Photorefractive Keratectomy (PRK) is an advanced laser surgery that is used to treat refractive vision errors like myopia (nearsightedness), hyperopia (farsightedness), presbyopia (loss of the ability of the eye to focus and see near objects) and astigmatism (an imperfection in the curvature of your eye’s cornea or lens). The goal of PRK surgery is to allow less dependency on glasses and contact lenses. It is a flapless procedure that takes approximately 10 to 15 minutes per eye. Let us discuss how does PRK surgery work?

How Does PRK Surgery Work?

Once you have decided to go for PRK surgery, you need to plan well in advance for it. You should be aware of the care you need to take before, on the day, and after the surgery for a quick and safe recovery.

Before the surgery

In the initial visit, Your surgeon will ask about your medical and family history and will confirm if you are an ideal candidate for PRK after examining your eye’s health, vision in your eyes, and refractive error of your eye and will measure the cornea and the pupil size of your eye. PRK surgery is preferred if you have a thin cornea, flat cornea, corneal scars, or dry eyes. Your surgeon will inform you about the surgery cost, benefits, risks, and precautions to take before and after the surgery. Before the procedure, you should inform your surgeon about any medications or supplements you are taking, as you may need to stop some before surgery. You will be advised to stop using contact lenses at least 2 weeks before the scheduled surgery date. You will be asked to arrange for someone to drive you to your surgery and back home after the surgery, as PRK is an outpatient procedure, and you will be permitted to go home the same day. 

The surgery                                             

PRK is an outpatient procedure, meaning you can go home the same day. The procedure takes less than 20 minutes per eye. Local anesthesia is used for the procedure; hence you will be awake during the surgery.

• Your eye surgeon will numb your eye with anesthetic eye drops.
• You may be given an oral sedative to reduce anxiety during the procedure, as any movement during the surgery can cause untoward complications.
• An eyelid holder will be placed on your eye to clamp it and hold it in its position. This is done to keep your eyes open during the procedure.
• Your surgeon will use a special brush, blade, laser, or alcohol solution to remove the cornea’s outer layer (epithelium).
• You will be asked to stare at a target light so that you do not move your eyes while the laser is used to reshape your cornea. Your surgeon will use a targeting or excimer laser programmed according to your eye measurements. This will be done by using a pulsating beam of ultraviolet light. You will hear multiple beep sounds while the laser is used.
• The surgeon will put a contact lens over the eye to prevent eye irritation. This contact lens acts as a bandage and should be placed for 4 to 5 days. Your surgeon will remove the contact lenses after 4 to 5 days of surgery.
• The same procedure is done for the other eye. A scalpel is not used in the entire procedure, and no incisions (cuts) on your eye are made.

Postoperative recovery

You will be kept in the observation area to check your vitals and progress and be allowed to go home after some time. You should arrange for a family member to drive you home on the day of the surgery as you may be feeling dizzy anf sleepy from the effects of anesthesia. Initial recovery from PRK takes about 4 to 6 weeks. Complete vision is restored between 3 to 6 months. You may experience watering, sensitivity to bright lights, pain, blurry vision, dryness, irritation, itching and a feeling of a foreign body in the eyes for the first 2 to 3 days of surgery. These will subside with anti-inflammatories, antibiotics and painkillers prescribed by your surgeon. You will be advised not to-  indulge in high impact, drive, swim, apply makeup, wash your hair for a few weeks after surgery as the waer and chemicals can enter your eye and cause infections.

What Are The Advantages of PRK Surgery?

PRK surgery is a safe procedure when other surgical methods are not an option. The restoration of visual acuity is the same as with LASIK, but thee are some advantages of PRK surgery.

• PRK is the ideal procedure if you have a thin cornea as other surgeries like SMILE and LASIK can only be performed on thick corneas. PRK surgery also corrects all refractive errors like myopia (nearsightedness), hyperopia (far-sightedness), presbyopia (difficulty in seeing near and far objects due to aging), and astigmatism (abnormal curvature of the cornea).
• PRK is the preferred surgery if you play high-impact contact sports like football, soccer, rugby, wrestling, etc. It is also effective if your profession demands precision and make you vulnerable to injuries  like an army, police officer, military, airforce, navy, etc. This is because, in PRK surgery, there is no cutting of a flap on the cornea, unlike LASIK, where a flap is cut, and the excimer laser is used to reshape the cornea.  Hence in PRK, there is no risk of flap detachment during any significant blow to the head or face.
• After PRK surgery, There is a low risk of dryness of the eye or infections in the eye when compared to other surgeries. PRK is a minimally invasive, modern laser treatment that causes fewer postoperative complications because the natural lubricating mechanism of the eye is not disturbed during the surgery.
• After the surgery, there is minimal dependence on eyeglasses or contact lenses. This is the main reason that individuals opt for PRK surgery.
• PRK, when compared to others, is a cost-effective treatment. It is generally a cheaper surgery than other laser eye surgery methods.

What Are The Disadvantages of PRK Surgery?

PRK is a simple and safe surgery with minimal side effects, but any procedure has its own disadvantages. Some of the disadvantages of PRK surgery are

• The recovery time is longer- With PRK you should expect a longer recovery period than LASIK because, in PRK, the cells in the cornea’s epithelium are removed before the application of laser and these cells would require time for healing, so initial recovery after PRK would take 3 to 5 days and it would be between 3 months to 6 months when the vision stabilizes. Saying that it is important to note that the improvement in vision is much better in PRK when compared with other surgeries, days after the procedure.
• All surgeries come with complications but with PRK, the complications can be severe and include scarring of the cornea,  cloudy cornea, and a permanent “halo” effect post-surgery. These pose a difficulty in resolving. One rare complication that can occur with PRK is that the vision instead of becoming better may become worse. 
• With PRK, there is always a risk of over or under-correction of vision and due to this, you might require glasses or contact lenses or may even have to undergo additional surgery to correct this.

When you weigh the pros with the cons, PRK surgery comes out as a winner. PRK is the most popular, safe, and effective surgery that provides excellent visual outcomes. At Medfin, we have state-of-the-art equipment and trained ophthalmic surgeons to perform the surgery. Consult our surgeons to know more about PRK  procedures- Book your appointment NOW!