What is a Photorefractive Keratectomy?

Photorefractive keratectomy (PRK) is a type of eye surgery conducted with a laser to reshape the surface of the cornea for the purpose of vision correction. This procedure was developed in the 1980s and is considered appropriate for treatment of patients with mild to moderate cases of farsightedness, nearsightedness, and astigmatism. It is available at outpatient eye clinics and is performed by a specialist with training in laser surgery.

In this procedure, the patient holds still and eyedrops are used to provide anesthesia. A laser is aimed at the eye and while the patient focuses on a light, the laser is fired several times to ablate corneal tissue, flattening the cornea. When the procedure is over, the patient can leave, although it is usually advisable to have someone else drive or guide the patient on public transit, as the vision can be blurry and distorted initially after photorefractive keratectomy as a result of the anesthetic.

For several days after photorefractive keratectomy, the patient's eyes may feel irritated and swollen. Vision can be poor, and sometimes, halos can be seen around objects. It can take up to three months for the eyes to settle and the patient's vision to hit a stable point. During this period, patients may note that glasses do not work quite right. Patients may take some medications to prevent infection and inflammation in the eye and are advised to avoid sources of eye strain and injury, including using makeup or rubbing the eye.

Periodic checkups are used after photorefractive keratectomy to see how well the patient's eye is healing and to check on the progress of the patient's vision. Once the eyes have healed, patients may experience a significant improvement in vision quality. Some patients still need glasses for very close work, but can go without glasses and contacts the rest of the time.

Other laser eye procedures including LASIK are available for vision correction. One distinct disadvantage of photorefractive keratectomy is the extended healing time. LASIK patients heal much more quickly and notice vision improvements rapidly. Patients can discuss the pros and cons of laser eye surgery with a doctor before deciding on the method they think will be most appropriate and making an appointment for surgery. It is advisable to get information about healing times in advance so patients can prepare by taking time off from work and other activities, if necessary. There may also be restrictions on activities like swimming or driving that patients will need to take into account.