PRK may be suitable for people who have thin corneas and difficulty seeing. It has a longer recovery period than LASIK. Talking with an eye care professional can help determine which surgery is right for you.

Photorefractive keratectomy (PRK) is a type of laser eye surgery that improves vision by correcting refractive errors.

Nearsightedness, farsightedness, and astigmatism are all examples of refractive errors. Based on your needs, you may have PRK surgery done in one or both eyes.

PRK was developed before LASIK surgery and is a similar procedure. Both PRK and LASIK work by reshaping the cornea, the clear front part of the eye, improving the eye’s ability to focus.

Some people are good candidates for both PRK and LASIK, while others are better suited to one or the other. It’s important to understand the PRK procedure and how it differs from LASIK before deciding which is best for you.

If you’re ready to do away with eyeglasses or contacts, this is what you need to know.

You’ll discuss specific PRK procedure guidelines with an eye doctor prior to your surgery date. There are several steps you’ll be instructed to take.

Before surgery

You’ll have a preoperative appointment to have your eyes assessed and your vision tested.

In preparation for surgery, the refractive error and pupil in each eye will be measured, and the corneal shape will be mapped. The laser used during your procedure will be programmed with this information.

A full exam should be done to check for other issues that could affect the outcome.

Let your doctor know of any prescription and over-the-counter medications you regularly use. You may need to temporarily stop taking them. If you use antihistamines, your doctor may tell you to stop taking them 3 days before your scheduled surgery date.

If you wear rigid gas-permeable contact lenses, your doctor will tell you to stop wearing them at least 3 weeks prior to surgery. Other types of contact lenses should also be discontinued, usually 1 week before the procedure.

An eye care professional may prescribe an antibiotic eye drop, such as Zymaxid, for you to start using 3 to 4 days prior to surgery. You’ll continue to take these after the procedure for around 1 week. Your doctor may also recommend an eye drop for dry eye.

Around 3 days before surgery, you’ll need to start thoroughly cleansing around your eyes, which will empty out the oil glands located near your lash line:

  1. Place a warm or hot compress on your eyes for 5 minutes.
  2. Gently run your finger on your upper eyelid from the inside near your nose to the outside near your ear. Do this two or three times for the upper and lower lash lines.
  3. Wash your eyelids and eyelashes thoroughly with a gentle, nonirritating soap or baby shampoo.
  4. Repeat the entire process twice each day.

Day of surgery

You won’t be able to drive and may feel very tired after PRK, so make arrangements to have someone pick you up after the procedure.

It’s a good idea to eat a light meal before you arrive. You should expect to be at the clinic for several hours. Unless you’ve been told otherwise, take your usual prescription medications.

Don’t wear makeup or anything that might interfere with the surgeon’s ability to position your head underneath the laser. Other accessories to avoid include barrettes, scarves, and earrings.

Wear comfortable clothing to your procedure. If you’re sick, have a fever, or don’t feel well in any way, call your doctor and ask if the procedure should continue.

Ask your doctor if you should bring eye drops or any other medication with you.

Surgical procedure

PRK takes 5 to 10 minutes per eye. This type of surgery doesn’t require general anesthesia. You may be given oral medication, like Valium, or anesthetic eye drops in each eye.

During the procedure:

  1. An eyelid holder will be placed on each eye to keep you from blinking.
  2. The surgeon will remove and discard the corneal surface cells of your eye. This may be done with a laser, blade, alcohol solution, or brush.
  3. The laser programmed with your eye measurements will reshape each cornea using a pulsing beam of ultraviolet light. You may hear a series of beeps while this is being done.
  4. A clear, nonprescription contact lens will be placed on each eye as a bandage. This will keep your eyes clean and avoid infection during the healing process. The bandage contact lenses will remain on your eyes for several days to 1 week.

You can expect to feel discomfort or pain for up to three days following PRK surgery. Over-the-counter pain medication is often sufficient for handling this discomfort.

If you’re concerned about pain or experience more pain than you can handle, ask your doctor for prescribed pain medication. Your eyes may also feel irritated or watery.

You may find that your eyes are more sensitive to light while healing. Some people also see halos or bursts of light for days or weeks following PRK, especially at night.

You may also experience corneal haze, a cloudy layer that can significantly obstruct vision, for a short period of time after surgery.

