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Photorefractive keratectomy (PRK) is a procedure in which the surface of the cornea is reshaped using an excimer laser. This process removes only 5-10% of the thickness of the cornea for mild to moderate myopia - about the thickness of 1 to 3 human hairs.
Anesthetic drops are applied to the patient's eye to numb it and prevent discomfort during the PRK procedure and a device is placed to hold the lids apart, eliminating any concern about blinking. The eye surgeon then gently removes the surface corneal cells (epithelium) and proceeds with the laser aspect of the procedure.
The laser, being computer driven for accuracy and precision, is programmed based on the patient’s refractive error (nearsightedness, farsightedness and astigmatism). The laser is used for less than one minute for most patients. Once the PRK surgery is completed the doctor places a temporary contact lens which is used a bandage on the eye for improved comfort.
The national average PRK cost in 2015 for Custom PRK is $2,081 per eye. The price of PRK surgery varies by surgeon and region of the country, and the cost of PRK surgery with doctors who only offer one price model for LASIK eye surgery was $2,259 per eye in 2014.
PRK recovery begins when a contact lens is placed on the treated eye and is worn for the first 3 to 5 days until the surface epithelium is healed. Expect to attend several appointments with your surgeon during the first month following PRK surgery, with the first visit being the day after surgery. When the surface epithelium is healed the eye will be comfortable and the bandage contact lens is removed. Vision may still be blurry at this time as your vision gradually improves.
Typically your recovery will allow you to drive a car within a week or two, but your best corrected vision may not be obtained for up to 3 months following surgery. PRK surgery results are very similar to LASIK for patients with up to approximately 6.0 diopters of myopia (nearsightedness). PRK recovery will be slower than LASIK recovery, however, studies at the 6 month postoperative visit in both patients show essentially equivalent results.
PRK surgery does not create a corneal flap utilizing the microkeratome, and therefore, the protective superficial layers of the cornea must heal post PRK surgery. The most common PRK side effects are complications of scarring (haze) and unpredictable healing of the cornea.
In addition, PRK side effects also include risk of infection, although infections following either PRK or LASIK is rare. Many eye surgeons prefer PRK surgery for patients with large pupils or thin corneas due to complications with the flap creation, potential halos and starbursts.