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PRK Recovery, FAQ & Guide

Drs. Robert Maloney, Neda Shamie, and Arjan Hura believe that a well-informed patient is key to successful vision correction surgery. They wants to be sure that you fully understand what you can expect from your procedure you choose.

They want to help you care for and preserve your eyesight in the best way possible. Here, you can find the information that you need to help you make informed choices about health care for your eyes.

Frequently Asked Questions about PRK

PRK surgeons are accustomed to having patients ask many questions. An important part of our role as surgeons is to educate you. Here are some of the questions I’m asked most often.

Does the PRK procedure hurt?

No. The procedure is painless because the eye is completely numbed with anesthetic eyedrops. These drops are very effective, so no injections or IVs are needed. After the surgery, discomfort occurs on and off for three or four days. Surgeons typically prescribe an oral pain reliever for you. At my center, we also give you numbing eyedrops to take home to ensure that you are comfortable.

How long does the PRK procedure take?

Most patients are pleasantly surprised at how quickly PRK is performed. Expect an experienced surgeon to complete the procedure in five or six minutes per eye.

How long will it take for my eyes to heal?

The healing process during PRK recovery takes longer than for LASIK because the epithelium is removed from the surface of the eye. The epithelium takes three or four days to heal. During this time you will experience discomfort and very blurry vision after PRK. By one week after surgery your vision begins to clear up, although it may takes several weeks to a month to become excellent. Visual clarity and crispness after PRK continue to improve for three to six months and then stabilize.

What happens if my vision isn’t clear enough after PRK?

Even in the hands of a skilled surgeon, each person’s eyes respond differently to the excimer laser, both during the surgery and while healing. Not everyone gets perfect vision. About 5 percent of PRK patients find their vision isn’t as clear as they hoped. In this situation we usually recommend an enhancement procedure, which means doing another PRK procedure for the small residual correction. If you do need an enhancement procedure, it is usually done six months after the original surgery. An enhancement procedure can be performed years later if your eyesight changes over time.

How long will the correction last?

The results of your PRK do not diminish over time. Once your eyes have stabilized, usually in three to six months, your vision correction is permanent. This doesn’t mean, however, that your vision won’t change. Reading vision normally declines with age, and PRK doesn’t prevent that decline. Also, vision is a combination of different parts of the eye, not just the cornea. Changes in other parts of the eye, like development of an early cataract, can change your vision. Usually, though, we find that vision stays excellent for many years to decades after PRK. If your vision does change when you are older, an enhancement procedure can usually be done to restore excellent vision without glasses.

Will I be able to drive immediately after PRK?

You can’t drive the day of surgery because you will have blurry vision and may have taken a sedative. By the next morning, most people are seeing well enough to drive during the day without glasses. You should use good judgment, and drive only if you can see well enough to do so safely.

When can I go back to work?

Most patients can return to work four or five days after their PRK procedure.

If I have dry eyes, will it affect my PRK surgery?

That depends. Many people have PRK done because they have mild dry eyes and cannot wear contact lenses comfortably. These patients are delighted to have good vision without the irritation of contacts. On the other hand, if you have moderate or severe dry eyes, PRK may not be a good idea. Part of your comprehensive preoperative exam will be to evaluate your eyes for dryness and alert you if any abnormalities are found. Sometimes dry eyes can be treated preoperatively and you can still have successful PRK.

If I’ve had previous eye surgery, am I still a candidate for PRK?

Often, people who have had previous eye surgery are candidates for PRK. However, these can be more difficult surgeries and have less predictable results. For example, PRK has been used following an older form of refractive surgery, radial keratotomy (RK). With RK, the cornea is flattened by making small, spokelike incisions around its periphery to correct myopia and astigmatism. PRK following RK can succeed as long as the patient’s vision is relatively stable and is still correctable with glasses.

If I have thin corneas, am I still a candidate for PRK?

Yes. PRK is the preferred procedure in patients with thin corneas because PRK does not sculpt as deeply into the cornea as LASIK.

Can I wear contact lenses after surgery, if needed?

After surgery, if you still need correction in one or both eyes, you may elect to wear contact lenses. Some patients who have monovision surgery will occasionally use a distance contact lens in the reading eye. They might do this in a situation where they want excellent distance vision in both eyes, such as playing tennis. If you tolerated the contacts before PRK, it is likely you will tolerate them afterward. In practice, though, rather than returning you to contact lens wear, your surgeon will generally recommend an enhancement to sharpen your vision.

Could the surgery cause problems years from now?

The chance of unknown complications years down the road is very unlikely. PRK is a form of lamellar refractive surgery, a type of surgery that has been performed since 1949. People who have undergone earlier types of lamellar refractive surgery—much less accurate and more invasive than PRK— have not developed unexpected problems during the past fifty years.

Will having PRK prevent eye diseases?

No. PRK does not prevent cataracts, glaucoma, retinal detachment, macular degeneration, or any other eye disease. That is why it is important to still have regular eye checkups after PRK, even if your vision is perfect. Equally true, PRK doesn’t increase the risk of these problems or impair their treatment if you are diagnosed with these in the future.

Should I have both eyes done at the same time?

Some patients choose to have one eye treated at a time because of the relatively slow recovery from PRK. These patients rely on the un-operated on eye while the first eye recovers. Then, they get the second eye done. Most patients, however, prefer to do both eyes at once, to avoid going through the procedure twice and the recovery twice. In the end, the choice is yours, and you should feel no pressure to do it one way or the other.

Should I wait for the next generation of PRK treatment?

Recent years have brought several advancements to PRK surgery. We now routinely perform wavefront-guided PRK. This advanced way of measuring the eye prior to PRK surgery is described in detail in chapter 5 on LASIK. Wavefront-guided PRK gives a more accurate correction and better night vision than older forms of PRK.

Another advancement in PRK is the near-elimination of the risk of developing corneal haze after PRK. Better lasers and the use of an eyedrop called Mitomycin C at the end of surgery results in crystal-clear corneas in almost everyone.

PRK is a fairly stable technology now, with advances happening incrementally. In general, you are getting older much faster than PRK is getting better. For most people, waiting longer doesn’t make much sense.

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