What complications are possible with PRK eye surgery?
Doctor Answers (6)
Complications of PRK include:
- Dryness, requiring treatment with artificial tears, Restasis drops or punctal occlusion (comfort inserts)
- Corneal postoperative haze, reversible clouding of the cornea. This is a less common complication with the advent of flying spot lasers (Wavelight Allegretto), intraoperative use of Mitomycin C, UV protection in the immediate postoperative period lasting for about 6 months. It used to be common to see “holiday haze” in patients who would go on vacation to sunny climates immediately after surgery.
- Corneal ectasia; Abnormal thinning of the cornea, resulting in irregular astigmatism. Rare especially when appropriate candidate selection is performed with modern corneal imaging techniques such as with Pentacam or Gallilei instriments. Treatment: Corneal cross linking to strengthen the corneal and prevent further thinning.
First, let me say that PRK is extremely safe.
The most common complication is probably corneal haze after the surgery. This is uncommon and can be treated with steroid drops, superficial excision or more laser treatment. It will actually usually resolve with no treatment if it is left alone long enough but this can take a year or more so most surgeons will treat it. The next most common problem is a possible infection. This typically occurs within the first week as the surface of the cornea is healing. This is generally treated with antibiotic drops which you every patient takes as a preventative measure and again, the likelihood of this is extremely low.
The very worst, but very uncommon complication is corneal ectasia. This is the development of keratoconus after PRK or LASIK. It is not known for certain if the PRK/LASIK actually causes the keratoconus or whether it is simply that people with very early keratoconus. Ectasia patients can not have any further refractive surgery and are put back into glasses if possible. If not, contact lenses are prescribed. If even contacts are not good enough, they may require collagen cross linking therapy or even a corneal transplant. Again, this is very rare but not impossible. Recently studies have shown that patients who develop ectasia were borderline keratoconus patients BEFORE having either PRK or LASIK.
PRK is one of the safest surgeries in existence, but no surgery is totally devoid of potential complications. Remember, your cornea is the fastest healing area of the body.
There is no such thing as risk-free surgery
There is no such thing as risk-free surgery. PRK and LASIK are very safe but infection, inflammation, scarring, dry eye, halos, and weakening of the cornea are probably the top complications. Serious complications are generally less than 1%.
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PRK potential complications
PRK(photorefractive keratectomy) is extremely safe when performed properly. It is also the treatment I had on my eyes 16 years ago this month(July, 1994)! The two most significant complications of PRK would be a postoperative infection, the chance of which is lower than when you wore contact lenses, and post operative haze of the cornea. Let's talk about post op haze as the risk of infection is so very low(I have never seen one). PRK is indicated for low to moderate nearsightedness and astigmatism, as well as low degrees of farsightedness. If a surgeon attempts PRK on more severe prescriptions then there is a small chance of postoperative corneal haze, which can last many months. I use a medication during the PRK procedure which reduces the chance of haze, however, the best way to avoid haze is to stick to the parameters. If your prescription is too high for PRK, then either LASIK or a Phakic Intacoular lens is indicated.
I have not seen a case of post PRK haze in over 5 years, so that should help ease your mind.
The best way to understand the full spectrum of potential side effects for any surgery is to read the doctor's consent form. We have our consent forms on our website to give you an idea of what you will find at various doctors' offices. Go to http://www.edow.com/patient-information/patient-forms/ and scroll down to the link to PRK. It'll give you the option to download the .pdf. Hope that helps!
Complications of PRK
PRK, known as photorefractive keratectomy, is a laser vision correction procedure which is similar to LASIK and may provide individuals freedom from glasses or contact lenses. There are a number of procedures which are similar to PRK but are modern day equivalents. These names include Advanced Surface Ablation, LASEK, and epi-LASIK. Each doctor has his/her own preference.
Just like LASIK, the results may vary. The most common side effects include a small residual prescription, dryness of the eye, fluctuating vision. Healing issues account for the majority of side effects, although as with any surgery, rare serious complications such as an infection can occur.