Poor Vision After PRK. Will This Improve?

While it is impossible to accurately diagnose and give treatment advice without seeing a patient, a few things do come to mind. From the description of your preoperative refraction it sounds like you were very nearsighted with a high degree of astigmatism. We can also postulate the reason PRK was chosen over LASIK was the corneal thickness on the lower side. Here are some of the reasons that could explain your symptoms: Dry Eyes. A common finding after LASIK or PRK causing irregularity in the corneal surface. This should be treated with Artificial Tears, Restasis drops and most likely punctal occlusion.Post PRK haze. This occurs in patients who have high degrees of correction. To minimize the risk of postoperative haze formation doctors use mitomycin C during the procedure. Postoperatively patients should be encouraged to avoid UV exposure by wearing sunglasses. Haze usually responds well to topical corticosteroids and resolves over weeks to months of treatment. Haze may also be associaged with significant regression of treatment (return of nearsightedness).  If significant regression occurs an enhancement procedure maybe contemplated. The most dreaded complication would be corneal ectasia or irregular thinning of the cornea. This condition should be diagnosed as early as possible by corneal imaging and may be treated with corneal collagen crosslinking. It is bet to return to your surgeon ASAP and have a thorough evaluation.

It typically takes about 3 months to reach your full vision after PRK. After this time, if the vision is not ideal, then further treatment may be needed. I would recommend that you see your doctor to determine what the problem is now, and what should be done to improve it. You should expect excellent quality of vision after your treatment is complete.

Hi Jandj Typically PRK results stabilizes by the third month following PRK. If it has been more than three months since your PRK procedure and you continue to have issues with quality of your vision, you should see your refractive surgeon to see if an an enhancement is advised for any residual refractive errors. 

You had a large treatment with significant astigmatism in both eyes so your vision should continue to improve for several more months. Having said that, after three months your vision would generally be moving in the right direction. If you have seen no improvement at all, it is possible you will need an enhancement at some point. It would be best to have your surgeon take a look to make sure that you do not have any problems unrelated to your surgery that might be affecting your vision.

It is not unusual to have blurred vision, glare and halos immediately after PRK. There is a normal amount of inflammation in the cornea after PRK which can cause this. This inflammation will likely reduce in time with the proper use of medications. Make sure you follow up as directed by your surgeon and take the medications as prescribed. It can take several weeks for the corneas to fully heal and vision to sharpen.

unfortunately, the recovery after PRK is very slow, and can take weeks to months

that's why I stopped doing PRK in 1999--in my opinion, that's an archaic procedure

in LASEK or epiLASEK, which are the Advanced Surface Ablations (ASAs) which have replaced PRK, the recovery is much quicker than in PRK

you should have had your Bandage Contact Lens in place for nearly a WEEK, not just a few days. when we started leaving the BCL in longer, our recovery time decreased a lot

here's a list of things that your surgeon should tell you to do to speed up your recovery:


don't do any optional recreational activities (eg TV) until you see clearly

use a high-quality, preservative-free artificial tear every hour while awake

use an ointment at night

drink enough water so when you pee it's clear (best evaluation of hydration)

500mg Vit C 2x/day

sunglasses when outdoors always

punctal plugs

branded PredForte 4x/day for this entire month (dec to 3x/day in July)

need to check IOP to make sure #8 isn't raising your eye pressure


Anyway, if you do ALL of the above you will see well by July 4th, and then you can tell your friends that they should get LASEK so their recovery is much quicker than PRK!:)