Photorefractive Keratectomy: Causes, Symptoms, Treatment and Cost

Photorefractive keratectomy (PRK) is a laser eye surgery used to repair visual abnormalities including nearsightedness, farsightedness, and astigmatism. PRK is an outpatient procedure that takes only a few minutes and does not require any stitches or sutures. .

• Laser-Assisted Subepithelial Keratectomy (LASEK): This type of photorefractive keratectomy is used to treat mild to moderate levels of nearsightedness, astigmatism, and farsightedness. During the process, a thin tissue layer is removed from the cornea's surface. An excimer laser is then used to reshape the cornea.
• Phototherapeutic Keratectomy (PTK): This type of photorefractive keratectomy is used to treat more severe levels of nearsightedness, astigmatism, and farsightedness. During the operation, a thin layer of tissue is removed from the cornea's outer layer and it is reshaped using an excimer laser.
• Advanced Surface Ablation (ASA): This type of photorefractive keratectomy uses an excimer laser to remove a thin layer from the surface of the cornea without removing any tissue from beneath it. It may be used to cure minor instances of farsightedness, nearsightedness, and astigmatism.
• Conductive Keratoplasty (CK): This type of photorefractive keratectomy uses radiofrequency energy instead of an excimer laser to reshape the cornea in order to correct refractive errors such as nearsightedness or astigmatism.

PRK provides several advantages over other methods of vision repair.

• Fast Recovery Time: PRK requires only a few days of recovery time, and patients can often experience improved vision within 24 hours of the procedure. This makes it a perfect alternative for individuals who want speedy repair with little downtime.
• Safe and Effective: PRK is considered one of the safest and most effective forms of laser eye surgery available today, with a success rate of up to 95%.
• No Risk of Corneal Infection: Unlike other forms of laser eye surgery, PRK does not involve cutting or reshaping the cornea, so there is no risk of infection or other complications associated with the procedure.
• Long-Lasting Results: The results from PRK are typically long-lasting, as long as patients continue to take proper care for their eyes after the procedure has been completed.
• Cost-Effective: Since there are no incisions made during the procedure, it tends to be more cost-effective than other forms of laser eye surgery such as LASIK or IntraLASIK.

PRK is used to address vision issues caused by refractive defects including myopia (nearsightedness), hyperopia (farsightedness), and astigmatism.

PRK can reduce or eliminate the need for eyeglasses or contact lenses, providing patients with improved vision and greater freedom from corrective lenses.

PRK is also used to treat corneal irregularities, such as scarring from injury or infection, which can cause vision problems.

• Risk factors of photorefractive keratectomy
• While PRK is generally a safe and effective procedure, there are certain risks associated with it that should be taken into consideration.
• The most common risk factors associated with PRK include dry eyes, light sensitivity, glare or halos around lights at night, over-correction or under-correction of vision, and infection. When the treatment is done by a qualified surgeon in a clean and hygienic setting, these risks are often negligible.
• In addition to these general risks, there are some additional risk factors that may increase the likelihood of complications from PRK. These include having thin corneas; having certain medical conditions such as diabetes; being pregnant; having had previous eye surgeries; taking certain medications such as steroids; having an autoimmune disorder; or having a history of herpes simplex virus infection.

• Before having Photorefractive Keratectomy (PRK) surgery, it is important to prepare both physically and mentally.
• It is essential to cease using contact lenses at least two weeks before the operation, as well as refrain from using any eye medicines.
• Additionally, an eye test should be performed to confirm that your eyes are healthy enough to receive the treatment.
• Additionally, you may need to avoid certain activities such as swimming or using a hot tub for a few days before and after the surgery.
• It is crucial to know what PRK comprises and the possible outcomes. Additionally, it is essential to have reasonable expectations about the result of the procedure..
• Talk with your doctor about any questions or concerns you might have before undergoing PRK so that you can feel prepared for the procedure.

An excimer laser is utilised during PRK surgery to remove a very thin layer of tissue from the cornea's surface. This reshapes it so that light may be correctly focused on the retina. After surgery, a contact lens or bandage lens may be worn over the eye while it heals. The whole procedure takes around 15 minutes each eye, and most patients see an improvement in their eyesight within 24 hours after surgery.

