With PRK the cornea is sculpted with an Excimer laser. The thin skin that covers the cornea must first be removed. The laser is then applied. Over the next 3-4 days, the skin (epithelium) grows back over the cornea. PRK is a simpler procedure than LASIK. PRK has a longer visual recovery than LASIK because the vision will not be fully improved until the epithelium has completely healed and become smooth again. There is also more discomfort with PRK as the nerves in the cornea are exposed when the thin skin is removed. Because PRK is a simpler procedure there is less potential for some complications that can happen with a LASIK flap (see below). Because nerves are not cut, there is less chance for dry eye problems after the procedure.
To improve vision the focusing problems of the eye need to be corrected. Laser technology is used to reshape the cornea. By making the cornea more flat or more curved, the light rays are bent differently and focusing can be improved. The Excimer (excited-dimer) laser uses light energy to break chemical bonds in the cornea. The ultraviolet light energy (wavelength of 193 nm) comes from an Argon-Fluoride laser, which produces very short pulses of energy (10 nanoseconds). These pulses of light energy actually dissolve or ablate the collagen fibers. By using a computer to guide the location of each laser application into a complex pattern of overlapping spots, the shape of the cornea is sculpted to a new and improved shape, resulting in better focus and clearer vision.
LASIK and PRK are very safe procedures with a track record of success over 15 years. Treatments and technology improve each year, bringing the opportunity to achieve better vision with minimal risk. However, each person responds differently to surgeries, and any surgical procedure can have risks involved. Some of the main risks include…
You have the choice to do PRK/LASIK in both eyes on the same day, or separate the two surgeries into two different days. The safest option is to do the eyes on two different days. This allows Dr. DeBry the opportunity to assess the outcome of the first surgery before the second procedure. Based on the first procedure, small adjustments in laser power can be made prior to the second eye being done. However, many people have scheduling constraints with work or family responsibilities that make it difficult to take extra days off to do the surgeries on different days. If you choose to have the surgeries done on the same day we will have you sign an extra consent form acknowledging this choice. The risk of a severe bilateral problem such as an infection is very rare. Plan on your vision being blurry for the first day or two while the eye is healing from the procedure. We recommend you don’t plan any important meetings or travel for at least a few days after the procedure to allow your vision time to improve.
The most important thing to avoid after the procedure is rubbing your eyes. This can displace the flap if you had LASIK or the bandage contact lens if you had PRK. Otherwise, there are very few restrictions. You can bathe and shower like normal, just avoid getting soap and water in your eyes. It would be a good idea to avoid visually demanding tasks for a few days after the procedure. You should stay out of the swimming pool or hot tub for a few weeks after the procedure.
LASIK and PRK change the shape of the cornea, but there can be regression over time. Also, some people don’t achieve perfect results after the first treatment and a second treatment needs to be applied. Some people require an enhancement procedure years after LASIK/PRK. Our policy is that enhancements are included with the original surgery fee for the first year. If an enhancement is needed years later there will be a new fee for those services.