Photorefractive Keratectomy (PRK)

Photorefractive keratectomy is a procedure to correct your vision. It is done by changing the curve of the clear front surface of your eye (cornea) using a laser. Changing the shape of your cornea can help focus light rays correctly on the light-sensitive tissue at the back of your eye (retina).

You may have this procedure to correct vision problems, such as nearsightedness, farsightedness, and astigmatism. This procedure can reduce or eliminate the need for glasses or contact lenses. You may have one eye done at a time or have both eyes done the same day. If you are near or over the age of 40, make sure to talk to your health care provider about how this procedure will affect your reading vision.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any medical conditions and eye problems you have or have had, including dry eye.
• Any surgeries you have had, including eye surgeries.
• Whether you are pregnant, may be pregnant, or are nursing.
• Any eye problems members of your family have had, especially cornea problems such as corneal dystrophies, keratoconus, and corneal transplantation.
• Your use of contact lenses and when you last wore contacts.
• How stable the prescription is in your current glasses or contact lenses.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Over-correction or under-correction of your vision. If this happens you may still need glasses or contact lenses or require another surgery.
• Worse dry eye.
• Vision loss or worsening of vision.
• Trouble fitting contact lenses, if you need them.
• Scarring of the cornea. This may require corrective surgery or, rarely, a corneal transplant.
• Problems with night vision.
• Dropping eyelid.
• Complications from steroid drops and bandage contact lenses used after the procedure. These may include increased pressure in the eye or infection.

What happens before the procedure?

• You will have a detailed eye exam to help make sure your eyes are healthy and to plan the surgery.
• If you wear contact lenses, stop wearing them as told by your health care provider.
• Your health care provider may ask you to stop wearing makeup, lotions, and perfume for 1–2 days before the procedure.
• Follow instructions from your health care provider about eating or drinking restrictions.
• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• Plan to have someone take you home after the procedure since your vision will be fuzzy.
• If you will be going home right after the procedure, plan to have someone with you for 24 hours.
• You may be given antibiotic medicine to help prevent infection and pain medicines.

What happens during the procedure?

• Your surgeon may put an antibiotic eye drop into your eye.
• Your surgeon will put a numbing eye drop (local anesthetic) into your eye.
• A device will be used to hold your eye open and prevent blinking (eyelid speculum).
• A small blade-like instrument will be used to remove the outer surface of your cornea (epithelium).
• A computer-controlled laser will be placed in front of your eye. The laser will have been programmed based on your eye exam.
• You will be asked to focus on a point of light. During this time, the laser will use pulses of light to reshape your cornea.
• Additional medicines may be applied to your eye, such as a medicine to reduce the risk of corneal scarring.
• A type of contact lens will be placed over your eye. It will act like a bandage and protect your eyes.
• Eye drop medicines will be placed in your eye.
• The eyelid speculum will be removed.
• After the procedure is done on one eye, the other eye may be done.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• You will need to return to your surgeon for a checkup.

Photorefractive Keratectomy, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• Mild to moderate pain.
• A feeling like there is something is your eye.
• Watery eyes (tearing).
• Bloodshot eyes.
• Itching.
• Light sensitivity.
• Blurred vision or other vision changes.
• Distorted vision, especially at night. You may see halos or starbursts around lights.
• Dry eyes.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Use eye drops as told by your health care provider. You may need to use them for several months.
• Use liquid tears as told by your health care provider.

Activity

• Do not drive or operate heavy machinery until your health care provider approves. It may take several months for your vision to stabilize.
• Do not drive at night until your health care provider says you can do so.
• Do not play contact or racquet sports until your health care provider approves.
• Rest at home until your health care provider says you can go back to work. Ask your health care provider when you can return to your usual activities.

General instructions

• Do not put your contact lenses back in, even if your vision is blurry. Only start wearing your contact lenses once your health care provider approves.
• Wear sunglasses when you are outside.
• Avoid bright lights as told by your health care provider. Try to rest your eyes in a dark room as much as possible.
• Do not wear eye makeup until your health care provider approves.
• Keep all follow-up visits as told by your health care provider. This is important.
• Do not rub your eyes.
• Wear your protective contact lenses until your health care provider says they can be removed.
• Do not take baths, swim, or use a hot tub until your health care provider approves.

Contact a health care provider if:

• You continue to have significant pain, blurred vision, or light sensitivity after several days.
• You have new symptoms.
• Your symptoms get worse.

Get help right away if:

• You have severe eye pain.
• You have any sudden vision loss.

Photorefractive Keratectomy, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• Mild to moderate pain.
• A feeling like there is something is your eye.
• Watery eyes (tearing).
• Bloodshot eyes.
• Itching.
• Light sensitivity.
• Blurred vision or other vision changes.
• Distorted vision, especially at night. You may see halos or starbursts around lights.
• Dry eyes.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Use eye drops as told by your health care provider. You may need to use them for several months.
• Use liquid tears as told by your health care provider.

Activity

• Do not drive or operate heavy machinery until your health care provider approves. It may take several months for your vision to stabilize.
• Do not drive at night until your health care provider says you can do so.
• Do not play contact or racquet sports until your health care provider approves.
• Rest at home until your health care provider says you can go back to work. Ask your health care provider when you can return to your usual activities.

General instructions

• Do not put your contact lenses back in, even if your vision is blurry. Only start wearing your contact lenses once your health care provider approves.
• Wear sunglasses when you are outside.
• Avoid bright lights as told by your health care provider. Try to rest your eyes in a dark room as much as possible.
• Do not wear eye makeup until your health care provider approves.
• Keep all follow-up visits as told by your health care provider. This is important.
• Do not rub your eyes.
• Wear your protective contact lenses until your health care provider says they can be removed.
• Do not take baths, swim, or use a hot tub until your health care provider approves.

Contact a health care provider if:

• You continue to have significant pain, blurred vision, or light sensitivity after several days.
• You have new symptoms.
• Your symptoms get worse.

Get help right away if:

• You have severe eye pain.
• You have any sudden vision loss.