PRK LASIK- Laser Treatment for Eyes

When PRK is chosen over LASIK surgery?

Though LASIK is the standard method of vision correction, there are specific scenarios where PRK is preferred over LASIK. These scenarios include- 

• If the patient’s cornea is too thin or there is another issue with the cornea, such as evidence of forme fruste keratoconus. 
• If the patient is at high risk of developing severe dry eye. 
• If the patient’s occupation increases the risk of dislodging the flap, such as patients who are from sports backgrounds like kickboxing, hockey, etc. 

If there are no such issues, then the surgeon would recommend having standard LASIK. 

How to prepare for PRK Surgery?

Before deciding to perform PRK surgery, the doctor discusses all PRK-specific guidelines. Initially, there will be a pre-operative appointment during which the doctor will thoroughly assess the eyes. The refractive error, pupil size, and corneal shape are mapped before the surgery as these measurements will be used to program the laser. 

Other instructions given by the doctor may include the following- 

• Stop using steroids, blood thinners, and antihistamines 3 days before the surgery. 
• Stop wearing contact lenses at least 3 weeks before the surgery, as they can alter the cornea’s shape. 
• In case an antibiotic eye drop is prescribed by the doctor, start using it 3-4 days prior to the surgery. 
• Start using a warm compress on your eyes 3 days before the surgery. 
• Cleanse the eyes properly to ensure that the oil glands near the lash line are empty. 

For the day of surgery, further instructions will be given to the patient- 

• Take a shower and clean both eyes properly. 
• Have a light meal before the surgery, as there is no need for fasting. 
• Arrive at the clinic at the right time, as suggested. 
• Do not wear makeup or use other products that have chemicals, even moisturizers. 
• Avoid wearing accessories or jewellery, as they will be removed before the procedure. 
• Wear loose and comfortable clothes that can be worn and taken off easily without rubbing the eyes. 

Potential Risks of PRK

As with all eye surgeries, there are some risks of PRK eye surgery too. These risks include- 

• Loss of vision that can’t be corrected with eyeglasses or contact lenses. 
• Double vision or diplopia that doesn’t go away. 
• Night vision changes and seeing glares or halos around the light sources. 
• Severe or permanent dry eye. 
• Diminished results over time, especially if patients who are in their late 30s and have farsightedness. 

What to expect after PRK Surgery?

Immediately after the surgery, expect to feel mild discomfort or pain (rarely) in the first 2-3 days. For that, over-the-counter medications will be prescribed. The eyes will also feel watery for a few days. Initially, the eyes may be more sensitive to light while they are healing and the flap is forming. Halos and glares will be there for days or weeks following PRK and are likely to get worse during nighttime. 

Benefits of PRK Surgery

PRK eye surgery is highly beneficial for patients who are ineligible to undergo conventional LASIK surgery. The key benefits of the treatment procedure are explained below- 

• PRK is a better option for patients with thin corneas. 
• It has no risk of flap-related complications. 
• The chances of long-term complications are also minimal. 
• The success rate is very high. 
• PRK can correct myopia or nearsightedness with higher precision. 
• PRK is the best option for people who are professionally involved in contact sports. 
• The chances of developing dry eye are lower than in other types of refractive surgeries. 
• It is a cost-effective treatment for refractive errors. 

Results & Recovery

The entire recovery after PRK surgery takes place at home. The patient is discharged on the same day within 1-3 hours after surgery. It’ll be best for the patient to take proper rest, sleep, or keep the eyes closed for comfort. Blinking might lead to a scratchy feeling in the eye. 

A follow-up will be scheduled for the next day so that the doctor can assess the results of PRK surgery. The patient is also informed about the signs of eye infection, such as redness, swelling, pus, fever, etc. The patient also needs to ensure that the bandage contact lens doesn’t dislodge or fall out. It’ll be removed from the eyes after 7 days. 

The doctor or his/her team will provide detailed instructions for the recovery. The instructions will include- 

• Avoid rubbing the eyes as it can dislodge the bandage contact lenses. 
• Keep soap, shampoo, and other chemicals away from the eyes for at least a week. 
• Ask the doctor when it’s safe to wash the face with soap, drive, read, watch TV, or perform other activities. 
• Avoid areas of smoke and dust, as these particles can cause irritation in the eye.  
• Don’t participate in contact sports or any strenuous activities that can damage your eyes. 
• Wear protective eye gear for several months or as long as the doctor suggests. 
• Swimming and other water activities should also be avoided until the eyes heal. 
• Shield the eyes from bright sunlight for at least a year. 

Initially, after PRK eye surgery, the vision will get better than it was before. However, in the upcoming days, the vision might become blurry first and then improve significantly. Many patients also notice an improvement in vision after the removal of the bandage contact lenses. 

In general, the vision will take several weeks to stabilize completely. Around 80% of the vision will improve within a month and 95% in the next 3 months.