What is PRK Eye Surgery: Purpose, Complications & After Care

Photorefractive keratectomy (PRK) is a type of laser eye surgery that corrects vision problems caused by the eye not being able to bend light properly on the retina, causing blurred vision. After the surgery, you may not need to wear glasses or contact lenses. The procedure improves your ability to perform most activities without being dependent on glasses.

PRK works by reshaping the cornea with a laser to help the light focus correctly on the retina. It can treat conditions like myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. If necessary, both eyes can be treated during the same session. It's a flapless procedure.

When is PRK recommended?

PRK surgery is recommended for patients with:

Myopia (nearsightedness)

Hyperopia (farsightedness)

Astigmatism (irregular shape of the eye causing blurry vision).

It is also a good option for people with dry eyes or thin corneas, where other types of refractive surgeries like LASIK, CONTOURA, SMILE or SILK may not be suitable. Additionally, PRK is ideal for those with active lifestyles, as it doesn't involve creating a corneal flap like LASIK, reducing the risk of flap dislodgement. It is the only approved procedure for spectacle removal for the US armed forces and now for the Indian Army because of its flapless nature with minimal side effects.

Diagnosis

Your doctor will perform eye scans, corneal topography, Optical Coherence Tomography, Pachymetry and dilated retina exams to assess your vision and determine if PRK surgery is needed.

Treatment and Instructions 

Before Surgery

Avoid driving and eat light meals.

Do not wear eye makeup, hair accessories, or jewellery that may interfere with the surgery.

Wear comfortable clothing.

Surgical Procedure

The procedure takes about 5 to 10 minutes per eye.

Local anaesthetic eye drops will be applied.

An eyelid holder will keep your eye open.

The surgeon will remove the surface cells of the cornea using a laser, blade, alcohol solution, or brush.

The cornea will be reshaped with an Excimer laser based on your eye measurements.

A clear contact lens will be placed on each eye as a bandage to protect them during healing.

This clear contact lens is usually removed after 3-5 days.

Best Candidates for PRK Eye Surgery

To be considered for PRK, one should:

Have healthy corneas and eyes.

Be at least 18 years old.

Have a stable eye prescription for at least a year.

Have realistic expectations about the surgery.

Who Should Not Consider PRK Eye Surgery?

PRK may not be suitable for you if you:

Have advanced Glaucoma

Are pregnant or breastfeeding

Have cataracts

Experience eye infections, dry eye syndrome, or blepharitis

Have eye scars or injuries

Have uncontrolled diabetes or conditions affecting healing.

Preparation for Surgery

Before surgery, you'll have a consultation with an ophthalmologist to discuss your expectations. Your eyes will be measured and mapped to program the laser. You should:

Inform your doctor about any medications you take.

Stop wearing rigid gas-permeable contact lenses three weeks before surgery (other types one week before). Soft lenses require at least one week of discontinuation.

Use prescribed antibiotic eye drops before and after surgery.

Clean your eyes thoroughly for three days before surgery.

Possible Complications

After surgery, you may experience discomfort or pain for up to three days. Over-the-counter pain medications can help. Your eyes might feel irritated and sensitive to light, and you may see halos or bursts of light. 

Other risks include:

Loss of vision not correctable with glasses or lenses

Permanent changes in night vision, including glare and halos

Double vision

Severe or permanent dry eye

Reduced results over time, especially in older or farsighted people.

Care After PRK Eye Surgery

After surgery, you should:

Rest and avoid physical activity as advised.

Take time off work if needed.

Use pain-relieving medications or prescribed eye drops to manage discomfort.

Wear sunglasses outside to protect your eyes.

Though it may be blurry initially, your vision will start improving after three to five days. Significant improvement may take a month or more.