LASIK Alternatives
Photorefractive Keratectomy (PRK)
Photorefractive Keratectomy, commonly referred to as PRK, is a vision correction procedure which uses an excimer laser to reshape the surface of the transparent outer portion of the eye (the cornea). Until the approval of the use of lasers to perform LASIK, PRK was the most popular form of corrective eye surgery and continues to be regularly performed. It is often used for patients who fit the appropriate criteria for corrective eye surgery, but are not good candidates for LASIK. This can include patients with thin corneas, dry eyes, corneal dystrophies, corneal scars, or recurrent corneal erosions.
Like LASIK, PRK is elective same day surgery. Using eye drops for local topical anesthesia, the central surface of the cornea is removed either mechanically or chemically. Next, an excimer laser is used to reshape the cornea to lessen or eliminate the patient’s need for glasses or contact lenses. The PRK laser vision correction surgery is typically painless and usually takes only a few minutes.
While each individual’s results will be unique, commonly over 90% of the patients having PRK treatment have 20/40 vision after having PRK and most achieve 20/20 or better. Like many people with good distance vision, it is not uncommon for individuals, as they reach their 40’s to need reading glasses after PRK or LASIK. . This is due to an age related condition called presbyopia which is believed to be caused by a stiffening of the natural lens, reducing its ability to adjust for near vision and is unrelated to the excimer laser procedure..
Risks and Possible Complications
PRK is a safe and effective treatment. But as with any surgery, you should discuss the risks, benefits and alternatives to the PRK procedure with your surgeon. Following PRK surgery, some common side effects patients have experienced include:
- night glare such as starburst or halos
- infection
- under-correction or over correction of your vision
- decrease in best-corrected vision
- excessive haze
Some of these possible complications can be corrected by additional treatment. A complete list of specific risks and concerns should be obtained from and discussed with your doctor before determining whether you are a candidate for PRK or any elective procedure.
Candidacy for PRK Surgery
The following are some of the criteria your doctor might consider when helping you evaluate PRK:
- At least 21 years old and have a stable vision for at least 1 year.
- The eyes should be healthy and free of eye disease.
- Have mild to moderate nearsightedness (myopia), farsightedness (hyperopic) or astigmatism within the treatment range. Your doctor can share this range with you and determine your degree of correction.
- You are fully informed of the benefits and risks of the PRK surgery compared with other options available to you such as spectacles, contacts or other refractive surgeries.
- You willingly accept the potential benefits and risks or PRK surgery.
You should consult your board certified ophthalmologist for a full list of considerations. He or she is the ultimate resource for information on PRK and the qualities that make a person a good candidate with greatest probability of a successful procedure.
LASEK
LASEK, or Laser Assisted Subepithelial Keratomileusis, is a modification of the LASIK procedure. The eye is bathed in a special solution. Then a thin flap of corneal tissue is lifted so the central cornea may be treated with an excimer laser.
After treatment the flap is replaced and allowed to heal. A contact lens may be worn for a few days until recovery is complete.
