Patient Information – Photorefractive Keratectomy (PRK)

Due to the latest developments excimer laser vision correction is performed ​​with high precision and the results are excellent and predictable.

Laser treatment types:

There are two types of laser vision correction that we offer: surface ablation, more commonly known as photorefractive keratectomy (PRK) andunder flapcorrections -FemtoLasik. The excimer laser that alters the refractive power of the cornea, is carried out for each method. The industry gold standard, FemtoLasik, is the preferred refractive laser treatment of choice worldwide accounting for over 70% of all refractive procedures carried out, however some patients are not eligible for this procedure and are offered the best alternative which is the PRK.

Advantages of PRK include:

  • Safe method
  • Patients with thinner corneas can still have their eye sight corrected
  • Provides a safe alternative to those who are not eligible for FemtoLasik

Eligibility Test

You are eligible* if:

  • you are over 18
  • Myopic from -1.0D up to -10.0D
  • Hyperopic from +1.0 up to + 2.5D
  • Astigmatic from +2.5D up to -4.0D
  • Have not had significant change in refraction for one year prior to the procedure date
  • Your eyes no longer tolerate wearing contact lenses
  • Want to see clearly without your glasses or contact lenses

* This table is intended to serve only as guidance and is not a substitute for a professional eye examination

Contraindications for laser treatment:

  • Diabetes
  • Autoimmune disease
  • Wound recovery problems, keloid susceptibility
  • Amblyopia, lazy eye
  • Cataract/Glaucoma
  • Pregnancy planned within six months
  • Nursing mothers
  • Keratoconus (irregular shaped cornea)
  • Previous Herpes infection in the eye
  • Severe dry eye syndrome
  • Wearing reading-glasses only

PRK – The Procedure

You may be given a mild sedative tablet before surgery, a few anesthetic eye drops will be applied and the eyelids and area around the eye will be cleansed with an antiseptic solution. The surgery is completely painless. You will hear the noise of the laser machine during the treatment which lasts just a few seconds.

The surgery consists of 2 steps:

1.First we remove the top layer of the cornea (the epithelium) by means of a special instrument, followed by a few seconds of laser treatment.

2. Subsequently, a therapeutic soft contact lens is placed around the eye and has to be left there for approximately 3 days.

Mild pain and foreign body sensation may be experienced for 24-72 hours after the surgery. This discomfort can be improved by pain-relieving drugs. The epithelialization is usually complete in 3 to 5 days, and then the symptoms disappear. Vision improves gradually following the treatment, and may be unstable depending on the diopters corrected. Best visual acuity is restored usually within 1-4 weeks however there are some cases that may take longer to recover. After surgery, eye drops must be used for a few months and check- ups with the doctor need to be scheduled. It is advisable to wear sunglasses for UV protection for 2 to 3 months following the surgery.Some eyelid swelling might be present after the surgery and this will resolve within a few days.

What to prepare before the surgery:

  • Do not wear any eye make-up
  • Do not put any face or eye cream
  • Do not put any perfumes or aftershave
  • Have someone to accompany you

What to do after PRK:

  • You can use eye make-up after 1 week
  • Protect the eye from water for a week whilst showering
  • You can swim after two weeks
  • Do not perform contact sports for 4 weeks
  • After a week you are allowed to run, ride a bike, do aerobics
  • Do not rub your eyes for 2 weeks
  • Sauna after 1 month
  • Avoid solarium for six months
  • Put the eye drops as advices by the doctor

Risks and Complications:

Like any other surgery, there may be risks and complications associated with this procedure. We always do our utmost to ensure that no complications arise and from past studies, we can say that PRK is considered as a safe and effective procedure.

Dry eyes

Dry eye is a common side effect in post- operative stage. For this reason, it is recommended thatlubricating eyedrops are applied to the operated eyes for a three- to six-month period. Most patients report, however, that they no longer needthese eyedrops for more than a month or two after surgery. Very few patients will need to put these drops for a longer period of time.

Decreased night vision

Risk of decreased night vision is extremely small and nowadays it is rarely documented to advancement in technology.

Over or Under correction
Over or under correction means that the final outcome will be slightly on the plus or minus side, which usually evens out with time.

Regression of Refraction

This rare condition can occur due to the unpredictable healing that comes with PRK and if it has to happen, usually it happens with high miopes

Sensitivity to light
There might be an initial sensitivity to light that usually resolves within a few hours.

Haze

Haze is a rare complication but can happen to patients with higher corrections that undergo PRK. It can be treated by steroid eye drops, but in very rare cases, it does not respond to the treatment

Infections
Infections are extremely rare and can be prevented by putting the eye drops as advised by our team and to perform correct hand hygiene.

The bandage lens

Rarely the lens can fall down, if this happens throw it away and do not put it back. You might experience some more discomfort, but this does not affect the healing time or the vision.

Patient Safety:

  • Laser Technician present on site to assist during the procedure
  • Patient identity checks according to WHO Safe Surgery Checklists

Professional and well trained team with longstanding experience in refractive surgery

Patient Information – PRK SJHB-07 doc 9 V2

Authors: Tanya Costa / Dr Edit Kelemen / Dr Andrea Kovacs

Date: March 2014Saint James Hospital - Budapest