PRK and LASEK Eye Surgery

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Last updated 4/4/2024
Dr. Assil explains PRK

What is PRK and LASEK laser vision correction?

PRK, which stands for Photorefractive Keratectomy, and LASEK (short for Laser-Assisted Sub-Epithelial Keratectomy) are two closely related types of vision-correcting laser eye surgery. They both reshape the cornea (the front part of the eye) to correct each individual's refractive errors.

 

PRK or LASEK surgery may be an option for those unsuitable LASIK candidates for reasons we’ll discuss.

What's the difference between LASEK vs. PRK vs. LASIK eye surgery?

 

The main difference between PRK (FDA approved in 1995), LASEK, and LASIK (both FDA approved in 1999) are with the epithelium, the transparent, thin, outermost layer of the cornea that covers the front of your eye. 

 

PRK

In PRK, the epithelium (located on the surface of the eye) is completely removed and discarded, but don’t worry, it grows back in three to seven days. Then the exposed corneal tissue is reshaped using an excimer laser (which removes microscopic amounts of tissue from the cornea) to correct your vision. Then a soft bandage contact lens will be placed on the eye to accelerate epithelial layer regrowth and make your eye's surface more comfortable during the healing phase.

 

LASEK

In LASEK, the epithelium layer is not removed but chemically loosened before a laser is used to create a flap in the epithelium. The flap is gently folded back, exposing the layer of the cornea underneath. Then the exposed corneal tissue is reshaped with the same excimer laser we use during PRK.

 

After our laser reshapes the exposed corneal tissue, the epithelial flap is folded back on the cornea. A soft bandage contact lens may also be placed on the eye to promote healing.

 

LASIK

With the LASIK procedure, our surgeon creates a thin flap from your cornea’s outer layers (the epithelium) as well as a thin portion of the underlying middle layer known as the stroma (This flap is then peeled back, and laser sculpting is done on the cornea's middle stromal layer. After the sculpting, the flap is repositioned to cover the LASIK surgery site, and the epithelium remains intact.

 

LASIK's main advantage over PRK is maintaining the central corneal epithelium. This increases comfort during the early postoperative period, allows for rapid visual recovery, and reduces the wound-healing response.

 

Why would a patient choose PRK or LASEK over LASIK?

PRK Surgery Los Angeles

Though LASIK is far and away the most popular laser vision correction surgery today, there are reasons that LASIK may not be a good option. These reasons include the following: 

 

Thin corneas

LASIK (and LASEK) requires the creation of a corneal flap, and it may not be suitable for people with thinner corneas. PRK surgery does not require a flap and leaves a more significant portion of the cornea untouched by the surgery, which is essential in patients with thin corneas or at risk for future eye problems. 

 

Very nearsighted or farsighted (myopia)

More severe near or farsightedness can be an exclusionary factor for patients who desire LASIK. But PRK and LASEK can do an excellent job of correcting high degrees of nearsightedness.

 

Dry Eyes 

Dry eye disease (when your tears can’t provide adequate lubrication for your eyes) can be an exclusionary factor for LASIK, Corneal nerves heal faster with LASEK, minimizing dry eye symptoms that can sometimes occur after surgery. This procedure could be a good alternative since dry eye is less concerning with PRK.

 

Patients with larger pupils

Larger pupils can sometimes lead to side effects after LASIK, like halos and starbursts, which is usually not the case with PRK or LASEK,

 

Corneal dystrophies or corneal irregularities

PRK or LASIK might not be the best choice if you have specific corneal abnormalities. Since LASEK Involves less depth of laser treatment to the surface of the cornea when compared to LASIK, PRK or LASEK may provide the extra margin of safety in patients whose corneas have an unusual shape and don't qualify or choose not to undergo LASIK.

 

Recurrent corneal erosion 

This is another circumstance where LASIK might not be an appropriate vision correction procedure. LASEK Involves less depth of laser treatment than LASIK, so more corneal thickness is preserved, which can benefit these patients.

 

Procedure Preference 

Some individuals opt to have PRK or LASEK over LASIK—especially Military personnel like pilots and others if EagleVision LASIK is not available to them.

 

You may have read that people with occupations, hobbies, or who play physically jarring contact sports could be better LASIK candidates. This is no longer true, thanks to the development of EagleVision LASIK by Dr. Kerry Assil!

 

EagleVision LASIK has become the choice of some of the world’s most talented and successful professional athletes. These include LeBron James, Anthony Davis, Paul George, Chris Paul, and Sugar Shane Mosley, to name just a few.

 

Schedule your consultation with those Lebron James trusts with his eyes

 

What are some disadvantages of PRK or LASEK?