While considered safe, PRK surgery is not without risk. Risks include:

  • a loss of vision that contact lenses or eyeglasses may not be able to correct
  • permanent changes to night vision that may include seeing glare and halos
  • double vision
  • severe or permanent dry eye
  • diminished results over time, especially in older and farsighted people
  • infection until the surface of your eye heals

After surgery, you’ll rest at the clinic and then go home. Don’t schedule anything else for that day. Keeping your eyes closed may help with recovery and your overall comfort level.

Your doctor may wish to see you the day after the procedure to assess the results and your comfort level. Call your doctor immediately if you notice any signs of an eye infection, such as:

  • redness
  • pus
  • swelling
  • fever

Let your doctor know immediately if the bandage contact lens is dislodged or falls out. You’ll need to return within 7 days to have the lenses removed from your eyes.

Initially, your vision may be better than it was before the procedure. It will, however, become somewhat blurry during the first 3 to 5 days of recuperation. Then it’ll improve significantly. Many people notice an improvement in vision when their bandage contact lenses are removed.

Don’t rub your eyes or dislodge the contacts covering them. For at least a week, try to avoid getting cosmetics, soap, shampoo, or other substances in your eyes. Ask your doctor when you can wash your face with soap or use shampoo.

Your doctor may recommend taking some time off while your eyes heal. Talk with your doctor about driving, reading, and computer use. These types of activities will initially be difficult. Driving should be avoided until your eyes are no longer blurry, especially at night.

Try not to get sweat in your eyes for at least a week, as this may cause irritation. Don’t participate in contact sports or any activity that might cause damage to your eyes for at least 2 weeks to ensure the surface heals.

Wearing protective eye gear for several months is a good idea. Swimming and other water sports should be avoided for at least 2 weeks, even with goggles. Also, try not to get dust or dirt into your eyes for that same period of time.

It may take several weeks before your vision stabilizes completely. Light sensitivity should resolve after 7 to 10 days. You should be able to see well again within a month. Complete healing can take up to 3 months.

You should shield your eyes from bright sunlight for about a month and wear nonprescription sunglasses on sunny days. Sunglasses can prevent too much sun exposure, which can lead to haze formation.

The cost of PRK varies based on where you live, your doctor, and the specifics of your condition. On average, you can expect to pay $1,800 per eye for PRK surgery.

PRK and LASIK were both designed to correct refractive vision problems by reshaping the cornea. Both procedures use lasers and take around the same amount of time to perform.

With PRK, the surgeon removes and discards the cornea’s outer epithelial layer, which leaves the eye exposed, prior to reshaping the cornea. This layer regenerates itself and grows back over time.

With LASIK, the surgeon creates a thin flap on the surface of your eye and moves it out of the way to reshape the cornea underneath. The flap is commonly made with a bladeless laser or a blade. It remains attached to the cornea and is put back in place after the procedure is completed.

You must have enough corneal tissue to make this flap to be eligible for LASIK surgery. For this reason, LASIK may not be suitable for people with difficulty seeing or thin corneas.

The procedures also differ in terms of recovery time and side effects. Recovery and vision stabilization are slower with PRK than with LASIK surgery. People having PRK can also expect to feel more discomfort afterward and experience more side effects, such as corneal haze.

Success rates are similar for both procedures.

PRK pros

  • It can be done on people who have thin corneas or less corneal tissue caused by low vision or severe nearsightedness.
  • There’s less risk of removing too much of the cornea.
  • It’s less expensive than LASIK.
  • There’s less risk of complications caused by the flap.
  • Dry eye is less likely to result from PRK surgery.

PRK cons

  • Healing and visual recovery take longer because the outer layer of the cornea needs to regenerate itself.
  • There’s a slightly higher risk of infection compared to LASIK.
  • Blurry vision, discomfort, and sensitivity to light typically occur when you wear the bandage contact lens during recovery.

PRK and LASIK are both considered safe and effective procedures that dramatically improve vision. Deciding between the two can be difficult unless you have specific conditions that require that you do one or the other.

If you have thin corneas or difficulty seeing, your doctor will guide you toward PRK. Depending on your hobbies, your doctor may also recommend PRK. If you require a quick recovery, LASIK may be a better choice.