PRK or photorefractive keratectomy is a refractive surgery used to correct refractive errors including hyperopia (farsightedness), myopia (nearsightedness), and astigmatism. By correcting these refractive errors, the goal of PRK is to improve the vision of the patient.
It can also treat presbyopia, a condition where as the patient ages, their eye has difficulty focusing on close objects. By treating one eye with PRK, monovision can be achieved where one eye is used for focusing on near vision and the other is used for far vision.
Unlike LASIK which is done by creating a flap in the eye and using a laser to reshape the cornea, PRK does not create a flap. Instead, the surgeon removes the top layer of cells of the cornea, called the epithelium, and uses a laser to reshape the cornea.
In order to be eligible for PRK, a patient should:
PRK can be used to treat refractive errors even in instances where LASIK cannot due to thin corneas.
Additionally, some professions or more active lifestyles do not allow for LASIK as it runs the risk of complications with the flap created in the LASIK procedure. Some of these professions include pilots as well as athletes such as those who play football.
In certain situations, a patient may not be a good candidate for PRK. Some reasons for this may include:
Before proceeding with PRK or any vision correction surgery, your ophthalmologist will discuss your medical history with you and examine your eyes to ensure that you are a good candidate.
Prior to surgery, you should always meet with your ophthalmologist. They will evaluate your eye health to ensure there are no complications or underlying diseases, will test your vision to ensure your prescription is stable and within correctible range, and will take measurements of your cornea. These steps to ensure you are a good candidate are critical to reaching the best outcome possible with PRK.
Your doctor may also discuss your lifestyle including your hobbies and profession to assess your vision needs with you. Lastly, expectation setting is necessary so that you know what to expect after surgery, in terms of what the procedure will entail, post-operative care, and finally results. In some cases, perfect vision won’t be achieved, however most patients are able to achieve results within .5 diopters where glasses and contacts will not be needed for daily life. In some cases, glasses or contacts may still be necessary for certain tasks like reading or low-light activities such as driving at night.
PRK is an out-patient surgery, meaning while you will have to go to a surgery center for this treatment, you will be able to go home on the same day. To begin, your doctor will apply numbing drops to your eye and an eyelid retainer is placed to keep the eye open during the procedure. Afterwards, the outer most layer of the cornea, the epithelium, is removed. This can be done through various means including a specialized brush as well as a femtolaser. While you may feel some pressure during this process, it is generally described as painless.
With the epithelium removed, your doctor will ask you to stare into a target to ensure the eyes do not move while a laser works to reshape the cornea. This laser has been specially calibrated to your eye with the measurements taken in your pre-surgery appointment with your doctor.
The procedure takes 15 minutes or less to complete.
After surgery, your doctor will place a bandage over your eye to protect it. Your doctor will provide you with eye drops to help prevent infection during the healing process. You will not be able to drive home from surgery, so make sure you have someone with you to take you home afterwards.
Your doctor may instruct you to rest over the next few days and to avoid strenuous activity. It is also recommended to wear sunglasses in order to protect your eyes as they may be sensitive. Some pain or discomfort has been reported 2-3 days after surgery, however this should be manageable through over the counter painkillers. If the pain does not go away or you experience flashers or sudden loss of vision, contact your ophthalmologist immediately.
You should begin to notice your vision improving over the next 3-5 days, but it may take as long as a month for it to reach your best vision.
With any surgical procedure, there are some risks involved, however fortunately most are treatable. While the likelihood is small, it is important to be aware that complications can occur including:
Brittany struggled with nearsightedness since she was 5 years old. This made her reliant on glasses and contacts to see clearly. PRK was life-changing for her as she is now able to see clearly free of glasses or contact lenses. Watch below to learn more about her journey.
At Thomas Eye Group, we are very fortunate to have Dr. Carlisle and Dr. Sackel on staff. Together, they have performed thousands of refractive surgeries including PRK, ICL, and LASIK over their careers to improve the vision and lives of many patients in the Atlanta area. If you are interested in PRK in Atlanta, please schedule a consultation today.
Content last reviewed on 5/14/2025 by Dr. Sandy Carman