There are advantages and disadvantages to every surgical procedure. Some of the disadvantages of PRK or LASEK (when compared to LASIK) can include:

  • Slower recovery time than LASIK: most patients can drive from 4-6 days after surgery, and it can take three months to one year until your vision fluctuation has stabilized.
  • There is an increased risk of early post-surgery eye infection, inflammation, and haze. Patient compliance with post-operative eye care is essential.
  • While healing from PRK or LASEK, you may have post-operative discomfort compared with LASIK.

 

 

Who is not a good candidate for PRK or LASEK? 

Like with LASIK, certain eye conditions or circumstances would preclude you from being a good candidate for PRK or LASEK. These include a patient with:

  • An unstable (changing) refractive error
  • Skin or another disease that can affect healing
  • A history of excessive corneal scarring
  • Corneal scars or corneal disease
  • Advanced Glaucoma
  • Cataract affecting vision
  • Uncontrolled diabetes
  • Pregnant or nursing women
  • A history of certain eye infections

 

Which is best for me, PRK, LASEK, or LASIK? 

Choosing the best vision correction surgery is never a one-size-fits-all decision. That is why Assil Guar Eye Institute offers complimentary evaluations with our ophthalmologists to ensure you obtain 100% accurate information about which type of refractive surgery would best suit your vision needs and lifestyle.

 

Ready to consider PRK or LASEK? You owe it to yourself to talk with the Assil Gaur Eye Institute experts.

Assil Gaur Eye Institute's nationally recognized ophthalmologists and optometrists are expertly trained in PRK, LASEK, and LASIK. Also, our eye centers offer state-of-the-art treatments for all eye conditions, including glaucoma, macular disease, dry eye, and diabetic eye conditions, to name just a few. 

 

Request your free consultation to learn how we perform our vision-correcting surgeries, which are best for you, and to answer all your questions.

 

Call us at (866) 945-2745 or click here to request an appointment online.

 

Our complimentary LASIK eye exam is convenient for patients throughout Southern California and the Los Angeles area in or near Beverly Hills, Santa Monica, West Los Angeles, West Hollywood, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, and Downtown Los Angeles.

 

Schedule your consultation now!

 

Our complimentary LASIK eye exam is convenient for patients throughout Southern California and the Los Angeles area in or near Beverly Hills, Santa Monica, West Los Angeles, West Hollywood, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, and Downtown Los Angeles.

 

PRK FAQs

PRK FAQs

How long does PRK last?

The effects of PRK are generally considered permanent, and it's important to note that as we age, our eyes can change, and vision can gradually worsen. Therefore, while PRK can provide long-lasting correction, it doesn't prevent age-related eye changes that may require glasses or contacts later in life.

How to speed up PRK recovery?

Recovery after PRK surgery can take several days to a few weeks. While the recovery period cannot be avoided entirely, some steps can be taken to help speed up the healing process.

 

  • Following your doctor's post-operative instructions is crucial, including using any prescribed eye drops, avoiding rubbing your eyes, and protecting them from bright light and dust.
  • Rest and avoid strenuous activities such as exercising, swimming, and heavy lifting.
  • Use lubricating eye drops as your doctor directs to keep your eyes moist and comfortable.
  • Wear protective eyewear such as sunglasses or goggles outdoors to protect your eyes from dust, wind, and other environmental factors.
  • A diet rich in antioxidants and omega-3 fatty acids can help promote healing and reduce inflammation.
  • Avoid smoking and alcohol consumption which can slow healing and increase the risk of complications.

How long after PRK can I watch TV?

It's important to avoid activities that could strain your eyes, including watching TV or using a computer, for the first few days after surgery.

 

Your doctor will provide specific instructions on when it's safe to resume normal activities, including watching TV. Most people can resume watching TV and using a computer within a few days to a week after surgery

Is PRK better than LASIK?

Both procedures effectively treat common vision problems such as nearsightedness, farsightedness, and astigmatism, but they differ in how the surgery is performed and the recovery process.

 

Ultimately, choosing between PRK and LASIK should be made in consultation with our experienced eye surgeon, who will evaluate your needs and recommend ‌the benefits of PRK, LASEK, or LASIK. 

How long does PRK surgery take?

The actual PRK surgery typically takes only less than 15 minutes per eye. However, the process may take several hours, including pre-operative preparations and post-operative follow-up appointments.

Can you get PRK twice?

Technically, you could, though it is infrequent at Assil Gaur Eye Institute. Sometimes a new patient comes to us after an unsuccessful initial PRK surgery elsewhere that did not fully correct the refractive error, or the patient's vision may have changed over time, thus requiring revision surgery.

 

It's important to note that undergoing a second PRK surgery can be more challenging than the first, as the cornea may be thinner and more fragile due to the previous surgery. Additionally, there may be an increased risk of complications such as haze and cornea clouding that can affect vision.

