101 PRK FAQ
101 PRK Frequently Asked Questions
PRK (Photorefractive Keratectomy) is an FDA-approved refractive surgery that reduces your need for glasses or contact lenses. It has been refined over the last two decades to provide vision correction with a high level of precision.
2. For how long has the procedure PRK been around?
PRK was first introduced in 1985.
3. For how long has the use of excimer laser for PRK been around?
The excimer laser has been used to perform surface ablation since 1985 as well.
4. How long has refractive surgery been done on human eyes?
Incisional surgery in attempt to correct prescription of human eyes has been around since the 1800′s.
5. What conditions does PRK treat?
PRK can correct myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. It can also be used to help presbyopia (difficulty with reading as we get older).
6. What kind of LASER is used for the PRK treatment?
The laser used for PRK is called an excimer laser. The excimer laser is a kind of laser that does not penetrate the surface of the eye. The excimer laser breaks intra-cellular bonds and evaporates very small amounts of surface tissue at a time. Guided by a precise computer system, the excimer laser re-shapes the surface of the eye in a way that will focus light more precisely and make more clear images. At the San Diego Laser-Vision Center, we use the state-of-the-art AMO Star S4 laser to apply excimer laser.
7. Does PRK have a “flap”?
No there is no flap made on the cornea to perform a PRK surgery.
8. If there is no PRK flap, then how is the laser vision correction done with PRK?
A diluted alcohol solution is used to loosen corneal epithelial cells. This very thin epithelial layer is cleared using a blunt instrument. Laser treatment is performed and this epithelial layer grows back usually over the next 4 to 10 days.
9. Am I a good candidate for PRK?
People who are near-sighted (myopic), farsighted (hyperopic), and astigmatic are all potential candidates for PRK. Certain individuals with very thin corneas or with corneal ecstasia (called keratoconus) are not good candidates for PRK. People with severe dry eyes are not good candidates for PRK. Certain systemic diseases (such as diabetes) and certain infectious conditions (such as HSV1 infection) can also make some individuals not good candidates for PRK. Every eye is unique, however, and only a qualified surgeon, after careful examination, can detemine if each indivisual is a good PRK candidate. The San Diego Laser-Vision Eye Center San Diego PRK surgeons will conduct a very thorough comprehensive eye examination prior to your surgery to determine if you are a good PRK candidate and answer all questions prior to proceeding with surgery.
10. What if I am not a good candidate for PRK? Are there other options for correcting my vision?
Yes. Many patients who are not good PRK candidates, are in fact good candidates for intraocular contact lens implantation (ICL). Please look at the section for ICL on this website for more information.
11. What if I have had previous corneal surgery such as RK(radial keratotomy) or corneal transplantation? Can I still have PRK?
Some patients who have had RK or corneal transplant can also be candidates for laser vision correction. However, this needs to be examined on a case-by-case basis. The skilled clinicians at the San Diego Laser-Vision Eye Center will conduct a thorough examination to assess if you are a good candidate for laser vision correction if you have had RK, corneal transplant, or other corneal procedures.
12. What laser machines are used to perform the PRK?
Some of the leading technologies for the PRK are the AMO Star laser and the Allegretto laser. There are also a few other, usually less expensive, laser machines that can be used to perform PRK. At the San Diego Laser-Vision Eye Center, we exclusively use the leading technologies for the best results.
13. Are there any sharp, cutting instruments used for PRK?
No. No sharp instruments are used to perform PRK. In fact no cuts are made to perform the PRK not with a cutting blade or a cutting laser.
14. What is myopia?
Commonly known as “nearsightedness,” myopia is a condition that causes people to not see far objects very well. Myopia is a condition that usually starts in childhood, but can start at any age. Nearsighted individuals can see the near objects better than objects far away. Nearsightedness can be improved with PRK. The diagram bellow demonstrates how myopic or near-sighted eyes focus light at a point in front of the retina (which is the eye’s equivalent of the film of a camera).
15. How is myopia improved with PRK?
A myopic eye is an eye that has too much power and thus bends light too strongly, focusing the image in front of the retina rather than exactly on it. Retina is equivalent to the film of a camera that takes a picture and sends the picture to the brain. In order to treat myopia, the power of the eye to bend light needs to be decresed. The excimer laser flattens the surface of myopic eyes in order to decrease its power and thus allow it to focus light better on the retina rather than in front of it as in the picture above.
16. What is hyperopia?
Commonly known as “farsightedness,” hyperopia is a condition that blurs vision in the distance as well as the near. Farsighted people, usually, see the far objects better than the near objects. With hyperopia, the focus point of light in the eye is at a point behind the retina as can be seen in the diagram bellow.
Hyperopia
17. How is hyperopia treated with PRK?
Eyes with hyperopia have too little power for bending light. For this reason, they focus the image behind the retina (as depicted in the picture above.) In order to improve vision for farsighted (hyperopic) eyes, the eye’s power of bending light needs to be increased. This is done by using laser to increase the steepness of the surface of the eye, thereby increasing its ability to bend light.
18. Does PRK improve far-sightedness?
Yes, PRK improves hyperopia (farsightedness). However, results are best with low to moderate levels of hyperopia. Hyperopic or farsighted people will be initially blurry in the distance as the laser initially has to over-correct and make them slightly nearsighted. This over-correction normally improves over the next 12 months after surgery.
19. What is astigmatism?
Astigmatism is a condition that causes blurred vision in both the near and distance. Astigmatic eyes have a power curve that is steeper (or more powerful) in one direction compared to the other, similarly to how a football has a steeper radius of curvature in one direction compared to the other. Conversely an eye without astigmatism has similar power in all directions, similar to a tennis ball having the same curvature in all directions. Astigmatic eyes, as depicted bellow have multiple focus points causing blurred vision. PRK can improve astigmatism as well as myopia and hyperopia above.
