If you've thought about getting rid of glasses or contacts, photorefractive keratectomy (PRK) is an option. While LASIK remains a popular form of laser vision correction, PRK has been around longer. In this article, we'll compare the pros and cons of PRK against LASIK to help you decide which surgery is better for you.
PRK corrects a wide range of refractive errors (including myopia, hyperopia, astigmatism, and presbyopia) by reshaping your cornea with a laser.
PRK has been shown in studies to be a safe and effective procedure.
The results of PRK are permanent and allow most people to function without any glasses or contacts.
PRK is an excellent alternative to LASIK, particularly if you have a high prescription, thin corneas, or participate in high-impact activities.
What is PRK?
Photorefractive keratectomy (PRK) is a form of laser refractive surgery. The procedure corrects a variety of vision problems (or refractive errors), including:
- Hyperopia (farsightedness or blurred near vision)
- Myopia (nearsightedness or blurred far vision)
- Astigmatism (irregular curvature causing blurred distance and close vision)
- Presbyopia (blurred near vision after age 40)
By reshaping the surface of your eye with the laser, PRK improves these refractive errors. As a result, over 90% of people who receive PRK have excellent visual outcomes of 20/30 or better. Furthermore, many people maintain these results nearly 20 years after surgery!
How does PRK work?
During a pre-surgical consultation, the surgeon maps out your cornea (clear structure in front of the eye), checks your refractive error, measures your pupil size, and performs other tests. The surgeon can then formulate a treatment plan to correct your vision with high accuracy and precision.
The procedure only takes about 20 minutes for both eyes and includes the following steps:
- The eyes are numbed with anesthetic drops so that you don't feel pain during surgery.
- The surgeon uses a tool or alcohol solution to remove the cornea's outer layer (epithelium).
- Then, they apply an excimer laser to reshape your cornea based on the surgeon's measurements.
- After surgery, you'll receive bandage contact lenses to protect your corneas while they heal and the epithelium grows back.
After the procedure, you'll need to arrange a ride home and plan to rest for the day. Many people take a few days off work while their vision recovers. The surgeon will prescribe medicated eye drops, typically an antibiotic and steroid, to help facilitate recovery. They can also recommend pain relievers if you experience discomfort. It's important to use medications as directed and follow all aftercare instructions.
Of course, go to all follow-up visits so the surgeon can check if your corneas are healing normally and for any complications. Most people experience clearer vision and resume regular activities within a week. However, the cornea and vision may take about one month to stabilize and 3 to 6 months to fully recover.
PRK vs LASIK – comparison:
Laser-assisted in situ keratomileusis (LASIK) is another popular form of laser vision correction. Although PRK is an excellent alternative to LASIK, you should consider the pros and cons of each and talk to your surgeon to see what’s best for your situation. Everyone's eye needs are different, so not everyone is a candidate for PRK or LASIK.
|Candidacy||Suitable for patients with thinner corneas||Patients with thin corneas may not be a candidate for the surgery|
|Risks||Lower risk of dry eyes and safer for patients who participate in high-impact activities, but higher risk of infections||Higher risk of dry eyes and complications due to corneal flap|
|Pain during recovery||Causes more discomfort and pain||Less painful|
When discussing the benefits of PRK, it's essential to mention that no corneal flap is required. LASIK, on the other hand, requires the surgeon to cut a flap on the cornea to access the tissue underneath. Although rare, the flap can cause complications specific to LASIK. Also, by avoiding a corneal flap, the surgeon can remove less tissue with PRK. Additionally, if your corneas are thin, you may not be a candidate for LASIK.
Beware that, since the LASIK flap affects the nerves in your cornea, you may be more likely to have dry eye. Your surgeon may recommend PRK to reduce your risk. And PRK corrects higher prescriptions. The laser must remove more corneal tissue if you have a high prescription. In these cases, PRK is ideal so that your corneas won’t be too thin after surgery.
If you are very active or work in an environment where you can get hit in the eye, PRK may be a better choice as well. In rare cases, eye trauma can dislodge a corneal flap. Additionally, some surgeons may charge less for PRK since LASIK technology is newer.
However, PRK surgery also has its drawbacks. Firstly, your vision can take several days to clear as your cornea's epithelium grows back and a few months to stabilize. In contrast, most people who get LASIK see relatively well immediately and may return to work the next day.
Also, since there is no corneal flap to protect the surgical wound, you are more likely to experience pain after surgery. With LASIK, most people feel better within a day. With PRK, you may experience discomfort for several days while your eyes heal. And PRK leaves your cornea with an open wound. Although the bandage contact lens and antibiotic drop help prevent infection, there is still some risk.
Overall, PRK and LASIK offer similar results and have similar safety profiles. However, some studies indicate that LASIK yields slightly better outcomes in people with astigmatism. However, both surgeries provide permanent visual results. Nevertheless, your vision can still change as you age or from other factors.
Photorefractive keratectomy is a safe and effective procedure that is still widely performed since its approval by the FDA in 1995. Although 95% of people are satisfied with their vision after PRK, every surgery has risks. A surgeon can determine if you’re a candidate with a complete evaluation of your vision, eye, and general health.
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