PRK Eye Surgery Recovery


PRK RECOVERY & LASEK PRK EYE SURGERY.

Information on PRK surgery and PRK recovery.

What is PRK eye surgery?

Photorefractive keratectomy (PRK) and Laser-Assisted Sub-Epithelial Keratectomy (or Laser Epithelial Keratomileusis) (LASEK) are laser eye surgery procedures intended to correct a person’s vision, reducing dependency on glasses or contact lenses.  LASEK and PRK permanently change the shape of the anterior central cornea using an excimer laser to ablate (remove by vaporization) a small amount of tissue from the corneal stroma at the front of the eye, just under the corneal epithelium. The outer layer of the cornea is removed prior to the ablation. A computer system tracks the patient’s eye position 60 to 4,000 times per second, depending on the brand of laser used, redirecting laser pulses for precise placement. Most modern lasers will automatically center on the patient’s visual axis and will pause if the eye moves out of range and then resume ablating at that point after the patient’s eye is re-centered.

The PRK surgery procedure:

The outer layer of the cornea, or epithelium, is a soft, rapidly regrowing layer in contact with the tear film that can completely replace itself from limbal stem cells within a few days with no loss of clarity. The deeper layers of the cornea, as opposed to the outer epithelium, are laid down early in life and have very limited regenerative capacity. The deeper layers, if reshaped by a laser or cut by a microtome, will remain that way permanently with only limited healing or remodelling. With PRK, the corneal epithelium is removed and discarded, allowing the cells to regenerate after the surgery. The procedure is distinct from LASIK (Laser-Assisted in-Situ Keratomileusis), a form of laser eye surgery where a permanent flap is created in the deeper layers of the cornea.

When was PRK invented?

The first PRK procedure was performed in 1987 by Dr. Theo Seiler, then at the Free University Medical Center in Berlin, Germany. The first LASEK procedure was performed at Massachusetts Eye and Ear Infirmary in 1996 by ophthalmologist, refractive surgeon, Dimitri Azar. The procedure was later popularized by Camellin, who coined the term LASEK for laser epithelial keratomileusis.

PRK RECOVERY.

PRK surgery is still performed on a widespread basis instead of the more well known LASIK.

Immediate PRK Recovery:

PRK surgery is sometimes preferred to LASIK because of the reduced risk of complications. LASIK involves cutting a flap in the cornea, and it is this flap that gives the greatest risk of infections and complications. PRK surgery involves gently rubbing away the top layer of cornea, leaving less room for complications, but requiring a longer recovery period. The surgery is completely painless for the majority of patients. While there is some discomfort involved when the surgeon is wiping away the cornea, the patient will have been given pain medication, usually orally, as well as numbing drops for the eyes. The following couple of days will usually be the most painful. For this reason, most surgeons prescribe Vicodin and tetracaine drops that the patient may use as needed. This immediate recovery time (three days following the surgery) should be spent doing as little as possible, particularly as it pertains to using the eyes.

Long Term  PRK Recovery:

Five days after the surgery, the patient will  have his temporary bandage lenses removed and can resume normal activities. The exception would be vigorous exercise, or any sport or activity that would result in eye contact . Unlike LASIK patients, who often will have achieved the full benefits of the surgery by this time, PRK patients may have to wait up to six months to finally see exactly how the surgery went. They will be able to see during this time, and able to see well, but it may be premature to gauge the true limits of the patient’s vision until six months out.

There are many things the patient should do during his recovery to speed the process and ensure thorough healing. Most doctors will recommend omega 3s as a vital supplement. These supplements help lock moisture into skin cells, and can help the patient avoid dry eye syndrome. Omega 3s come in supplement form as either fish oil pills or flaxseed, or can be obtained through diet in the form of two or more fish meals per week. The patient is also advised to avoid fans and extended computer work as much as possible, particularly in the first week or so after surgery, as these can contribute to dry eyes.

PRK results:

In some cases, the patient and the doctor may not be seeing the results they want after six months. It should be noted that these cases are very rare in comparison with the number of cases where the surgery is a success the first time out. Still, it is worth asking the doctor if he will perform the surgery again for free if the results are not optimal. Most reputable surgeons have such a program in place and will discuss this before the surgery. If another surgery is necessary, the recovery time following the second PRK will be the same as the first one.

What can the PRK patient do?

While true recovery is done within the first year after PRK surgery, it is important that patients continue to care for their eyes following this procedure. This includes keeping eye drops at the ready for moistening, wearing sunglasses whenever driving or out in the daylight, and supplementing with omega 3s and vitamins on a regular basis.

There are many things the patient should do during his recovery to speed the process and ensure thorough healing. Most doctors will recommend omega 3s as a vital supplement. These supplements help lock moisture into skin cells, and can help the patient avoid dry eye syndrome. Omega 3s come in supplement form as either fish oil pills or flaxseed, or can be obtained through diet in the form of two or more fish meals per week. The patient is also advised to avoid fans and extended computer work as much as possible, particularly in the first week or so after surgery, as these can contribute to dry eyes.

Who can have excimer laser PRK surgery?

A candidate for successful PRK should be at least 20 years of age, have an eyeglass prescription which has been stable for at least one year, have healthy eyes which are free from hereditary or acquired diseases and have realistic expectations for laser-refractive surgery and its ability to reduce or eliminate the need for glasses or contacts. These guidelines ensure that only those patients for whom laser-refractive surgery is most appropriate will consider proceeding with this treatment.

PRK surgery success percentages:

98% of myopic (nearsighted) patients can expect vision of 20/40 or better within one year. 82% can expect vision of 20/25 or better. These statistics are slightly better for patients with lower levels of myopia and slightly worse for those with higher refractive errors. In a recent survey, 95% of all patients that undergo PRK laser surgery would decide to do it again.
PRK has a ten year history of clinical success. The majority of patients that undergo PRK will find that their final uncorrected vision is similar to what they had with glasses or with contact lenses. Its safety and efficacy have been established by over 300,000 patients treated in approximately 47 countries.


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