Photorefractive Keratectomy PRK or Laser Eye Surgery

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Photorefractive Keratectomy: aka Laser Eye Surgery, PRK



What is it?

Photorefractive keratectomy is a laser eye surgery that seeks to fix any deficiencies in a person’s vision, reducing or eliminating their need to wear corrective lenses, whether they are contact lenses or glasses.  This surgery is becoming more popular as the price of the surgery has decreased over the years.  Not everyone’s eyesight can be corrected by this type of surgery, so it’s suggested that you consult with a doctor to see if you are eligible.  As this type of surgery is usually considered to be cosmetic, insurance usually doesn’t cover it, but this may change in the future.



The Operation

Before the surgery starts, the patient is often given a sedative to relax them for the surgery, and drops are put into the eyes so that the patient won’t experience any pain while the surgery is being done.

Once the eye drops are put in, the surgeon will start preparing the eye for surgery.  If the patient is having both eyes done, the surgeon is going to put a patch over the eye that hasn’t been treated yet.  A speculum is then inserted into the eye that is being treated so that the eyelids are held apart and to keep them from moving.  The patient has to to stay still and stare at the blinking light of the surgeon’s laser microscope and keep his or her gazed fixated on the light.

The surgeon will double check the settings on the laser to make sure that they have been correctly programmed for the error of the refraction.  When everything is in place, the surgeon will then remove the corneal cells on the surface, which are known as the epithelium, with a sponge, a mechanical blade, or an excimer laser.  When this has been removed completely, the surgeon will then start ablating, or reshaping, the patient’s cornea.  This only takes approximately 15 to 45 seconds, depending on the amount of refractive error.   For stronger errors, the ablation is longer.  Even though patients may be concerned that if they move, it’s going to cause damage that won’t be able to be fixed.  But they should know that the the doctor stops the laser at the slightest movement, so there is nothing to worry about.  Once the ablation is done, the doctor will put a bandage contact lens on the eye that has been treated.  This protects the eye and lets the process of healing to start.  It also helps to ease part of the pain t hat the patient will feel because their cornea is exposed.  The surgeon will also give the patient eye drops that are antibiotic and anti-inflammatory to help stop infection and reduce discomfort and pain.



Alternatives to surgery

Instead of having Photorefractive keratectomy, you can choose to have Laser in-situ keratomileusis, also known as LASIK,  Radial keratotomy or RK, or Astigmatic keratotomy or AK.  Some of these other types of corrective surgeries don’t have such a long healing period.


If the surgery makes you nervous or you don’t have the funds to have the surgery done  yet, you can continue to wear your contacts or glasses.   If you are currently wearing glasses and want to look as if you aren’t, you can try contact lenses until you save up the money for the surgery.



Before the operation

Before the operation, the candidate will need to have an eye examination and discuss his or her medical history with the surgeon.  If they are determined to be a good candidate, the surgery will be scheduled.

If the patient wears contact lenses, they will need to stop wearing them immediately.  For two days before the surgery, the patient shouldn’t use lotions, creams, perfume or makeup, and the patient may also need to scrub their lashes so that there aren’t any debris on them.



After the Operation- In the Hospital

As this is an outpatient surgery, the patient will be sent home after the surgery.



After the Operation - At home

The patient will need to go back to see the doctor 24 hours after the surgery.  Drops need to be used on a regular basis to help prevent pain and infection - they are used up to four moths and more depending on the patient.  The healing process may seem long, but it helps to give the person the amount of correction that is desired.

The doctor will remove the bandage contact lens approximately four days after the surgery is complete.  The patient is urged to refrain from strenuous activity for a month after the surgery, and should not use lotions, makeup or cream for two weeks after the surgery.



Possible Complications

As with any type of surgery, there are some possible complications that may occur when you have this type of surgery, including:

Extended healing period

Discomfort or pain

Starburst, halos, or glare aberratios

Over- or under-correction

Myopia recurrence

Haze on cornea




General Advice

This surgery isn’t suggested for people with certain conditions, such as pregnancy or breastfeeding a baby, diabetes, autoimmune disorders, glaucoma, extremely large or small refractive errors, and patients with macular disease or corneas that are scarred.


Estimated Costs for Photrefractive Keraectomy

USA $1300-2200
Singapore $1000-1200
Malaysia $800-1000
India $600-1000
Thailand $1000-2000

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