PRK Surgery: What You Need To Know

Understanding PRK Basics

Photorefractive Keratectomy (PRK) is a laser-based eye surgery that corrects vision by reshaping the cornea. Unlike LASIK, which creates a flap in the cornea, PRK removes the outer layer of the cornea completely before applying laser treatment to the underlying tissue.

The PRK procedure follows these steps:

• The surgeon removes the epithelium (the thin outer layer of the cornea)
• An excimer laser reshapes the corneal tissue underneath
• A bandage contact lens is placed over the cornea to protect it while healing
• The epithelium regenerates naturally over 3-5 days

PRK is particularly suitable for patients with thin corneas who may not qualify for LASIK. It also eliminates flap-related complications since no flap is created during the procedure. While recovery takes longer than LASIK, many ophthalmologists consider PRK results to be equally effective for vision correction.

PRK vs. LASIK: Key Differences

When comparing PRK to LASIK, several important distinctions emerge that can help determine which procedure might be right for you:

PRK may be recommended over LASIK if you have thin corneas, participate in contact sports, or have a profession with high risk of eye trauma. The absence of a corneal flap in PRK eliminates flap complications and makes the procedure more suitable for certain lifestyles and occupations.

While LASIK offers faster recovery and less initial discomfort, PRK may provide better long-term stability for some patients. Both procedures achieve similar visual outcomes when performed on appropriate candidates.

PRK Recovery Timeline

The PRK recovery process follows a predictable pattern, though individual healing times may vary:

Days 1-3: This period typically involves the most discomfort. Patients experience light sensitivity, watering, and a gritty sensation as if something is in the eye. Vision is usually blurry during this phase. Pain medication and lubricating drops help manage symptoms.

Days 4-7: The bandage contact lens is removed once the epithelium has sufficiently regenerated. Vision begins improving but remains fluctuating. Light sensitivity decreases, though many patients still prefer wearing sunglasses outdoors.

Weeks 1-4: Functional vision continues improving. Most patients can return to work and normal activities, though night driving may remain challenging. Regular use of prescribed steroid drops is essential during this period to prevent corneal haze.

Months 1-3: Vision stabilizes for most patients. Clarity continues improving, with many achieving their final visual outcome. Some patients may still experience mild dry eye symptoms requiring artificial tears.

Months 3-6: Final visual results become apparent. The cornea completes its healing process, and vision stabilizes. Follow-up appointments with your ophthalmologist track progress and address any remaining concerns.

During recovery, patients should:

• Avoid rubbing eyes
• Use all prescribed medications as directed
• Wear sunglasses outdoors
• Avoid swimming pools and hot tubs for at least two weeks
• Attend all scheduled follow-up appointments

Ideal Candidates for PRK Surgery

PRK offers vision correction for many people, but certain factors make some individuals better candidates than others. Understanding these criteria helps set realistic expectations about outcomes and recovery.

Medical factors that make someone an ideal PRK candidate include:

• Age 18 or older with stable vision prescription for at least one year
• Corneas too thin for LASIK (under 500 microns)
• Refractive errors within treatable range (generally -8.00 to +4.00 diopters)
• No active eye diseases such as keratoconus, severe dry eye, or glaucoma
• No autoimmune disorders that might affect healing
• Not pregnant or nursing

Lifestyle factors that favor PRK over LASIK:

• Participation in contact sports or martial arts
• Military or law enforcement careers with risk of facial trauma
• Occupations involving potential eye injury
• History of eye rubbing or likelihood of flap displacement

A comprehensive eye examination by a qualified ophthalmologist remains the only definitive way to determine PRK candidacy. This evaluation typically includes corneal mapping, measurement of pupil size, assessment of tear production, and detailed examination of overall eye health.

Patients with realistic expectations about recovery time and temporary visual fluctuations tend to report higher satisfaction with PRK outcomes. The procedure offers a permanent vision correction solution for those willing to endure a slightly longer recovery period compared to LASIK.

Long-term PRK Results and Success Rates

PRK has demonstrated impressive long-term results since its FDA approval in 1995. Clinical studies tracking patients over 10+ years show sustained vision improvement with minimal regression in most cases.

Success rates for PRK include:

• 95-98% of patients achieve 20/40 vision or better (legal driving standard without correction)
• 70-90% achieve 20/20 vision or better, depending on their initial prescription
• Less than 5% require enhancement procedures within 10 years
• Very low rates of significant complications affecting vision

Long-term studies comparing PRK to LASIK show comparable visual outcomes after the initial recovery period. Some research suggests PRK may have slight advantages in preventing corneal ectasia (abnormal thinning) in susceptible patients due to greater corneal biomechanical stability.

Patient satisfaction surveys consistently show over 90% of PRK recipients report being satisfied or very satisfied with their results. The most commonly reported long-term side effect is occasional dry eye, which typically responds well to over-the-counter lubricating drops.

While PRK cannot prevent age-related vision changes like presbyopia (difficulty focusing on close objects after age 40), it provides lasting correction of the original refractive error. Many patients who undergo PRK in their 20s or 30s enjoy decades of reduced dependence on corrective lenses before experiencing age-related vision changes.