Questions about PRK
Chicago, Illinois
PRK- ADVANCED SURFACE ABLATION- LASEK- EPI-LASIK
What is PRK?
PRK is a procedure in which the curvature of the eye is altered to reduce nearsightedness (myopia), farsightedness (hyperopia), and astigmatism. PRK stands for Photorefractive Keratectomy. Modern PRK is very different than the procedure done in the 1990’s. It goes by many names including Advanced Surface Ablation, Lasek, and Epi-LASIK. The process is simple. The surface potion of the cornea is cleaned off and then the laser is reshaped as directed by the previously calculated WaveScan measurements. A medication may be used to prevent scarring postoperatively and then drops and a contact lens is placed.
Why PRK?
The results from LASIK and PRK are identical. Both use the same laser to reshape the cornea. The difference is the location in the cornea. With LASIK, a flap is made keeping the surface of the cornea intact. This flap has a thickness and those with thinner corneas may not have adequate corneal substance to have a safe LASIK result. Others may choose not to take the risk of having a flap that could displace. The military prefers PRK for those going in to active combat to eliminate the worries of flap displacement for trauma. Most people are good candidates for LASIK and prefer the overnight healing of LASIK, but there is a role for PRK. About 25% of Dr. Golden’s patients have PRK for one reason or another.
What you can expect - The Laser Vision Process
Your pathway to visual freedom is made up of five distinct phases; The Screening Evaluation, The Pre-surgical Evaluation, The Surgical Procedure, Recovery and Follow-up Care.
The Screening Evaluation
This evaluation takes about twenty minutes and is available at either office by appointment. Upon arrival, a brief registration will be obtained. There will be several tests, including creating a map of your eyes with an Orbscan® and another checking your current visual status with an autorefractor. Based on these results, we are able to rule out most people who would not be candidates for surgery. We will then have a chance to sit down and talk about the surgical process and answer any questions that you have.
The Pre-surgical Evaluation
The pre-surgical evaluation gives us a chance to thoroughly understand your eyes and will give us a chance to take the measurements needed for surgery. We will discuss all aspects of the surgery and help you to decide whether or not corrective surgery is your best option. The concern of the Doctors For Visual Freedom team is to recommend what is best for you whether that be surgery or another option.
Depending on your needs, this comprehensive evaluation takes about an hour and a half and includes a wide dilation of your pupils. Your vision up close will be blurry for about four to six hours and your pupils are usually dilated until the next day.
In order to have final surgical results you should not wear your daily wear soft contacts for one week before your evaluation or surgery and two weeks for extended wear or toric soft lenses. If you chose, you may wear your extended wear lenses only during the day for a week and then get out of them entirely for the last week. Gas permeable lens wearers typically take about one month per decade for the corneas to stabilize and you should be out of these lenses for a minimum of three weeks. It may be possible for you to switch into soft contact lenses until the corneas stabilize and then just stay out of even soft lenses for the last week.
The Surgical Procedure
The day of surgery, feel free to shower or bathe. There is no limitation to shampoos or scrubbing of the face. Do not use eye make-up, perfumes or strong smelling hair sprays or deodorants as they may affect the ability of the laser to give you a good treatment. You can eat normally before and after the procedure but limit your caffeine intake as you need to be relaxed during your procedure and sleep afterwards. Take all of your usual medications. Please arrange to have someone drive you home after your procedure.
When you get to the laser center you will meet with our surgeon, Dr. Mark Golden. He will check your eyes at the slit lamp to make sure that you have no eye infection and then you will have a chance to ask any questions that you might have. He will highlight the important steps of the surgical procedure.
When all of your questions have been answered, you will be asked to sign your informed consent form. You will then be offered Valium, sedative to make you more comfortable and relaxed. The sedation takes 20-30 minutes to take affect and you will sit in a quiet room with your eyes closed until ready.
Dr. Golden talks non-stop during the entire procedure. He will tell you what is going to happen, what is happening and then how you did. If there are any problems, he will just stop the procedure, talk with you and then start up again when you are ready. Once in the laser suite, you will receive drops to numb your eyes. The area around the eyes is cleaned with a cold antibiotic soap. The left eye is covered and a special device is placed to keep the eye from blinking. The laser treatment is then performed. You will see a pulsing red light and it is critical for you to hold the light as still as possible during the procedure. Dr. Golden will guide you through this portion telling you of how you are doing and let you know if there is too much movement. There is a safety feature on the laser called a tracker. This means that if you move a little bit, the laser will move with you. If you move too much then the laser will automatically stop. When this is completed, a medication will be placed on the eye to decrease the chance of scarring. Drops and a contact lens are then placed and a similar procedure is then done on the left eye.
Amazingly, patients immediately notice that their nearsightedness is gone and their vision is quite adequate to get around.
Recovery
You should arrange to have someone to drive you home. Your vision will be blurry and you will be groggy from your sedation. Preoperatively, you will be given medications to reduce discomfort during your healing period and you should start that before surgery as directed. Most people heal in about four days. The more time spent with the eyes closed leads to faster healing. Most people choose to sleep and medications will be given to assist and to take care of the possibility to discomfort. See the resources section for a list of usual medications.
Please wear sun glasses when outside for the next year when exposed to sunlight.
Pregnancy
It is best to avoid pregnancy for three months after your PRK procedure.
Follow-up Care
It is critical that you keep your scheduled appointments. You will be seen at the center the day after the procedure, then at then four to five days later. Typically, you will be on drops for several months and will be seen at least monthly until off of all drops and then every three months for the first year. If you are having problems, there will be more visits and they are included in your surgical fee. These visits usually take only a few minutes. If you are having a problem during the follow-up period, please feel free to contact us at any time.
