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PRK = Photo Refractive Keratectomy
PRK was the first method that used the precision of the excimer laser to reshape a human eye during FDA monitored clinical trials in New Orleans in 1987. The first person to have PRK surgery started with an uncorrected vision of 20/200 (legal blindness) and was able to achieve 20/20 vision without glasses after the surgery. They continue to see 20/20 without glasses to this day. In the 21st century, PRK has largely been replaced by LASIK or LASEK surgery due to their advantages of less pain, faster return to excellent vision, and shorter course of eyedrop usage after the surgery
Steps to PRK
Under the LADARVision excimer laser, the patient's eye is numbed using anesthetic drops, and cleaned with sterile tear solution The eye is tracked to freeze it on the LADARVision computer screen, and the area that will be reshaped is superimposed. The cornea surrounding the area to be reshaped is marked, and the epithelium is removed within this area. The LADARVision tracking / flying spot laser is then used to precisely reshape the outermost stromal layer of the cornea. After the laser reshaping is complete, Dr. Soloway cleans the surface of the newly shaped cornea. A bandage contact lens is then applied to the eye which allows the epithelium or skin of the cornea to begin to heal over the next 3 three to five days. Eyedrops are started immediately. Unlike LASIK, the patient does not require eye shields to protect a flap. The epithelium of the cornea regenerates on its own
Potential Problems with PRK Surgery
The potential problems of PRK surgery are due to the fact that the epithleium takes three to five days to heal after the surgery so there is a larger amount of inflammation in the eye:
Pain: During the surgery the patient's eyes are numbed with anesthetic. During the 3 to 5 day healing period for the epithelium, the scratch on the eye can cause some pain Vision: The quality of the vision is reduced during the 3 to 5 day healing period making returning to work the next day difficult if not impossible Medication: PRK surgery can require the use of prescription eye drops for up to six months after surgery Scar formation: Due to the amount of healing required on the epithelium in PRK surgery, some patients have eyes that over-react and some scar or haze can form on the surface of the eye. This can occur months after the surgery. Dr. Soloway is an investigator for the use of a medication called MMC to prevent this scar formation in PRK, and LASEK
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