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Surgery without a Flap
Similar to Lasik
This is the type of refractive surgery the military recommends to soldiers. It is less expensive than LASIK.
Our St. George eye doctors can tell you that photorefractive keratectomy (PRK) is a specific type of eye procedure used to correct astigmatism, nearsightedness, and farsightedness. PRK is the procedural predecessor of LASIK surgery, which may be more familiar to people nowadays.
PRK was the first practical and effective type of eye surgery which relied upon lasers to accomplish the necessary visual corrections. Although LASIK surgery gets a lot more press currently, PRK is still commonly performed. PRK even has certain advantages over the newer procedure.
What is PRK surgery?
Here are the steps necessary to perform PRK laser surgery:
- Your doctor will first remove a section of the corneal epithelium, using a surgical instrument and an alcohol solution.
- An Excimer laser (a special laser which uses ultraviolet light), is used to slightly modify the shape of the corneal surface, in a high-precision process controlled by a connected computer. Regular pulses of cool ultraviolet light accomplish removal of tiny amounts of tissue, in a pattern completely managed by the computer.
- Following the laser procedure, the cornea of the eye must be protected by a flexible contact lens, which is placed over the cornea. While the cornea is thus protected, epithelial cells are regenerated, normally in about five days, after which the protective contact lens can be removed by your doctor.
Am I a Candidate for PRK Laser Surgery?
In order to get the maximum benefit from PRK surgery, you should contact your St. George eye doctor and undergo a thorough examination of the eyes, to ensure that you are in fact a good candidate for laser surgery. Optimum candidacy is determined by:
- Pupil size
- Corneal thickness
- Corneal curvature
- Eyes’ normal moisture content (eye dryness after surgery can present a significant problem)
- Overall health
- Number and types of medications you are currently taking.
Assuming all goes well with this examination, and your suitability for laser surgery is not in question, here’s what you can expect from PRK surgery.
What Can I Expect during PRK Surgery?
Since PRK surgery is performed on an outpatient basis, you’ll be awake through the entire procedure, although for your comfort a mild sedative may be administered by your ophthalmologist:
- Eyedrops which numb the tissue around the eyes are administered, and a medical instrument called an eyelid speculum is used to comfortably prop the eyelids open so they can’t close while laser surgery is in progress.
- Your ophthalmologist will position the Excimer laser over the cornea, and will commence the pre-programmed pattern of ultraviolet surgery.
- The doctor will ask you to focus on a target light or other object during the process. Then your doctor will observe your eye through a microscope while pulses of laser light carry out the re-curvature of your cornea.
- Some small amount of discomfort may be experienced, but it is rare for anyone undergoing the procedure to feel any pain.
- If you are having both eyes done on the same day, they will generally be done one after the other, since the procedure for each only takes about five minutes.
- After both eyes have been operated on, protective contact lenses will be placed over the corneas to allow optimal regeneration to occur in the following days.
What Can I Expect Following PRK Surgery?
After the eye procedure, you will be allowed to rest for a short period in your St. George eye doctor’s office, waiting for any blurriness to subside. After that, you can be driven home by the person who brought you, or another person you have arranged to give you a ride. Keep in mind that you will not be allowed to drive yourself home.
- Your PRK doctor will probably prescribe anti-inflammatory drugs to reduce any swelling, as well as pain medications, should you feel the need for them. Topical antibiotics may also be prescribed as an insurance against the possibility of infection developing.
- It will be very important for you to adhere to your doctor’s recommendations regarding the daily usage of all prescriptions so that your eyes return to normal as quickly as possible, and healing is allowed to occur optimally.
- You will likely be required to visit your doctor’s office every few days or weekly, for up to a month following the laser surgery. Generally speaking, you can expect eyesight to improve within two weeks of the surgery, and shortly after that your vision should be completely recovered.
Comparison of PRK and LASIK Surgeries
In terms of the results they produce, PRK surgery and LASIK surgeries are very similar, but there are some differences between the two procedures. Surprisingly, even though it is the older of the two procedures, PRK offers some distinct benefits which LASIK surgery cannot match. Here is a comparison of the two processes:
- Even though both types of surgery use lasers, the procedure is much different between the two. In LASIK surgery, your eye doctor will make a tiny cut with either a blade or a laser on the cornea of your eye to create a flap of tissue. After the flap is lifted, a laser will be used to reshape the cornea to repair any imperfections causing vision problems. After the pre-programmed laser routine is finished, the corneal flap is replaced over the cornea and healing begins. It is not necessary to create a corneal flap for PRK surgery since the outer layer of the cornea is simply removed, so that reshaping of the cornea by the laser can take place. Obviously, there is no risk of corneal flap complications with PRK, because no flap is created during the surgery.
- There is a slightly greater risk of discomfort during PRK surgery, as well as a slightly greater risk of eye infection afterward. However, the statistics show that this difference is very small difference between. For the most part, any risk is more or less equivalent between the two procedures.
- The recovery period after PRK surgery is usually a little longer than after LASIK surgery, and in a few cases, it may take longer to stabilize.
One of the biggest benefits of PRK is that the risk of compromising the corneal thickness is much less with PRK surgery. That’s because the depth of the laser treatment is more shallow.
Advantages of PRK Surgery
PRK surgery is often a well-suited option for eye patients whose cornea is too thin for LASIK surgery. This is especially true when a patient has been through LASIK surgery before and has a thinner residual cornea to operate on. Because PRK surgery does not penetrate so deeply, a thin cornea is much less of an issue so PRK might just be your best option for laser eye surgery.
Eye patients who have a history of chronically dry eyes will probably not make good candidates for LASIK surgery, whereas that is not issue for concern with PRK surgery. Patients with dry eyes are often still able to undergo PRK surgery, even though they are not considered eligible for the LASIK procedure.
To sum it all up, both PRK and LASIK procedures can achieve the aim of correcting your vision through laser surgery, and you will probably be very satisfied with the outcome. The main differences between the two are are:
- How the reshaping of the corneal tissue done
- The slight differences in the recovery period
- And that PRK can be used on a much broader group of people than can LASIK.
If you are ready to start living without contacts and glasses, you should consult with our St. George eye doctors. Together you can choose the best option for your laser vision correction.