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Patients recovering from PRK should take special care to follow all of their surgeon's post-operative instructions to ensure optimal recovery. This is important because failure to follow these instructions carefully can have an adverse impact on the outcome of the procedure. Each surgeon may have a unique set of guidelines for patient's recovering from PRK, but listed below are some of the common recommendations encouraged by most surgeons:
The PRK healing time is longer than the healing time required for LASIK and improved vision may not be evident for one to two weeks. Conversely, LASIK patients may experience improved vision within one to three days after the procedure. However, the flap required for the completion of LASIK surgery may take years to heal. Since PRK does not involve the creation of a flap, patients who undergo this procedure do not have the same concerns about disturbing the flap as LASIK patients have.
The PRK healing process is also considered to more uncomfortable than the process of healing from LASIK patient. Discomfort may be more severe and may last longer than the discomfort associated with LASIK.
The major advantage to PRK eye surgery is that it is a very uncomplicated procedure and does not require the creation of a flap. This is significant because it will not require the same degree of skill in the surgeon as the more complicated LASIK procedure. Another significant advantage to PRK eye surgery is it is available to many patients who are not ideal candidates for LASIK procedures. Patients who have thin corneas, as well as patients who have work or recreational activities which prevent them from having a procedure involving the cutting of a flap can both benefit from PRK eye surgery.
Patients undergoing PRK laser surgery should have a thorough examination before the procedure is completed. During this examination the doctor should check for ocular irregularities through a dilation exam, take refractive error measurements, take pupil measurements, take corneal thickness measurements, create a corneal topography map and perform a tear function analysis. Additionally, the doctor should also examine the patient's medical history.
Patients who are preparing for PRK laser surgery should consult with the surgeon prior to this extensive examination for guidelines to follow before the examination. This will likely include not wearing contact lenses for a period of time before the eye is examined to ensure correct measurements.
Comparisons of PRK versus LASIK are necessary for some patients to determine which procedure to undergo. This decision should also be discussed carefully with the patient's eye doctor to ensure the correct decision is made. Listed below is some basic comparison information for PRK versus LASIK, but ultimately the patient should rely on the recommendation from a qualified ophthalmologist before making a decision.
An eye doctor can help a patient to determine whether or not he is a good candidate for PRK surgery. Patients who are considering this procedure should visit the eye doctor for a thorough examination in order to determine if they are an ideal candidate and if the procedure is likely to be successful. In general, good candidates for PRK surgery include those who have mild to moderate myopia or hyperopia, those who have career or leisure requirements which make having a cut flap impossible and patients who are not eligible for LASIK based on the shape or thickness of their cornea.
Complications resulting from PRK eye surgery are relatively rare, making the procedure fairly safe. However, as with any type of procedure, patients should be aware that there is the potential for complications. Some of the complications which may result from PRK surgery include infection, corneal hazing and the development of astigmatism. Patients considering the procedure should discuss the risks associated with the procedure with their surgeon before making the decision to undergo the procedure.
Patients should also consider the risks involved in conjunction with statistics regarding the results of this procedure. Based on this information, patients can determine whether or not the potential for success is greater than the risk of complications. 65 percent to 70 percent of patients who fall within the ideal range for the procedure obtain visual acuity of 20/20 or better while 90 percent to 95 percent of the same group obtain visual acuity of 20/40 or better.
After having PRK you should follow your doctor's instructions and limit yourself from the following activities:
You should avoid strenuous activities or visually demanding activities for three days. Do not play sports, go swimming or play contact sports for several weeks following the surgery. Your doctor will tell you the exact number of weeks he wishes you to follow.
Do not use any eye makeup for the first week following the surgery. You also must not get water in your eyes during that first week. It is important to remember this when you are washing your hair or face.
You may need to limit your driving. Your vision may be blurry for up to three days after the surgery. It is best to have someone else drive you until you have no blurred vision.
These are guidelines most doctors follow; your doctor may have different time limits on the limitations for you. Please follow your doctor's instructions.
