Photorefractive Keratectomy (PRK)

Why is it needed?

It is an elective procedure. It is done for patients who are tired of relying on their glasses or contact lenses. It is an ideal procedure for thin cornea, scarred cornea, or irregularly-shaped cornea with lower refractive powers.

Benefits of the Photorefractive Keratectomy

• It takes approximately 5 to 15 mins per eye for the procedure

• Independent of glasses

• Flapless/bladeless procedure

• A suitable procedure for pilots, professional athletes, or other individuals in whom there is a higher risk of flap dislocation

• No flap based complications

Preparations before Photorefractive Keratectomy

• Patients should be above 18 years of age

• Should have had stable refraction of +/- 0.5 D for 6 months

• Should be off contact lenses for 2 weeks

• Old glass power and present degree of refractive error ( before and after applying dilating drops) will be assessed

• Pentacam scan – it will help evaluate the shape and thickness of the cornea

• Dry eyes will be ruled out

• Proper medical history regarding diabetes mellitus, pregnancy, thyroid disorder, abnormal wound healing, or chronic usage of any medicine should be informed to your doctor.

• A thorough eye examination (anterior and posterior) will be done to rule out any abnormalities

Treatment procedure

Anesthetic drops are applied to numb the eyes. The patient is asked to focus on the target light while the surgeon manually removes the top layer of the cornea.  The excimer laser is performed over the mid-cornea, which corrects the refractive power by reshaping it. A bandage contact lens is applied to the patient’s eye to decrease irritation and better healing. The contact lens will be removed 4-6 days postoperatively by your doctor.

Precautions and Care after Photorefractive Keratectomy

• After the surgery, a group of eye drops and oral medications will be started, which should be followed as advised by your doctor.

• The eye drops should be applied without touching the tip of the bottle to the eye.

• The bandage contact lens will be removed after 4-6 days after the surgery. The patient should not rub their eyes as that would cause the contact lens to fall out. If the contact lens falls out, the lens should not be replaced by the patient. Meet your doctor as soon as possible who will place a new contact lens.

• For the first few postoperative days, the vision tends to be a little blurry due to the epithelial formation, which should not be alarming.

• A normal diet should be followed

• UV protective dark goggles should be worn while going out for the first 6 months.

• Facewash and hair wash are to be avoided for one week

• Avoid driving till your vision is absolutely clear

• Makeup applications should be avoided for 1 month

• Swimming should be avoided for 3 months.

Result of Photorefractive Keratectomy

The patient will gain his preoperative vision but without being dependent on glasses.

Written by: Dr. Ramya Sampath – Regional Head – Clinical Services, Chennai