• Perform a comprehensive eye exam to assess the patient’s vision and overall ocular health.
• Before beginning the surgery, get informed permission from the patient.
• Administer topical anesthetic drops to numb the eye before surgery.
• Apply a speculum to hold open the eyelids during surgery, and place a lid holder if necessary.
• Cleanse and disinfect the eye area before beginning surgery, and drape with sterile towels or paper drapes for added protection against infection during surgery.
• Mark any areas of concern on the cornea for reference during surgery, as needed for guidance in performing PRK safely and effectively.

Use an excimer laser to reshape corneal tissue by removing microscopic amounts of tissue from specific areas of the cornea based on pre-operative measurements taken during eye exam (elevation map).

Check for proper ablation depth, pattern, centration, etc., as needed throughout the procedure to ensure accuracy of results achieved with PRK procedure.

• Apply a patch or shield to the eye to protect it from rubbing and further irritation.
• To minimise the chance of infection, use antibiotic eye drops.
• Monitor any changes in vision, such as blurriness or light sensitivity, and report them to your doctor so they can be addressed right away if necessary.
• Instruct patient on how to care for their eyes after PRK (i..e., use lubricating drops regularly; avoid rubbing eyes; wear protective eyewear when outdoors).

In India, the expense of Photorefractive Keratectomy (PRK) varies based on the kind of surgery, the complexity of the treatment, and the surgeon's training. Generally speaking, PRK costs between Rs. 30,000 and Rs. 1 lakh in India.

• After Photorefractive Keratectomy (PRK), it is important to eat a nutritious diet that includes plenty of proteins, healthy fats, and complex carbohydrates.
• Eating foods that are high in antioxidants, such as fruits and vegetables, can help to reduce inflammation and promote healing.
• Drinking enough water can also help keep your eyes moisturised.
• Foods that are rich in omega-3 fatty acids, such as salmon or flaxseed oil, can also be beneficial for eye health after PRK.
• Additionally, eating foods with lutein and zeaxanthin can help protect the eyes from further damage caused by ultraviolet light.

Yes, Photorefractive Keratectomy (PRK) is generally considered to be a safe procedure. PRK is an FDA-approved laser vision correction surgery that has been used for more than 20 years to correct nearsightedness, farsightedness, and astigmatism.

Yes, Photorefractive Keratectomy (PRK) is a surgical procedure that can cause some discomfort and pain. The procedure involves the use of a laser to reshape the cornea, which can cause a burning sensation and stinging during the procedure. After the procedure, patients may experience pain, sensitivity to light, tearing, and blurry vision for several days.

Recovery from Photorefractive Keratectomy (PRK) typically takes around 3 to 5 days. Patients may have slight pain, light sensitivity, and some blurriness in their sight during this period. After the first few days, most patients will see a significant improvement in their vision and should be able to resume normal activities within 1-2 weeks.

The following are the most typical side effects of Photorefractive Keratectomy (PRK):

• Temporary light sensitivity
• Temporary blurry vision
• Halos and glare around lights
• Dry eyes
• Mild discomfort or pain during and after the procedure
• Undercorrection or overcorrection of vision, requiring additional treatment to achieve desired results.

Aftercare for PRK is crucial for ensuring a favourable result and lowering the likelihood of complications.

• Wear protective eyewear: It is important to wear protective eyewear such as sunglasses when outdoors for the first few days after PRK surgery. This will shield your eyes from dust and particles, which might irritate them.
• Avoid rubbing your eyes: Rubbing your eyes can cause irritation and damage to the corneal tissue that has been treated with the laser during PRK surgery, so it’s important to avoid doing this for at least one month after surgery.
• Use eye drops: Your doctor will likely prescribe lubricating eye drops or ointments to help keep your eyes moist and reduce any discomfort or dryness you may experience following PRK surgery. It’s important to use these as directed by your doctor in order to get the best results from your treatment.
• Limit activities: Avoid strenuous activities such as swimming or contact sports for at least one week after PRK surgery, as these can increase your risk of infection or injury to the eye area. Additionally, it’s best not to drive until you have fully recovered from the procedure and are able to see clearly again without any blurriness or double vision issues that may still be present in the days following PRK surgery.
• Follow-up visits: Be sure to attend all follow-up visits with your doctor so they can monitor how well you are healing from PRK surgery and make sure there are no complications developing such as infection or scarring of the cornea tissue treated with laser during this procedure

Photorefractive keratectomy (PRK) is a safe and reliable refractive surgical treatment that may be used to treat a wide range of vision issues. PRK has been shown to be an effective method of correcting vision problems with minimal risk of complications. With its proven track record, it is likely that PRK will continue to be a popular choice for those looking for an alternative to glasses or contacts for their vision correction needs.