What is PRK eye surgery?

PRK, or photorefractive keratectomy, is a type of laser eye surgery. It is used to correct some common vision problems, including short-sightedness, long-sightedness and astigmatism.

PRK works by using a laser to reshape the cornea, which is the clear front surface of the eye. Changing the shape of the cornea can help light focus more clearly on the retina at the back of the eye.

PRK has been used for many years and is one of several laser eye surgery options available today. At Envision Eye Centre, Dr John Males has been performing PRK for more than 20 years.

If you are thinking about laser eye surgery, it is important to understand how PRK works, what recovery may be like, and whether it may be suitable for your eyes.

How does PRK work?

The surface of the cornea

The cornea is a clear layer at the front of your eye. It helps focus light as it enters the eye.

During PRK, the thin outer layer of the cornea is gently removed. This layer is called the epithelium.¹https://my.clevelandclinic.org/health/procedures/photorefractive-keratectomy-prk-eye-surgery

A laser is then used to reshape the corneal tissue underneath.

The aim is to change how light enters the eye so it can focus more accurately on the retina.

The surface layer grows back

Unlike LASIK, PRK does not create a flap in the cornea.

After treatment, the outer layer of the cornea grows back naturally as the eye heals.

A protective contact lens may be placed over the eye while this happens.

Your surgeon will explain how to care for your eyes during this stage of recovery.

What happens during PRK surgery?

Before treatment

Before PRK, you will have a detailed eye assessment.

Your surgeon will check your vision and eye health and take measurements of your cornea.

You will also have the chance to discuss your lifestyle and what you hope to achieve from treatment.

Not everyone is suitable for PRK or other forms of laser eye surgery. Your surgeon will explain whether PRK may be appropriate for you.

During the procedure

PRK is performed using numbing eye drops.²https://my.clevelandclinic.org/health/procedures/photorefractive-keratectomy-prk-eye-surgery

You will be awake during the procedure.

Your surgeon will ask you to look at a target light while the laser treatment is performed.

The procedure itself is usually brief.

You may notice lights, sounds, or some pressure during the treatment, but the numbing drops are used to reduce discomfort.

Is PRK painful?

During the procedure

The eye is numbed with anaesthetic eye drops before surgery.

This means you should not feel significant pain during the laser treatment.³https://my.clevelandclinic.org/health/procedures/photorefractive-keratectomy-prk-eye-surgery

You may feel some pressure or notice unusual sensations, but your surgeon will talk you through the procedure.

After the procedure

The recovery period can be more uncomfortable than LASIK.

This is because the surface layer of the cornea needs to heal after it has been removed.

You may experience watery eyes, light sensitivity, a gritty feeling, or discomfort during the first few days.⁴https://my.clevelandclinic.org/health/procedures/photorefractive-keratectomy-prk-eye-surgery

Your surgeon will provide instructions and medication to help manage your recovery.

How long does PRK recovery take?

The first few days

The first few days are an important part of PRK recovery.

Your vision may be blurry, and your eyes may feel uncomfortable or sensitive to light.⁵https://my.clevelandclinic.org/health/procedures/photorefractive-keratectomy-prk-eye-surgery

A protective contact lens may be used while the surface of the cornea heals.⁶https://my.clevelandclinic.org/health/procedures/photorefractive-keratectomy-prk-eye-surgery

You should follow your surgeon’s instructions carefully during this time.

The first few weeks

As the surface of the cornea heals, your vision should gradually improve.

However, recovery varies between people.

Some people may return to everyday activities relatively quickly, while others may need more time.⁷https://my.clevelandclinic.org/health/procedures/photorefractive-keratectomy-prk-eye-surgery

Your surgeon will tell you when it is appropriate to return to work, driving, exercise, swimming, and other activities.

Vision continues to settle

Although the surface of the eye may heal within weeks, your vision can continue to settle over a longer period.

Your follow-up appointments allow your surgeon to monitor your progress and check that your eyes are healing as expected.

PRK vs LASIK

The main difference

PRK and LASIK both use a laser to reshape the cornea.

The main difference is how the surgeon reaches the corneal tissue.

LASIK involves creating a thin flap in the cornea. PRK does not.

Instead, PRK removes the outer layer of the cornea before the laser treatment. The surface then grows back during recovery.

Recovery can be different

PRK generally has a longer early recovery than LASIK.

The first few days can also be more uncomfortable because the surface layer of the cornea is healing.⁸https://my.clevelandclinic.org/health/procedures/photorefractive-keratectomy-prk-eye-surgery

However, the most suitable procedure is not simply the one with the quickest recovery.

Your surgeon will consider your individual eye measurements, eye health, prescription, and lifestyle when discussing your options.

Who may be suitable for PRK?

Your eyes need to be assessed

PRK is not suitable for everyone.

Your surgeon will assess your eyes to determine whether laser eye surgery may be appropriate.

They will consider factors such as your prescription, corneal shape, corneal thickness, eye health, and whether your prescription has been stable.⁹https://my.clevelandclinic.org/health/procedures/photorefractive-keratectomy-prk-eye-surgery

Your general eye health and expectations will also be discussed.

Your lifestyle matters

Your lifestyle may also influence which treatment is considered.

For example, people who take part in activities where the eye may be exposed to physical contact may need to discuss this with their surgeon.¹⁰https://my.clevelandclinic.org/health/procedures/photorefractive-keratectomy-prk-eye-surgery

There is no single procedure that is right for everyone.

What are the risks of PRK?

Understanding the possible risks

As with any surgical procedure, PRK has possible risks and side effects.

These can include dry eyes, glare, halos, light sensitivity, changes in vision, infection, inflammation, and problems with the healing of the cornea.¹¹https://my.clevelandclinic.org/health/procedures/photorefractive-keratectomy-prk-eye-surgery

Some people may need additional treatment.

Your surgeon will discuss the potential risks and benefits with you before you decide whether to proceed.

Results vary

Laser eye surgery does not guarantee perfect vision or that you will never need glasses again.

Your outcome depends on your individual eyes and how they respond to treatment.

It is important to have realistic expectations and understand the possible limitations of PRK.

What happens after PRK?

Follow your aftercare plan

After PRK, you will be given instructions for looking after your eyes.

This may include using prescribed eye drops and attending follow-up appointments.

You should avoid rubbing your eyes and follow your surgeon’s advice about when you can return to normal activities.

Contact your surgeon if you have concerns

Some discomfort and changes in vision can occur during recovery.

However, severe pain, increasing redness, a sudden change in vision, or other worrying symptoms should be reported to your surgeon promptly.¹²https://my.clevelandclinic.org/health/procedures/photorefractive-keratectomy-prk-eye-surgery

Your surgical team can assess your eyes and provide advice based on your individual recovery.

Is PRK right for you?

PRK is one option for people considering laser eye surgery. It can correct certain refractive errors, but it is not suitable for everyone.

The best way to understand whether PRK may be appropriate is to have a comprehensive eye assessment.

At Envision Eye Centre in Sydney, our team can assess your eyes, explain your treatment options, and answer your questions about PRK, LASIK, and other forms of vision correction.

Take the next step

If you are considering laser eye surgery, start by finding out whether you may be suitable for treatment.

Take our suitability self test to learn more about whether laser vision correction may be an option for you.