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Birla Eye Hospital
9-G-8, 3rd, Mahaveer Nagar Housing Board Colony, Mahaveer Nagar, Kota (Raj.)
Birla Eye and Child Hospital
Chota Choraha, 2-NA-22, Extension Kota, Dadabari, (Raj.)

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Photorefractive Keratectomy

photorefractive keratectomy

Photorefractive keratectomy (PRK) is a popular refractive surgery designed to correct common vision problems like myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. Introduced in the 1980s, PRK was the first laser eye surgery approved for vision correction and remains a go-to choice for patients with thin corneas. Unlike LASIK, PRK does not involve creating a corneal flap, making it suitable for people engaged in high-impact activities.

History of PRK

The journey of PRK began in the late 1980s when excimer lasers were first used to reshape the cornea. Early adopters embraced the procedure for its ability to deliver significant visual improvements without invasive surgical techniques. Over the years, advancements like customized ablation profiles and enhanced healing methods have improved its safety and outcomes.

How PRK Works

PRK uses a highly precise excimer laser to remove microscopic amounts of corneal tissue, reshaping the cornea and improving how light is focused onto the retina. Unlike LASIK, the epithelium (outer layer of the cornea) is removed during PRK, requiring several days for it to regenerate post-surgery.

Types of PRK Procedures

  1. Standard PRK: The conventional technique where the epithelium is removed manually before laser treatment.
  2. Advanced Surface Ablation (ASA): A more refined method with improved post-operative comfort and healing.
  3. Transepithelial PRK (transPRK): A single-step procedure that removes the epithelium and reshapes the cornea using the laser, reducing manual intervention.

Symptoms Treated by PRK

PRK effectively addresses:

  • Nearsightedness (myopia): Difficulty seeing distant objects clearly.
  • Farsightedness (hyperopia): Difficulty focusing on nearby objects.
  • Astigmatism: Blurred or distorted vision caused by an irregularly shaped cornea.

Causes Leading to PRK

Refractive errors corrected by PRK often result from:

  • Genetic predisposition.
  • Aging-related changes in the cornea or lens.
  • Eye trauma or surgery.
  • Environmental or lifestyle factors, such as prolonged screen exposure or poor visual hygiene.

Eligibility for PRK

Ideal PRK candidates meet these criteria:

  • Aged 18 or older with stable vision prescriptions for at least a year.
  • Corneal thickness too thin for LASIK.
  • Absence of eye diseases such as glaucoma or keratoconus.

Pre-Operative Preparations

Before undergoing PRK:

  • Eye Exam: Ensure suitability through detailed corneal mapping and prescription stability.
  • Contact Lens Discontinuation: Stop wearing contact lenses 1-2 weeks prior to surgery to allow corneal shape normalization.
  • Health Check: Avoid medications or conditions that could interfere with healing.

PRK Procedure: Step-by-Step

  1. Anesthesia: Local anesthetic eye drops are applied.
  2. Epithelium Removal: The outer corneal layer is gently removed.
  3. Laser Reshaping: The excimer laser reshapes the cornea with pinpoint accuracy.
  4. Bandage Lens Application: A protective contact lens is placed to aid healing.

Squint Eye in Children

Early detection and treatment are crucial for children:

  • Signs: Avoidance of reading, frequent blinking, or tilting the head.
  • Interventions: Patching the stronger eye or using corrective lenses.

Benefits of PRK

PRK offers:

  • Vision correction without creating a corneal flap.
  • Suitability for thin corneas or dry eye conditions.
  • Durable results with low risks of flap complications.

Comparing PRK and LASIK

PRK lacks the corneal flap required in LASIK, reducing risks of flap-related complications. While PRK has a longer recovery time, it is better suited for patients with thin corneas or active lifestyles.

Frequently Asked Question (FAQ)

1. Is PRK painful?

Mild discomfort is common but manageable with prescribed pain relievers.

Initial healing occurs in 3-5 days; full visual stabilization may take months.

Prices range between $1,500 and $3,000 per eye, depending on location and technology used.

Yes, the results are long-lasting, though natural age-related changes may affect vision over time.

Yes, PRK effectively corrects astigmatism.

Absolutely, PRK is a great choice for individuals in contact sports or physically demanding activities.

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