Photorefractive Keratectomy

The first procedure used to improve eyesight was called Radial Keratotomy (RK). RK is an operation to improve nearsightedness. It does this by changing the curve of the cornea over the pupil. The cornea is the clear covering in the front of the eye. RK is done with actual incisions (cuts) in the cornea.

A recent development in vision correction is a procedure called Photorefractive Keratectomy (PRK). PRK is done by laser, avoiding the need for incisions to be made. It is similar to RK, in that the cornea is changed to correct vision. PRK often takes less than one minute per eye. Although there is sometimes more discomfort and longer healing time than with LASIK (another common procedure, using a laser to correct vision), PRK can be performed on people who cannot have LASIK. This includes people with loose corneal surface cells or thin corneas.

ExitCare ImageThe process for PRK is different, and it offers improvements in patient risk and correction abilities. Rather than making cuts in the cornea like RK, or destruction of tissue like LASIK, the PRK process uses an excimer laser to sculpt an area 5 to 9 millimeters in diameter on the surface of the eye. This means it cuts thin layers of cells off the cornea. This changes your vision.

RISKS AND COMPLICATIONS

Complications during or after surgery are rare, but can be serious. Some people can have a poor healing response. Most complications can be treated with medicines or more surgery. The following is a list of some of the potential short and long-term complications:

  • Changes in vision, especially in the first few months after surgery.

  • A weakened cornea that is more likely to rupture, if hit directly.

  • Need for additional surgery.

  • Contact lenses can be difficult to fit, if they are required.

  • Glare, sensitivity, or starbursts around lights (haze) may occur.

  • Sores (ulcers) on the cornea.

  • Infection. (This can usually be treated with antibiotics.)

  • Delayed surface healing.

  • Double vision. (You could see two of everything.)

BEFORE THE PROCEDURE

If you are a contact lens user, stop wearing contact lenses for several days before surgery.

AFTER THE PROCEDURE

Immediately after surgery, some people have discomfort. But the use of bandage contact lenses and medicines usually control this. Light sensitivity happens to almost everyone. Halos and other unusual light effects can happen. Vision can be reduced while healing. You must discuss with your surgeon and fully understand all of these possible side effects and problems prior to surgery.

HOME CARE INSTRUCTIONS

  • Do not rub your eyes.

  • You may experience slight discomfort in the first 24 to 48 hours following surgery.

  • Rest your eyes in a dark room for the first 48 hours.

  • A protective "bandage" contact lens on the eye may keep irritation to a minimum.

  • Drops may be prescribed to soothe the eye(s). Use as directed.

  • Do not wear eye make-up for one week.

  • Do not go swimming, use hot tubs, saunas, whirlpools, or come into contact with possibly contaminated water for two weeks.

  • Do not play contact or racquet sports for one month after your procedure, or as directed by your surgeon.

  • Do not do anything that requires bending over (such as gardening) for the first two days after surgery.

  • You should stay home from work for at least two days.

  • Do not drive (day or night) until your surgeon has approved this.

  • Wear good quality sunglasses when outdoors.

  • Attend all follow-up appointments scheduled by your caregiver.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your vision gets worse or does not improve after a time specified by your caregiver.

  • You have pain in or discharge coming from the repaired eye(s), or redness or swelling around your eyes.

  • An unexplained oral temperature above 102° F (38.9° C) develops.