Photorefractive Keratectomy (PRK) Surgery: A Complete Guide

Medically Reviewed By Leela Raju, MD

Photorefractive keratectomy (PRK) surgery is a technique to treat refractive errors in the eyes. Refractive errors include nearsightedness, farsightedness, and astigmatism. PRK works by reshaping the outer layer of cells on the eye’s cornea. Refractive errors occur when an eye does not bend light correctly, causing blurry vision. Ophthalmologists can treat refractive errors with prescription eyeglasses, contact lenses, or PRK.

PRK works by reshaping the cornea, the transparent front part of your eye. This helps improve how the eye bends light and can reduce blurry vision.

This article explains PRK surgery, including the procedure, recovery, effectiveness, and risks.

Who is PRK surgery for?

Someone wearing glasses holds a paintbrush and paints on canvas.
Dusan Stankovic/Getty Images

PRK surgery is a treatment method for refractive errors. Eye surgeons perform this procedure to reshape your cornea, the transparent front part of your eye.

Refractive errors that PRK may help include:

  • Nearsightedness or myopia: This makes far-away objects look blurry.
  • Farsightedness or hyperopia: This usually makes nearby objects look blurry. However, some people also experience blurriness at both near and far distances.
  • Astigmatism: Astigmatism can make objects look blurry at any distance.

Learn more about nearsightedness and farsightedness.

PRK is an alternative to eyeglasses and contact lenses for correcting refractive errors.

However, you will have to meet certain requirements to have PRK. Typically, you have to be age 18 years or older and have stable vision, whereby your refractive error isn’t changing or worsening.

PRK may not Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source be safe or effective for you if you have:

PRK surgery vs. laser therapy

Like PRK, laser in situ keratomileusis (LASIK) is surgery to treat refractive errors. However, the steps involved in the two methods are different.

In PRK, surgeons remove the outer layer of the cornea tissue before using a laser to reshape the cornea. In LASIK, surgeons cut a thin flap into your cornea before reshaping it with a laser. The surgeons then close the flap to make the cornea heal faster.

Doctors more commonly Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source perform LASIK than PRK surgery because LASIK usually heals faster. However, PRK is preferable in specific instances, such as if:

  • you have a thin cornea
  • you experience dry eyes
  • you are highly active, as activity can dislodge the flap created with LASIK

Talk with an eye doctor if you have questions about whether PRK surgery or LASIK is right for you.

Read more about LASIK, including its procedure and outlook.

How do you prepare for PRK surgery?

An eye doctor will perform an initial eye exam to see whether PRK is suitable for you. This can include checking the pressure in your eye and the thickness of your cornea, among other factors.

Doctors may also check your vision and lens prescription after asking you to not wear contact lenses for a few weeks.

If you qualify for a PRK, your medical team will give you instructions on how to prepare. They may ask you to follow steps such as:

  • not wearing eye makeup on the day of the procedure
  • arranging for transport and any necessary help after the procedure
  • providing a list of your health conditions and any medications or supplements you take

What is the procedure for PRK surgery?

Eye doctors typically perform PRK surgeries as outpatient procedures. Often, the procedure is done within 15 minutes.

An eye doctor will perform the surgery in the following steps:

  1. Your eye doctor will apply an anesthetic using eye drops to numb your eyes. They will also place a special frame on your eye to stop you from blinking. The frame shouldn’t cause any pain.
  2. Next, your ophthalmologist will remove a part of your cornea’s outer layer using a brush, blade, alcohol solution, or laser.
  3. Then, the doctor will use a laser to reshape your cornea. During this time, they will ask you to look at a target so that your eyes stay still. You may hear a clicking sound while the laser is working.
  4. Finally, the doctor will place a special contact lens over your eye to help it heal.

What is recovery like after PRK surgery?

Your vision may be blurry immediately after the procedure. This blurriness usually decreases over the next 3 to 5 days. During this time, you may need to rest and take time off from work or school.

It can then take 6 weeks or longer after the procedure for your vision to reach its best.

During recovery, people typically need to:

  • avoid certain activities, such as driving or strenuous physical activity
  • avoid rubbing or touching your eyes
  • use special eye drops for around a month
  • wear sunglasses outside

Your medical team will let you know how long you need to take these precautions.

Some people experience eye pain for 2 to 3 days after PRK. Talk with a doctor or pharmacist for recommendations about which over-the-counter and prescription medications may help you.

Contact a doctor if you have any persistent or severe symptoms, such as severe pain or blurriness that doesn’t improve.

How effective is PRK surgery? 

For many people, PRK can correct vision errors and remove the need for glasses and contact lenses.

According to the American Academy of Ophthalmology, around 9 out of 10 people with refractive errors gain 20/40 vision without glasses or contact lenses after undergoing PRK. This means that what people with no refractive errors see at 40 feet of distance, you can see at 20 feet. This can be a big improvement on some severe refractive errors.

A 2021 review suggests that PRK is typically highly safe and effective in correcting refractive issues. The review also reports that PRK vision corrections can remain stable for a long time, meaning improvements can be long-lasting.

A 2020 review also suggested that PRK had an excellent safety and effectiveness profile, remaining effective after 10 years of surgery in 82% of cases.

However, PRK cannot treat presbyopia — an age-related cause of blurry close-up vision. As a result, you may experience blurry close vision once you are older.

Are there any risks to PRK surgery? 

Research suggests that PRK can be very safe. However, like any procedure, it can occasionally cause complications.

Possible complications of PRK include Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source :

  • mild discomfort or pain, such as feeling like there is something in your eye
  • dry eye
  • infection of the cornea
  • seeing halos around lights, especially at night
  • scarring of the cornea
  • corneal haze or cloudiness of the cornea 
  • vision becoming under-corrected or overcorrected

Some of these effects may be temporary, and others may experience long-term Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source complications.

Wearing glasses or contact lenses may improve these problems, according to the AAO. Getting additional laser surgery may also help.

Contact your doctor if you have concerns about PRK risks or any concerning or persistent symptoms.

Summary 

PRK can help treat refractive errors, such as nearsightedness or farsightedness. Eye doctors perform the procedure by removing a small layer of the eye’s cornea. It is an outpatient procedure that often takes around 15 minutes.

Generally, PRK is considered safe and effective. However, like any eye procedure, it does carry some risks.

Talk with an eye doctor if you have questions about PRK or experience eye symptoms afterward.

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Medical Reviewer: Leela Raju, MD
Last Review Date: 2024 May 8
View All Eye Health Articles
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