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Photo Refractive Keratectomy (PRK)

Photo Refractive Keratectomy, known as PRK, is a type of laser vision correction that is used on patients to correct myopia, hyperopia, and or astigmatism. It is one of the most common laser vision correction procedures, along with LASIK, and the two procedures share many similarities.

PRK was FDA approved in the mid 1990s. It is an excellent alternative for those who are not good candidates for LASIK laser vision correction. Dr. Iskander, the medical director and leading refractive surgeon of San Antonio Eye Specialists, has been performing PRK for over 20 years. PRK uses the same laser technology as LASIK laser vision correction. 

Who Is a PRK Candidate?

PRK is often used when a patient has thin corneas, corneal irregularities, epithelial cell deficiencies, and or strong refractive prescriptions. Below are some additional details on why some patients might be a better candidate for PRK vs LASIK.

Corneal Thickness: Patients who have thinner corneas may be better suited for PRK vs LASIK, because LASIK requires the creation of a protective corneal flap and PRK does not. PRKinvolves less tissue of the cornea with the laser, which leaves more residual tissue for a stronger cornea.

Corneal Anomalies: Some patients might have corneal scarring from trauma or long-term contact lens wear. Some have corneal opacities, surface irregularities or corneal dystrophies. Oftentimes, doctors have to use a procedure called Photo Therapeutic Keratectomy or PTK in order to correct the corneas. PTK allows the removal of superficial corneal opacities and surface irregularities, but does not correct for visual errors. PRK can correct visual errors AND correct the same issues that PTK does as well… all at the same time.

Vision Prescription: For patients that have large amounts of myopia (nearsightedness), hyperopia (farsightedness) and or astigmatism, more corneal tissue must be removed in order to correct the cornea to its ideal shape/prescription. Even if a patient has normal or thick corneas, patients with high prescriptions may be a better candidate for PRK because less tissue is involved vs LASIK, since a corneal flap is not created with PRK.

Employment & Recreation: Since PRK laser vision correction doesn’t require the creation of a corneal flap, it is often the preferred procedure for those who work in industries such as construction, the military, or fields in which there is a risk of displacing a corneal flap created by LASIK. This is important, because if their eye were to suffer trauma, in some cases, the protective corneal flap (only created in LASIK, not PRK) could become dislodged. For example, military pilots could have to eject at any time and face hand to hand combat over enemy territory. Professional boxers or UFC fighters get hit in the face all of the time. Construction workers could have objects fall on their face, possibly affecting the eye. The same holds true for people involved in martial arts or boxing classes. In general, if your career, recreational sports or hobbies could displace your corneal flap, that is created by LASIK, then PRK would be a preferred option as an alternative laser vision correction treatment.

How Does PRK Work?

PRK is virtually the same procedure as LASIK, except a protective flap is not created. Dr. Iskander begins the procedure by numbing the patient’s eye with numbing drops, and placing a speculum in the eye to hold it open during the procedure. Next, he gently removes the outer most layer of cells on the eye, called epithelial cells, using a special instrument. After the cells are removed, he then uses an excimer laser to gently reshape the cornea surface to the targeted prescription, with no flap creation. After the laser treatment is completed, Dr. Iskander places a clear contact bandage lens on the eye which the patient will wear for approximately one week. PRK does have slightly more discomfort than LASIK and does require a longer recovery time, up to one week. This is very normal and to be expected with PRK.  Patients who undergo PRK eye surgery will typically be able to drive within a few days, and their vision will continually improve during the week duration. 20/20 vision or better is the desired goal for both LASIK and PRK, only the surgical process and healing time differ.

All our laser vision correction consultations are absolutely complimentary and at that appointment, you will learn if you are in fact a good candidate for laser vision correction. If you are a candidate, Dr. Iskander will discuss which laser vision correction procedure is best for you. Dr. Iskander personally meets, evaluates and creates a treatment plan unique to each patient prior to any surgical intervention.