PRK Laser Eye Surgery

A comprehensive guidE

Over the years, photorefractive keratectomy has evolved into a highly precise procedure with excellent safety and efficacy outcomes. It remains a top choice for certain patients today.

What is PRK Laser Eye Surgery?

Photorefractive keratectomy PRK improves vision by reshaping the cornea with an excimer laser. Unlike LASIK, no corneal flap is created. Instead, your surgeon softens the surface cornea epithelial cells, which are gently removed to expose the underlying tissue, known as the stroma.

Alternative names include LASEK, epiLASIK and advanced surface ablation (ASA).

The excimer laser then painlessly sculpts the stroma, altering the eye’s focus. The laser pulses remove tiny amounts of tissue to either flatten or steepen the cornea, correcting nearsightedness, farsightedness, and astigmatism.

Once the laser treatment is complete, a soft bandage contact lens is placed on the eye as a bandage until the epithelial cells regenerate over the next few days. The lens will speed visual recovery and relieve pain. Lubricating drops aid healing and replace moisture on the surface of the cornea.

Over a million Americans have safely undergone PRK to gain freedom from glasses and contacts through LASIK-quality visual outcomes without the flap.

Who is a Candidate for PRK?

To determine if you are eligible for photorefractive keratectomy, your ophthalmologist will evaluate the following:

  • Your refractive error (nearsighted, farsighted, or astigmatism)

  • Your corneal shape, contours, and thickness

  • The health of your retina and optic nerve

  • Your medical history and any medications you take

  • The stability of your vision prescription

In general, good PRK candidates include those who:

  • Are 18+ years old with stable vision

  • Have no eye diseases or uncontrolled medical conditions

  • Do not take medications that could impact healing

  • Have enough corneal thickness

PRK laser eye surgery

PRK may be preferred over LASIK for people with thin corneas, certain occupations, or high involvement in contact sports.

 A PRK procedure is an outpatient surgery where the doctor uses a laser to reshape the cornea and improve your vision. After receiving numbing drops, the doctor removes the outer layer of cells from the surface of your eye to access the cornea underneath.

The laser is then used to sculpt and reshape it, correcting any refractive errors that may be present.

How Does PRK Work?

  • Short-sight (myopia) – The cornea is flattened so that distant objects come into focus. This is done by applying more laser pulses to the centre and fewer to the periphery.
  • Long-sight (hyperopia) – The central cornea is steepened to improve close-up vision. This is achieved by applying extra laser pulses to the outer corneal zone.
  • Astigmatism – Uneven curvatures are smoothed to provide a rounder, symmetric cornea. The number and position of pulses target irregular areas.
  • Presbyopia – The non-dominant eye is corrected for near vision, while distance vision remains in the dominant eye. This is called blended vision or monovision LASIK.

By reshaping the cornea, PRK helps focus light rays correctly on the retina for sharp vision. It treats all common vision disorders. Rather than fixing refractive errors with lenses like glasses or contacts, PRK permanently corrects vision by changing the anatomy of the cornea.

what happens during your procedure?

PRK Surgery Steps

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The skin layer needs several days to regrow. Patients can usually return to their normal routines within a 4-7days. Patients are counselled not to expect perfect vision. However, most patients achieve eyesight that matches or exceeds what they could see with their glasses or contact lenses.

Why should you
Choose me?

01

I have performed more than 25,000 laser eye procedures.

02

I have a published 100% success rate for 20/20 vision.

03

More than 2,000 5-star reviews confirm my obsession with safety and perfect results.

Benefits of PRK Surgery

PRK is a popular vision correction option, second only to LASIK. PRK is the original type of laser eye surgery that corrects problems with vision. It can fix nearsightedness, farsightedness, and astigmatism. This procedure is good for patients with thin corneas when LASIK is unsuitable.

The surgery benefits from its precision and safety, utilising state-of-the-art laser technology. Patients often achieve 20/20 vision or better and see lasting improvements in vision quality. PRK patients report better vision and improved quality of life a high success rate.

PRK is a good choice for those who want to stop wearing glasses, especially active sports people. It works well and is safe, giving long-term improvements in eyesight.

  • Treats most prescriptions
    It safely and effectively removes the need for glasses or contacts, making life more convenient. It is suitable for most prescriptions.
  • Thinner corneas
    PRK (LASEK) is the best option when you have thin corneas. PRK alters the least tissue compared to LASIK and SMILE lenticule extraction.
  • No LASIK flap
    Many patients like not having a LASIK flap, especially if they play contact sports. Without a flap, there are fewer potential complications.
  • Treats presbyopia
    PRK can be used for reading glasses
    with a blended vision procedure. One eye is better for distance vision and the other for near work. The combination works very well for most patients.
  • Recovery
    Recovery from PRK is straightforward. Most patients resume normal activities within 5-7 days. However, this is longer than LASIK and SMILE.
  • Cost
    PRK is affordable when compared with the cost of glasses and contacts. Over the long term, PRK is cheaper, although there is a larger upfront cost.
  • Customised treatments
    PRK can be used for customised treatments. These include wavefront and topography-guided corrections, similar to LASIK. This option is not available for SMILE lenticule extraction.