After PRK surgery your vision will either be perfect or it will have been under or over-corrected. If under or over-correction occurs, your eye surgeon will perform something called an enhancement to repair the problem.
If vision has not improved three months after PRK, then your eye surgeon will most likely perform this enhancement surgery around that time. The good news about enhancement surgeries and PRK is: only 10 percent of people who have the PRK procedure need enhancement afterwards.
PRK is a non-invasive procedure that users a laser to reshape the cornea. The laser used in this procedure is called an Excimer laser. The laser produces a cold ultraviolet beam of light during the PRK procedure. The Excimer has been determined to be able to remove tiny tissues as small as a molecule without damaging the surface of the eye and is able reshape the cornea.
During the PRK procedure the surgeon will direct the laser beam towards the cornea. This laser beam will be able to evaporate tissue so tiny (1/1000th mm) in the front part of the cornea, making the cornea less steep. This steeping of the cornea changes the shape of it and allows the eye to focus properly, improving vision.
Most doctors advise taking a few days off from work after PRK eye surgery. You'll also be advised to avoid strenuous exercise for up to a week, as this could get in the way of your healing.
You will wear a special "bandage" contact lens for a few days, and will need to use eye drops for several weeks. It may be several days before you can drive, and you may experience some pain or discomfort, controllable with over-the-counter medication.
It's a good idea to have someone available to drive you home from the surgery and back for the first one or two follow-up exams. Some patients have also reported that right after the surgery they are unable to see well enough to take their medications, so those who live alone may want to enlist some help for those first couple of days until they can see well enough to care for themselves.
The laser used in photorefractive keratectomy is called an excimer laser. It emits a specific wavelength of far-ultraviolet light energy that vaporizes fractional layers of cells, leaving a very smooth surface.
By carefully sculpting the shape of the outer layer of the cornea, this laser -- a "cool" laser that does not produce heat -- creates an optimal surface layer for the eye's lens.
For nearsighted patients, the laser slightly flattens the top of the cornea. For farsighted people, PRK surgery yields a slightly steeper cornea. In patients with astigmatism, the laser smooths out irregularities.
The equipment your surgeon uses includes a corneal topographer, an instrument that can perform the precise measurements and calculations needed to map your cornea and the desired correction.
Your eye will be numbed with anesthetic drops, and you'll lie down for the procedure. The surgical team will place a speculum over your eye to hold it open -- this sounds uncomfortable but normally isn't -- and you'll be asked to look at a target light while the doctor operates. Try to maintain your focus on this light -- it's important for getting the best results from the surgery. Many clinics find it helps to give the patient a stuffed toy or other object to hold onto during the surgery.
The actual PRK laser eye surgery takes less than a minute. The laser will probably make clicking sounds during the procedure, and you may smell a faint acrid odor. This is normal.
Do you have a career that requires a lot of activity such as military, police officer, firefighter, or other types of highly involved action based careers? Do you enjoy a very active lifestyle by doing things such as swimming, skydiving, or scuba diving? Do you have to wear glasses in order to do those things? If so, PRK may be the laser surgery for you!
People with active lifestyles or careers are said to have been recommended to have PRK because you may be more vulnerable to eye injuries. With PRK there is no flap made during the surgery so there would be less of a chance of eye damage should something come into contact with the eye. Therefore, if you lead an active lifestyle or have a career that is demanding physically, then PRK may be for you.
PRK is the common name for a surgical procedure called photorefractive keratectomy. It uses an excimer laser to sculpt an area on the surface of the eye, rather than making cuts in the cornea, removing an area the thickness of 1 to 3 human hairs and molding the top of the cornea to make accurate and specific corrections to the patient's vision.
PRK can be used to treat nearsighted, farsighted, and astigmatic eyes. It has some disadvantages compared to the newer and more common LASIK surgery – notably, a longer and more painful recovery time – but is still a valuable option, especially for patients whose corneas are too thin to make them candidates for LASIK. In addition, PRK is one of the procedures most likely to be approved for active-duty members of the U.S. military services.
