Photorefractive keratectomy (PRK) is a type of refractive surgery that uses an excimer laser to reshape the cornea. A thin layer of protective skin, called the epithelium, is removed with the laser and the cornea’s surface is reshaped. After the correction has been made, a contact lens is inserted into the eye to act as a bandage until the epithelium grows back over the next several days. The bandage contact lens is then removed by your surgeon. While the recovery time is longer than LASIK, the PRK procedure is a great option for those who have thinner corneas or stronger corrective prescriptions. If you have been told that you do not qualify for LASIK in the past, PRK could be an option for you.
To ensure that you have the greatest chance of success, trust a qualified ophthalmologist who has performed this type of eye surgery before.
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If you’re in the Tucson and Oro Valley area, you will find an experienced eye surgeon at Fishkind, Bakewell, Maltzman & Hunter Eye Care and Surgery Center.
In our practice, LASIK is performed on an outpatient basis at the Arizona Eye Laser Center on Oracle Rd. Although the procedure itself takes only a few minutes to complete, you should plan to spend a couple of hours at the center. Some of this time will be spent preparing you and your eyes for the procedure, while a few minutes will be required afterward for postoperative instructions and departure preparation.
Before the procedure begins, a nurse or technician will talk to you about any immediate health problems that may affect your readiness for the surgery. At this point, additional eye measurements will be taken if you are undergoing wavefront LASIK (read about wavefront technology below). Anesthetic eye drops will be given to completely numb your eyes during the entire procedure.
Currently, we create most LASIK flaps using the IntraLase® laser.This advanced technology “femtosecond laser” allows the formation of a corneal flap of any shape and size with tremendous precision, virtually eliminating the blade-related complications of a metal microkeratome. All cutting is done by laser, with no sharp instruments ever touching the eye. IntraLase LASIK has now been approved by the U.S. military for Air Force pilots, and by NASA for astronauts due to its precision and safety.
You will be comfortably positioned under the IntraLase device and a suction ring will be moved into place around your eye. Using a vacuum, this ring will hold your eye perfectly still while the laser creates the flap, a process that takes about 10-15 seconds. During this time you might feel a slight pressure, but no pain, and your vision will be diminished. Once the suction ring is released, you will notice a diffuse haze over your vision as the flap fully develops over the following few minutes. The procedure is then repeated on your second eye, if both are being treated.
In occasional cases, a microkeratome might still be used to create the flap. The overall process is similar, with placement of a suction ring. The microkeratome, which functions somewhat like a carpenter’s plane with a rapidly oscillating blade, passes over the cornea to cut the flap. This takes about 10 seconds, with no pain.
Your eye is now ready for the final phase of LASIK- administration of the laser pulses to reshape the cornea. You will lie comfortably below the laser aperture and the area around your eyes will be prepared with a sterile cleanser. A plastic or paper drape will be placed around the eye, and a small eyelid separator will be placed to keep the eye open. Your surgeon will use an instrument to gently lift up and fold back the previously created corneal flap. You will not feel any discomfort. The surgeon will ask you to look towards a fuzzy, blinking red light above you. You do not need to worry about small eye movements, as the laser tracks the movement of your eye and adjusts its aim accordingly. It will stop firing completely if you move too far off track. As the surgeon activates the laser, you will hear a rapid “clicking” or “tacking” sound. Again, you should feel no discomfort whatsoever. The total number of laser pulses required depends upon the amount of refractive error being corrected, with most treatments completed within 10 to 15 seconds. When the laser is complete, your physician will irrigate away any debris with a sterile solution and then carefully reposition the flap. A contact lens may be placed on the eye to help the flap heal more quickly.
When the procedure is complete, antibiotic drops will be given and your surgeon will cover your eye with a clear plastic shield. For a short time after the surgery, you will not have much sensation due to continued numbness. However, later in the day you may experience some light sensitivity and a scratchy or dry sensation as though you have dust in your eye. This usually resolves within a few hours. You should plan to have someone drive you home from your procedure, as you will most likely be given medication to help relax prior to surgery.
You will return to our office the following day for a postoperative examination. The flap will be checked to assure that it is healing properly. If present, the contact lens will be removed at this time. Vision at this time is usually between 20/20 and 20/40, depending on the degree of refractive error corrected. Vision may continue to improve over the next few weeks before stabilizing fully. At this point you should be able to go about your business as usual… with one exception- no more glasses or contact lenses!
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PRK is a form of corrective laser eye surgery that predates LASIK. While LASIK has become the standard for laser vision correction, there are a number of people who do not qualify for this procedure.
Just like all forms of refractive error vision correction, PRK can successfully treat nearsightedness, farsightedness, and astigmatism. Unlike the more traditional forms of correction, glasses, and contacts, PRK and other forms of laser eye surgery alter the structure of your eyes so that there’s no need for you to maintain any equipment in order to see clearly.
As with all surgical procedures, you should thoroughly research your options to find the best surgeon for you. First, check to see if your routine vision insurance plan provides a discount with your surgeon or the facility. Second, verify that your surgeon is local to your area and will be available for your post-operative care.
Find a facility that has high-quality equipment and experienced surgeons and staff. Also, carefully research the experience of the eye surgeons you have under consideration. Find one who has a good rate of success over a long history of performing eye surgeries.
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We know that you have a choice of several surgeons and locations for your surgery and our team of experts look forward to providing the highest quality care to ensure the success of your PRK procedure. Our experienced surgeons, high-tech equipment, and personalized care provide you with the best outcomes for your vision. Your PRK procedure also includes a year of follow-up exams to ensure you maintain your best possible vision.
PRK predates LASIK surgery and is among the safest procedures today. According to the FDA, about 95% of PRK patients achieve 20/40 vision without the need for corrective lenses or glasses one year post-surgery.
While PRK surgery is safe, like all surgical or medical procedures, there is always a risk of complication, but PRK eye surgery is generally a safe procedure with great outcomes.
If you’re interested in PRK, talk to your eye doctor about the qualifications. If you come to us, our ophthalmologists will review your medical history and conduct a comprehensive eye exam to evaluate your eye health and visual acuity to see if you would be a good candidate for this procedure.
In general, to be eligible for PRK surgery, you must be at least 18 years of age, have good eye health, have a stable eye prescription for one year prior to surgery, not suffer from dry eys, and have no medical conditions requiring medications that can interfere with your healing. PRK should also not be performed on pregnant or nursing women.
No. Your eye surgeon will put anesthetic drops in your eyes prior to your procedure to ensure you feel no pain. If you feel discomfort after the procedure, we can prescribe drops to minimize your discomfort and expedite your healing. Most patients feel fine within a few days.
We cannot guarantee every patient will attain 20/20 vision after PRK surgery. However, most patients attain substantial improvement in their visual acuity, making it unnecessary to wear glasses or contacts for optimal sight.
PRK results will reduce or eliminate your dependence on contact lenses or glasses for optimal sight. Over time, you may experience age-related changes to your vision, and there is a possibility you may need reading glasses. We provide ongoing care and can offer enhancements and treatments to age-related changes if necessary.