PRK Success Rates and Patient Outcomes

Numerous clinical studies validate PRK as a safe, effective procedure when performed on appropriately selected patients:

  • Over 93% achieve 20/40 or better (functional vision)

  • More than 95% attain 20/20 or better

  • Over 90% report satisfaction with their results post-surgery

  • Most see improvement within days, with vision continuing to sharpen over three months

  • For many, the visual improvements from PRK are long-lasting when applied to suitable candidates

Of course, your individual results depend on your starting prescription and ocular anatomy. Your surgeon can guide realistic expectations.

Click here to learn more about PRK results and your vision after PRK laser eye surgery.

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laser-eye-surgery-types

Alternatives to PRK

There are several alternative treatments to PRK. I will describe each below with a comparison table for easy reference.

  • LASIK
  • LASEK
  • Lenticule Extraction: SMILE, SILK, CLEAR
  • Implantable Contact Lenses (ICLs)
  • Refractive Lens Exchange (RLE)
  • Glasses and contact lenses

Each procedure has its specific place. Your ophthalmologist can advise which alternative option is best for you and your eyes.

Other OPTIONS

The most common alternatives to PRK are the other laser treatments: LASEK, LASIK and SMILE eye surgery. Each has unique differences, and your own eye anatomy, situation, and preferences will play a role in deciding which is best for you. You may also be suitable for a lens-based procedure, such as RLE or ICL.

PRK vs LASIK

The main alternative procedure to PRK is LASIK eye surgery. However, LASIK involves cutting the corneal tissue to create a flap, typically using a femtosecond laser.

A major benefit of a LASIK flap is that the eyes heal quicker, lessening the chance of an eye infection. PRK has a slightly higher risk of infection because the surface layer (epithelial layer) needs to heal, which takes several days. Also, the patients experience improved vision within 24 hours with LASIK, compared to several days for PRK eye surgery.

However, a LASIK flap is less suitable for those with a very active lifestyle with some risk of eye injury. The slower healing process may be a worthwhile trade for peace of mind against trauma, as PRK does not involve cutting.

Here’s a quick comparison of PRK eye surgery and LASIK. Click here for a detailed comparison of LASIK vs PRK.

PRK

LASIK

Surface cells removed

Flap created

More discomfort in recovery

Faster recovery

No flap complications

Risk of flap issues

Better for thin corneas

Requires thicker cornea

Enhance by repeat PRK

Easy to enhance

PRK vs LASEK

Another similar procedure is LASEK. This procedure is almost identical to PRK, but where the epithelium is replaced instead of removed. PRK and LASEK improve vision to the same degree (both require a contact lens), and the epithelium heals at the same rate.

The initial benefit of LASEK was to prevent corneal haze. However, the advent of mitomycin C (MMC) as a drug that prevents corneal haze has removed the rationale for performing LASEK.

Other types of refractive surgery include implantable contact lenses (ICLs) or refractive lens exchange (RLE). Your consultant ophthalmic surgeon can advise which may be the right choice for you.

Photorefractive keratectomy is better when there is less corneal tissue, e.g. patients with naturally thinner corneas.

Click here for a detailed comparison of LASEK vs PRK.

   

PRK

LASEK


Can treat all prescriptions

Speed of recovery

4-7 days

4-7 days

Final vision

Same as LASEK

Same as PRK

Prescription range *

Up to -12D (dioptres)

Up to -12D (dioptres)

Thin corneas

Fix astigmatism

Fast recovery


Post-op pain

Yes

Yes

Needs operating theatre

Infection rate

1 in 7,000

1 in 7,000

PRK vs ICL Implants

Implantable contact lenses can be a better option for very high or extreme prescriptions. The main benefits are:

  • Faster recovery
  • Less pain post-op
  • No regression over the years
  • Reversible

Implantable contact lenses are done in an operating theatre because of the increased need for a sterile environment.

If you are out of range for PRK surgery, ICLs might be an excellent alternative.

    FEATURES

ICL

PRK

Extreme prescriptions

Prescription range

Up to -18D (dioptres)

Up to -12D (dioptres)

Can regress and return to needing glasses

Stable, no regression

Can regress

Thin corneas

Maintains ability to read

Fast recovery

Reversible

Operating theatre

Infection rate

1 in 3,000

1 in 7,000

PRK Costs and Insurance Considerations

As an elective procedure, PRK is not covered by insurance plans. However, some financing options are available. The typical cost per eye is:

  • £1,800-£2,200 for conventional PRK

  • £2,000-£2,600 for custom wavefront PRK

To save money on PRK:

  • Ask about low-interest payment plans

  • Look for discounts and special offers

  • Have surgery at an ambulatory surgery centre rather than a hospital

  • Get treated in both eyes simultaneously

The price is well worth the investment for many patients, considering the benefits of freedom from glasses and contacts.

