Photorefractive Keratectomy (PRK), like LASIK, is a form of laser refractive surgery. This means that a laser is used to reshape the cornea, correcting refractive errors such as myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. PRK was the first laser refractive procedure performed in the United States, and the first to gain final FDA approval. While LASIK is more commonly performed than PRK today, PRK still represents a great option for patients who may not be ideal LASIK candidates due to thin or irregularly shaped corneas.
Let’s examine the steps in PRK, and how they differ from LASIK. In LASIK, the first step is the creation of a thin flap of corneal tissue, either with a microkeratome blade in traditional LASIK, or with a femtosecond laser in the modern blade-free LASIK procedure. That flap is then carefully folded back so that the excimer laser can reshape the central layer of the cornea, known as the stroma, correcting the patient’s refractive error. The flap is then folded back into place. PRK is similar to LASIK in that an excimer laser is used to reshape the stroma. The primary difference between LASIK and PRK is that in PRK, there is no flap created.
Numbing drops are administered so that the surgeon can operate on the eye without the patient feeling any pain.
The surgeon removes the outermost layer of cells, the epithelium, using a diluted alcohol solution.
Once the epithelial cells are removed, the excimer laser treatment is performed in the same way as LASIK. For LASIK as well as PRK, Hoopes Vision uses the Wavelight EX500 excimer laser, the newest, fastest and most precise vision correction laser in the United States. We have owned and used 7 different treatment lasers since 1995. The EX500 is nearly ten times faster than the most commonly used excimer laser in the U.S.
This means you’ll receive laser vision correction with the highest caliber of safety and accuracy. Your eye’s individual reshaping is pre-determined and carefully calculated by measurements taken at your pre-operative appointment. Laser treatment of the cornea takes only a few seconds.
After the excimer laser treatment, the surgeon places a clear, soft contact lens, called a bandage contact lens, on the eye. These special bandage contact lenses do not contain any prescription correction, but simply protect the eye and keep the patient comfortable while the epithelial cells grow back.
The epithelium regenerates in approximately 72-96 hours; the bandage contact lens is typically removed by the doctor at a postoperative visit around Day 5 after PRK.
LASIK and PRK both have similarly excellent long-term results. For the patient, the primary differences between PRK and LASIK have to do with recovery time and comfort. The great majority of LASIK patients report little or no discomfort, and are able to return to most normal activities, including driving, as quickly as the day after surgery.
Recovery from PRK surgery is a little longer. For the first few days while the corneal epithelium regenerates, PRK patients usually report hazy vision, some soreness, and light sensitivity. This typically clears up after the first few days, and most PRK patients are able to drive and return to work around Day 4 or 5. Vision continues to improve over the course of the first few weeks after surgery, and by approximately week 4, vision is similar between PRK and LASIK patients. One technique doesn’t give better vision than the other.
These commonly asked questions about our wavefront-optimized PRK procedure will help you learn more about your surgical options.
Ideal candidates for PRK eye surgery are healthy with realistic expectations of the results. Additionally, candidates must have a refractive error that is stable (has not changed for at least a year) and between +5.00 to -12.00 diopters. Patients with pre-existing conditions including collagen vascular disease, diabetes, rheumatoid arthritis, keratoconus, or glaucoma may not be good candidates for PRK. Patients should notify our surgeons of previous steroid use, as this may also make them ineligible for PRK .
PRK, the earliest form of laser refractive surgery is similar to LASIK. The main difference between these treatments is that PRK eye surgery does not involve the use of a laser to create a flap in the top layer of corneal tissue. Instead, a section of the outer, top layer of the cornea – the epithelium – is gently removed during the procedure.
Numbing drops are administered so that the surgeon can operate on the eye without the patient feeling any pain. While LASIK surgery requires the surgeon to create a corneal flap and fold it back to access the inner cornea, PRK requires the surgeon to remove a section of the surface layer (one to two cells thick) of the cornea called the epithelium.
After the section of epithelium has been removed, the surgeon reshapes the cornea with an excimer laser to correct the anomaly that has been causing vision problems. Once the cornea has been reshaped, the area is “bandaged” with a special contact lens that helps the eye feel more comfortable and allows the epithelium to heal.
