What is PRK? Is It Painful?

Think of PRK as 'Flap-less LASIK'. Both procedures are identical when it comes to correcting your eyeglass prescription, the only difference is that with LASIK a corneal flap is cut first (with a different machine) and in PRK the surface corneal epithelial cells (thin outer covering of the cornea) are removed first. PRK is often referred to as Surface Ablation because the laser treatment is performed closer to the corneal surface whereas in LASIK, because a flap is cut first , the laser treatment occurs much deeper in the cornea. PRK and other surface ablation procedures (LASEK, epi-LASIK) typically involve a little more post-operative discomfort when compared to LASIK. In my practice the average pain score on the first night and first day after PRK is between 0 and 1 on a pain scale from 0 (no pain) to 5 (worst pain of your life). With modern surgical techniques and medicines the pain after PRK is much much less than it used to be.

PRK means photorefracitve keratectomy.  It is laser eye surgery that corrects vision by reshaping the cornea, very similar to LASIK. 

 

It has been performed in the US for about 15 years with greater than 95% success at eliminating the need for glasses or contact lenses completely and higher for substantially reducing the need for glasses or contact lenses.  The procedure does not require creating a flap in the cornea like LASIK and because most LASIK complications are related to the flap, PRK is very safe.

 

The difference between PRK and LASIK is that during PRK instead of creating a flap the outermost layer of the cornea is simply removed and then the laser is applied to correct the vision. During the healing process this layer of the cornea regenerates and heals. There is some discomfort during the recovery phase (approximately one week), although is becomes progressively less over that period of time.  The initial discomfort has been compared to the feeling after having a contact lens in the eye for too long.

PRK stands for Photo Refractive Keratectomy and has been an FDA approved procedure for laser vision correction since the early 1990’s.  An excimer laser is used to reshape the cornea after removing the cornea’s outermost layer, called the epithelium which then heals over in subsequent days to weeks.  The post operative pain can usually be successfully managed with drops, pain medications and a bandage contact lens.