Click here for more information on PRK surgery costs.

Prices comparison LASIK PRK SMILE

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How to Prepare for PRK Surgery

Proper physical and mental preparation helps everything go according to plan before, during and after your LASIK treatment. Taking the following steps helps set the stage for the smoothest LASIK experience and recovery:

Preparing for PRK Surgery

Taking these steps can help optimize your PRK surgical experience and recovery:

  • Stop wearing contact lenses, usually for 1-4 weeks before your evaluation. You should wear glasses during this time.
  • Have a comprehensive eye exam to determine your candidacy
  • Follow your surgeon’s guidance on stopping certain medications before surgery
  • Make arrangements for transportation on the day of surgery
  • Ensure you can take 4-5 days away from work or school to rest your eyes after PRK
  • Mentally prepare for mild postoperative discomfort and light sensitivity
  • Don’t wear eye makeup on the treatment day

Recovery and Aftercare from PRK Surgery

With proper aftercare, most patients see well within a week and feel fully recovered within a month post-op.

Recovery from photorefractive keratectomy PRK involves:

  • Keeping all follow-up appointments with your surgeon

  • Using prescribed antibiotic and anti-inflammatory eye drops

  • Wearing sunglasses outdoors due to light sensitivity, especially in bright sunlight

  • Taking oral pain medication as needed for discomfort

  • Avoiding rubbing or touching the eyes for 4-6 weeks

  • Refraining from driving until vision is stable

  • Limiting screen time and activities requiring visual focus

  • No swimming or dirty/dusty environments which increase infection risk

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Risks and Complications of PRK Surgery

All surgery carries risks, but major complications from PRK are very rare. Potential side effects include:

  • Regression – some loss of effect and blurry vision requiring an enhancement

  • Scarring – haziness causing glare or reduced night vision (uncommon with modern lasers)

  • Infection – can cause corneal scars but extremely low risk with antibiotic drops

  • Visual loss – remote chance of severe vision impairment

Your ophthalmologist takes every precaution possible to mitigate risks and ensure satisfactory visual outcomes.

Choosing the Right Surgeon and Clinic for PRK

Selecting the best laser eye surgeon and facility is the most important factor for your PRK’s success.

Also, click here to learn more about finding the best laser eye surgery in London or elsewhere.

Seek a surgeon who:

  • Has extensive experience performing PRK, specifically

  • Uses the latest laser technologies and custom techniques

  • Has published research and helps train other surgeons

  • Specializes in laser vision correction procedures

  • Takes time to listen to your concerns and questions

  • Performs PRK safely and with excellent visual outcomes

  • Provides personalized, attentive follow-up care post-op

The Future of PRK Surgery

PRK technology advancements aim to improve precision, results, and recovery time.

The future looks bright for enhancing PRK outcomes through scientific innovations. While already proven over decades, PRK continues advancing.

This includes:

  • Faster, more accurate diagnostic devices to plan treatment

  • Lasers that measure and apply pulses in the trillionths of a second

  • Lasers are customised based on the unique irregularities in one’s eye

  • Collagen cross-linking to strengthen the cornea after laser reshaping

  • Newer corneal shield enzymes that facilitate epithelial regrowth

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Frequently Asked Questions About PRK

Here are answers to some common PRK questions:

Mild pain and light sensitivity are expected during recovery. Pain is managed with medication and improves within days.

PRK poses no risk of cornea flap complications. However, LASIK involves less discomfort after surgery. The overall risks are the same. PRK patients are at slightly higher risk of infection (1 in 7000 for PRK vs 1 in 21,000 for LASIK).

No driving is allowed until your surgeon confirms your vision is stable, generally within one week.

Yes, PRK is highly effective at reducing or eliminating astigmatism.

PRK can treat thin corneas that might be ineligible for LASIK. Enough corneal thickness must remain post-surgery.

Most insurance plans consider PRK an elective surgery and do not cover it. Check your specific policy.

Conclusion: Is PRK Right for You?

PRK offers a tested alternative to LASIK for laser vision correction, with unique advantages for certain patients. If you are dealing with glasses or contacts, meet with a specialist to see if PRK might provide the visual freedom you seek. With an experienced surgeon, thorough prep, and proper aftercare, PRK can safely help you achieve excellent, long-lasting results.

Take the Next Step: Book Your PRK Consultation

Don’t put up with poor vision any longer – call today to schedule an initial appointment with Dave Allamby, MD. Take control of your vision and change your life for the better!

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