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Photorefractive Keratectomy as an Alternative to LASIK

Photorefractive keratectomy or PRK is a form of laser eye surgery and it is used to solve problems such as myopia, presbyopia and astigmatism.

Although this procedure is not as popular as LASIK surgery, it is often procedure of choice for many patients. Those patients who have poor quality cornea choose this method to improve their sight. Weak and thin cornea cannot undergo the LASIK procedure, so in that case, the optimal solution is PRK surgery.

Preoperative Instructions

Preoperative examination takes around two hours and it determines if the patient is a suitable candidate for the procedure. It is recommended not to wear soft contact lenses at least 3 days before the examination and surgery. In case you use rigid gas permeable hard lenses, this period should be extended to two weeks. On of the most important steps in preoperative stage is the eye test.

The ophthalmologist places special drops in the eye of the patient that cause the pupil to dilate. By doing this, ophthalmologist can closely exam patient’s retina. Since eye drops causes dizziness and extensive eye sensitivity to bright light,  make sure you have someone to drive you back home. These symptoms usually last for four to six hours.

Course of Operation

Your eye doctor gives anesthesia in the form of eye drops which prevents the patient from feeling any pain during the procedure. But, after anesthesia wares off, the patient will start feeling the pain caused by mechanical removal of epithelium.

The Surgeon will use excimer laser (originally used in computer industry by IBM), just like in LASIK procedure, but instead of making the cover, outside layer of epithelium is removed. When the middle layer of cornea is open and accessible the laser is used and cornea is remodeled.

Changes in the shape of cornea are done by laser and there are no additional damages to tissue. Laser is used on the eye for about a minute. After that, soft protective lens is applied which protects epithelium from physical damage until epithelium is fully recovered. The Protective lens is then taken off a few days after the procedure at the first scheduled visit.

[box type=”note”]It is not recommended to rub your eyes, wash your eyes, use makeup, swim at the pool etc. Gradually, as the eye recovers, different restrictions are lifted. After one month the eyes are fully recovered and healthy.[/box]

What Should I Expect after PRK surgery?

Since epithelium is removed with a laser, PRK surgery is more painful than LASIK surgery and recovery time is a bit longer. In that case, the doctor might prescribe painkillers if needed. These problems last for three to five days, just as much it takes for epithelium to recover.

The positive side of this approach is that there is no need for an injections or incisions since epithelium have a high rate of regeneration. Your sight will start improving after few days and after a week the patient might return to work. The End result is the same, just as with the LASIK procedure and the patient is permanently freed from glasses and contact lenses.

[box type=”important”]PRK is often chosen over Lasik surgery by athletes who’re at risk of taking impacts in the face (martial arts, boxers, etc) since PRK doesn’t create the risk of dislocated corneal flaps.[/box]

Miloš Obradović is an chief editor of skidanjedioptrije.org blog which covers topics on refractive surgery and eye health in general.

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