PRK Surgery and Recovery
PRK is a laser correction procedure to treat nearsightedness, farsightedness, and astigmatism. Like LASIK, the procedure utilizes excimer laser technology to change the shape of the cornea (the transparent window-like dome in front of the iris.)
The cornea bends light rays entering the eye so they come to a sharp focus on the retina located in the back of the eye. When the corneal shape is not ideal, blurry vision will occur. The cornea can be:
- Too steep in nearsighted eyes
- Not steep enough in farsighted eyes
- Oval in astigmatic eyes
The excimer laser changes the corneal shape to allow light to properly focus on the retina for clear vision. The laser does not burn or cut; it breaks apart the individual chemical bonds between atoms so they are released into the air, elegantly reshaping the cornea without affecting its transparency.
PRK is often recommended for patients who are not candidates for LASIK because their corneas are too thin or shaped irregularly, or their anatomy does not allow adequate suction required for LASIK, or they are concerned about injury to the LASIK flap (especially if they are engaged in contact sports). PRK is another form of bladeless refractive surgery. Unlike LASIK, no corneal flap is created. Instead of doing the treatment under a flap as in LASIK, the treatment is done right on the surface of the cornea. The cornea’s thin outer (epithelial) layer is gently removed to allow access to the underlying tissue so the cornea can be reshaped with the excimer laser. The laser treatment itself is the same as in LASIK. Like LASIK, patients can achieve 20/20 vision after PRK. On the day of the procedure PRK is faster than that of LASIK and unlike LASIK no pressure like feeling is felt. The typical comment after the procedure by the patient is, “Am I done already?” PRK recovery does take longer than LASIK because of the corneal abrasion purposefully created, but the final results are equally dramatic as they are for LASIK.
No doctor can guarantee you will have perfect 20/20 vision after PRK. Most patients do achieve this level of vision, but there are other vision conditions that can develop as your eyes age. One condition is called presbyopia. This is a natural part of the aging process that starts around age 40. It is due to a change in the flexibility of the eye lens beginning around age 40 that causes the need for reading glasses. The good news is that with PRK Dr. Lipstock can help minimize the need for reading glasses for presbyopic patients. This can be done on those already presbyopic or on past PRK patients who have become presbyopic.
In the exam room, numbing drops will be placed in each eye. Dr. Lipstock will make a tiny orientation mark on the white part of the eye with a sterile marking pen.You will then be taken to the laser suite where you will relax on the VISX laser bed. A sterile drape will be placed over your face; this has an opening in it that is centered over your eye. The bottom part of the drape is taped up out of the way for comfort, especially for those that may be claustrophobic.
Dr. Lipstock will place an eyelid holder between your eyelids so you do not have to worry about blinking. You will feel no need to blink because of the numbing drops. You will be asked to keep your eye on the blinking red fixation light. More numbing drops will be placed in your eye and then Dr. Lipstock will place a rotating brush on the cornea to gently remove the superficial epithelial cells (these cells would otherwise block the uptake of the laser). This part of the procedure is not uncomfortable.
The tracking device will then be activated to center the laser treatment and follow the slightest movement of your eye. The laser will automatically and quickly reshape the cornea. On average this takes about 20 seconds. You will hear a clicking sound, but there is no discomfort.
A small, flat, round, white sponge (6mm in diameter) soaked in medication to prevent scarring is placed on the center of the cornea for about 15 seconds. The eye is rinsed with sterile water. This rinses off the medication.
An extended wear soft contact lens with no power is placed with sterile forceps onto the eye. This acts as a Band-Aid to prevent discomfort. It will be removed in an exam room by Dr. Lipstock with sterile forceps approximately 1 week later.
Your next stop is in the post-op room. A staff member will tape clear plastic shields over your eyes. You will then go home for a nap.
Immediately after the procedure most people will notice a significant improvement in their vision. However, since the vision will be somewhat blurry the first few days, we recommend staying home during that time period. Most patients can function fairly well at normal activities after about three to four days. Your vision may take several weeks or months to fully stabilize, but the outer corneal layer should be on its way to becoming perfectly smooth and providing crystal clear vision without eyeglasses.