Does PRK hurt?

During the PRK surgery, the patient typically does not experience any pain or discomfort. This is because the LASIK surgeon will use numbing drops, and the patient may also be given a mild sedative to help them relax. The patient may experience pressure on the eye's surface, but most report no discomfort.

 

After the surgery, however, it is common to experience some discomfort or mild to moderate pain. 

 

The discomfort experienced after PRK can vary from person to person and typically lasts a few days to a week. Pain relievers and lubricating eye drops can help manage discomfort during this time.

Does PRK fix astigmatism?

Yes, PRK surgery can effectively treat astigmatism, a standard refractive error that causes blurred or distorted vision at all distances. It's important to note that while PRK can be an effective treatment for astigmatism, it is not a guarantee of perfect vision. Some patients may need to wear glasses or contact lenses after surgery, particularly for reading or other close-up work.

How long does blurry vision last after PRK?

Blurry vision is a common side effect after PRK, and its duration can vary depending on several factors.

 

Generally, blurry vision can take several days to weeks to improve after PRK. During the first few days after surgery, vision may be blurry, and daily activities such as driving or reading can be challenging. The blurry vision typically improves as the eye heals, but it may fluctuate for several weeks or months after surgery.

Can you get LASIK after PRK?

Yes, getting LASIK after PRK is possible. One factor to consider is the amount of corneal tissue removed during the PRK procedure. LASIK involves creating a flap in the cornea to access the underlying tissue. If too much tissue was removed during the PRK procedure, there might not be enough corneal tissue to create the flap for LASIK safely. Additionally, the shape of the cornea after PRK may not be suitable for LASIK, and other vision correction options may be recommended.

 

Another factor to consider is the time since the PRK procedure. Waiting at least six months to a year after PRK before undergoing LASIK is recommended to allow the cornea to heal fully and stabilize.

Can you get PRK with astigmatism?

PRK may be a good option for individuals with mild to moderate astigmatism. In some cases, other types of refractive surgeries, such as LASIK, may be recommended, depending on the severity and type of astigmatism and other factors such as age, prescription, and overall eye health.

Does PRK correct nearsightedness and farsightedness?

Yes, PRK (Photorefractive Keratectomy) is an effective procedure for correcting both nearsightedness (myopia) and farsightedness (hyperopia).

Can you wear contacts after PRK?

During the initial healing period after PRK, the eyes may be more sensitive and drier, and wearing contact lenses can exacerbate these symptoms. Additionally, contact lenses can interfere with the healing process and affect the final visual outcome.

 

Once your eye doctor determines that your eyes have healed sufficiently and it's safe, they may recommend a specific type of contact lens or a contact lens wearing a schedule appropriate for your needs.

Does PRK cause dry eyes?

PRK can cause dry eyes in some individuals, particularly during the initial healing period after surgery. The procedure can temporarily affect the corneal nerves and reduce tear production, leading to dry eye symptoms.

 

The symptoms of dry eye after PRK are usually temporary and improve as the cornea heals. However, in some cases, dry eye symptoms may persist or worsen after surgery, and additional treatment may be necessary to manage the condition.

How long after PRK can I use a computer?

After PRK, it's generally safe to use a computer and other electronic devices once your vision has stabilized and you feel comfortable doing so. However, avoiding prolonged use of electronic devices during the initial healing period is essential, as this can put additional strain on your eyes and delay the healing process.

How long after PRK can I wear eye makeup?

After PRK, it's generally recommended to avoid wearing eye makeup for at least a week or until your surgeon gives you the green light to resume using it. Eye makeup can irritate the eyes if it gets in and increase the risk of infection during the initial healing period.

How soon can you exercise after PRK?

After PRK, it's generally recommended to avoid strenuous exercise and other physically demanding activities for at least a week. This is because physical activity can increase blood flow and pressure in the eyes, interfering with the healing process and increasing the risk of complications.

Can you have cataract surgery after PRK surgery?

Yes, it is possible to have cataract surgery after undergoing PRK.

 

  • Dr. Kerry Assil, Beverly Hills LASIK and Cataract Surgeon

    Kerry K. Assil, MD, is regarded as one of the world’s foremost experts in refractive surgery, having made significant advances in the field with his numerous inventions. Additionally he has the unique distinction of having trained thousands of eye surgeons in the latest refractive surgical techniques.

     

    Dr. Assil has authored more than one hundred textbooks, textbook chapters and articles on refractive surgery and has appeared regularly on major television network news programs as a pioneer in refractive surgery. He also leads educational forums for other eye care professionals, which have included featured lectureships at Harvard University, Johns Hopkins University and Tokyo University.

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