It is important to take it easy and get plenty of rest during the first few days after the procedure. You may return to work and/or drive when you are confident with your vision and your comfort allows.
After surgery the eye can feel as if it has experienced a scrape or abrasion. To minimize discomfort, a soft “bandage” contact lens is placed on the eye for 4 to 5 days to smooth and cover the surface until the epithelium has healed underneath. Vision is usually a little blurry at first, but improves after the epithelium or surface has healed. Studies have shown that after 3 weeks, visual acuity of PRK patients generally matches that of LASIK patients.
PRK is primarily recommended for patients who have thin corneas, have irregularities show up on their topography scans (irregular astigmatism), or are in professions that are not allowed to have LASIK.
It has been over a decade since Hoopes Vision pioneered blade-free LASIK in Salt Lake City, and the results have been impressive. We are very proud of our outstanding track record of safety and results.Learn More
Our book, LASIK: A Guide For Patients And Their Families, is a great resource for patients who wish to know more about the history of vision correction. It also discusses some of the things that set Hoopes Vision apart.Download Now
If you are interested in knowing if wavefront-optimized PRK, or any of our other vision correction procedures, is a good option for you, please contact us. We would be happy to offer you a free VIP examination and consultation to help you determine your vision correction options.Contact Us
The vision correction specialists at Hoopes Vision provide a wide range of refractive procedures, such as wavefront-optimized PRK and LASIK, ICL, and clear lens exchange. Our vast surgical experience and array of diagnostic devices allow our surgeons to recommend the best possible procedure for each patient’s unique eyes, needs, and lifestyle.
The most important advance in PRK technology since its introduction was the development of wavefront-optimized treatment. Wavefront-optimized PRK helps preserve the natural shape of the cornea, leading to better postoperative vision both day and night.Learn More
In addition to custom wavefront-optimized PRK, Hoopes Vision is the most experienced provider of blade-free LASIK in Utah. In 2003, Hoopes Vision was the first practice in Salt Lake City to embrace the improved safety and precision of this revolutionary advance in vision correction.Learn More
Hoopes Vision’s unmatched array of laser vision correction technology is put to its best use in the hands of our experienced, highly trained surgeons. Our surgical team is the most experienced in Utah at PRK as well as LASIK.Meet the Doctors
Our main facility in Draper, Utah features an impressive array of laser technology and a spacious clinic with an extensive collection of diagnostic devices. Patients are able to determine their vision correction options and have life-changing PRK and LASIK surgery in a comfortable, caring environment.Tour our Facility
Our commitment at Hoopes Vision is always to offer the newest, safest, most innovative procedures available. Our laser surgery center is home to an unparalleled collection of vision correction technology, housed in a laser suite designed from the ground up to optimize its performance.Learn More
In seeking out a provider for laser vision correction, most patients’ top priorities are safety and proven results. Nonetheless, many patients who come to Hoopes Vision for PRK or other vision correction surgeries are surprised at how affordable the best treatment can be.Learn More
After spending over 30 years requiring assistance to see and attempting to lead an active lifestyle I was more than ready to get rid of my glasses and contacts. But like most who are considering eye correction surgery I was concerned about who I could trust to perform the procedure. Over the years whenever talking to anyone who had LASIK or PRK done, everyone who had gone through Hoopes Vision had nothing but great things to say about Dr. Hoopes, the staff and how well they could see.
Growing up bike racing and now working in the cycling industry I now think back on all of the issues I dealt with like fighting wet, dirty or fogged up glasses or contact lenses shifting around in my eye, drying up or falling out. My vision was very poor and coupled with my astigmatism I did not think I would even be a candidate. The knowledgeable and friendly staff at Hoopes Vision put me through the most thorough exam I have ever experienced and determined that I would benefit best with the PRK procedure. I can honestly say that my life has gotten easier with not having to deal with corrective lenses and enjoy being active without the restrictions I have experienced in the past.
I highly recommend that anyone who is considering LASIK or PRK see Dr. Hoopes. They will be glad they did, I know I was.
2 X National Champion BMX Racer
Global Sports Marketing Manager
Cycling Sports Group