You should have a thorough consultation with your optometrist, and understand what correction is needed and why PRK is the best choice for you. You should also consult with your surgeon and understand the process and the risks.
You may also have your eyes tested for tear production -- if you have "dry eye," you can still have PRK, but may need to take extra steps to ensure your eyes are hydrated.
You will be asked not to wear your contact lenses for one to three weeks before the procedure, so that the error in your eyes can be measured accurately on the day of the surgery. In addition, you should be asked to refrain from wearing any scented product, hair spray, or makeup on the day of the surgery. Finally, you should arrange for someone to bring you home from the surgery and perhaps be available for a day or two afterwards -- some patients have reported they are unable to see well enough to take their medications until their eyes have healed a bit.
Any surgery, particularly on such a sensitive area as the eye, includes risks. PRK is considered safer than LASIK because the surgeon does not cut into the cornea, but works only on the surface.
Many of the risks of PRK are the same as those for LASIK. Night glare is a fairly common side effect and will improve with time. There is also a risk of not getting the precise correction needed, so that you may still need corrective lenses after the surgery. When you reach your 40s, you may still need reading glasses for presbyopia.
The FDA and FTC have required providers of PRK and other laser surgeries to inform patients about the risks in their advertising and in preoperative consultations. If you don't feel you're getting full information, ask questions, and consider using another provider.
PRK is a useful alternative to LASIK for patients who have thin corneas. In addition, some doctors believe PRK to be more effective than LASIK for mild to moderate nearsightedness, though clinical data on this suggest there is not much difference.
Otherwise, the criteria for PRK are the same as those for other forms of refractive surgery. People who have unstable eyes (particularly those under 18), women who are pregnant or nursing, and those with certain medical conditions are not considered good candidates for successful PRK eye surgery. A good surgeon will meet with you to answer any questions you have, but also to test your eyes and take your medical history, before you schedule your surgery.
How does PRK compare to other flap procedures, such as LASIK?
If your corneas are too thin and you are not eligible for LASIK, PRK may be for you. Both procedures are fairly short. During LASIK one may feel a bit of pressure or a fuzziness of vision while the corneal flap is created. PRK does not make a corneal flap.
LASIK is a more complicated process thanks to the need of a corneal flap. PRK and LASIK complication percentages are similar, but the complications may be more severe in PRK.
With LASIK you will have visual recovery sooner (like that day) than with PRK (may take three days or longer) and would most likely not need pain medications when compared to that of PRK.
LASIK patients must wear a plastic shield at night for the first 10 days. PRK patients have a soft bandage contact lens that is worn for five to 10 days after surgery. This is treated daily with antibiotics and eye drops. When the bandage is removed a topical cortisone is used on the area four times a day for one month, then tapered off in the following months.
Because surgeries such as LASIK cut a corneal flap during the procedure, LASIK then runs the risk of complications directly related to the flap itself. Things such as: an incomplete flap, a flap that comes off, or a flap that has holes in it. PRK does not use the flap method, therefore will not have these complications.
PRK laser eye surgery is an older procedure than LASIK, and most surgeons and patients today prefer LASIK, which has a shorter recovery time with fewer reports of pain than PRK.
However, PRK still has a place in the laser surgeon's practice. It is a useful option for patients whose corneas are too thin to make LASIK an option, or for patients who have moderately dry eyes.
Clinical trials in which patients received LASIK in one eye and PRK in the other showed that the result as far as their final visual acuity was much the same. The primary difference was in the recovery time and level of discomfort.
Photorefractive Keratectomy, also called PRK laser eye surgery, is a procedure designed to correct nearsightedness, farsightedness and astigmatism. This procedure involves sculpting the surface of the eye in an effort to improve visual acuity. This process differs from LASIK in which a flap is cut and the cornea is reshaped. Nearsighted patients have the cornea flattened while farsighted patients have the cornea steepened.