20. Does PRK improve astigmatism?
There is a false perception that PRK can not be used to improve astigmatism. Astigmatic prescription of most eyes can be improved with PRK. Very high levels of astigmatism, however, can not be fully treated with PRK. Your San Diego PRK surgeon at the San Diego Laser-Vision Eye Center will review your prescription precisely as well as the surface topography of your eye during your PRK consultation and let you know if your level of astigmatism is appropriate for PRK.
21. How is astigmatism treated with PRK?
Astigmatism causes different parts of the surface of the eye to have different powers of bending light, and thus blurring the image. To simplify this notion, astigmatic eyes can be compared to footballs that have more curvature in one direction compared to the other. The PRK laser can re-shape the power on the surface of the eye from more of a football shaped to a basketball-shaped shape allowing improved focusing of the light.
22. Does the power-curve on the surface of each specific eye look exactly like a football or a basketball?
No. Most eyes have what is called higher-order-aberrations which essentially means they need a very specific correction at every point on the surface of the eye. The surface power of the eye looks more like the surface of mars as compared to the smooth surface of a ball.
23. How are higher-order-aberrations treated?
Higher-order-aberrations are treated using Wave-scan technology and CustomVue technology as described elsewhere in this website. Make sure to ask your PRK surgeon about custom PRK correction prior to your surgery.
24. How long does the PRK procedure take?
The PRK procedure, on average, takes about ten minutes to complete. However, you need to allow some time for getting into the office, signing in, and doing the other preoperative arrangements before your PRK.
25. Does PRK hurt?
PRK is usually a painless procedure. However, during the treatment, you will feel some pressure on the eyelids. In addition, for about a week after the PRK surgery, you will have some eye discomfort and your vision will be blurry. The blurry vision will likely not be to the extent of not allowing you to do your daily activities. Your vision improves slowly after PRK. Most people will see a significant improvement about one month after surgery. The visual acuity usually continues to improve for 6 months after the PRK. The final visual outcome is comparable between PRK and LASIK.
26. Will I have to take any eye-drops prior to my PRK surgery?
Your surgeon will usually ask you to take some antibiotic eye drops 2 to 4 days prior to your surgery day. He or she may occasionally ask you to take anti-inflammatory eye-drops or eye-drops for dryness prior to you PRK.
27. Do I get any relaxing medications prior to PRK?
It is usually not necessary to take any relaxing medications prior to PRK. However, for those patients who do not have any medical contraindications to relaxing medications, and who may be unusually nervous, a small dose of relaxing medication can be given to make the procedure more comfortable.
28. Is PRK done for both eyes at the same time?
Almost always, PRK is done for both eyes at the same time. However, it can be done one eye at a time as needed.
29. What if my eyes itch after PRK, is it ok to rub them?
After PRK, in general, it is a good idea not to touch your eyes in order to avoid getting an infection. However, unlike LASIK, there is no flap in PRK and thus rubbing your eyes will not dislodge or wrinkle a flap. It may dislodge the contact lens in your eye after surgery, however, which can be uncomfortable. Should you accidentally dislodge the bandage contact lens in your eye, you should call your doctor immediately.
30. When is it ok to exercise after PRK?
We recommend no contact sports or sports that can result in the eye being hit or contaminated for about 2 weeks after PRK and at least until the corneal epithelial defect (or the scratch on the surface of the eye after PRK) heals.
31. How long after PRK surgery is it ok to swim?
We recommend that you do not do any swimming for at least 2 weeks after surgery and at least until your corneal epithelial defect (corneal scratch after surgery) heals.
32. Will my eyes be patched after PRK?
It is not necessary to patch the eyes after PRK surgery, however, it is a good idea to wear protective goggles while the eyes are healing (usually a period of 4 to 10 days.)
33. Are there any stitches in PRK?
PRK is stitch-free.
34. When does the doctor see me again after my PRK surgery?
Your surgeon will see you one to three days after and typically again at one week and one month after your surgery. However, this can change on a case-by-case basis. It is possible that you will need to be seen more frequently.
35. What will I see during the PRK treatment?
You will be trying your best to look at a blinking light in front of you. Your vision will be blurry and you may see a few flickers of light during the actual treatment.
36. Will my vision go dark at any point during the PRK treatment?
Your vision will get blurred during the PRK treatment, but unlike LASIK, there are no periods of dark vision.
37. How can I help healing after PRK?
You can take vitamin C supplementation and avoid rubbing or manipulating the eyes as much as possible.
38. How long does it take for my vision to improve after PRK?
PRK patients usually see improvement in vision within 1 to 4 weeks after surgery. However, visual changes and improvements continue to take place usually up to 6 months and possibly up to a year after surgery.
39. Will my eye get red or blood-shut after PRK?
After PRK, there is usually some redness that is normal. This redness will improve over the ensuing few weeks after your PRK.
40. How long after PRK can I go to work?
Usually, patients can go to work about one week after PRK surgery. However, for patients who heal slower than normal or work that requires fine-detail visualization it may take a longer time.
41. What about showers after PRK?
You surgeon will advise you more specifically, but you should not take a shower for at least 2 days after surgery. For the first 1 to 2 weeks after surgery, it is recommended to keep any water or soap out of direct contact with the eye.
42. Can I drive after PRK?
We advise that you do not drive at least one week after your PRK surgery and as long as it takes for your visual acuity to recover and meet the DMV requirements for safe driving.
43. How long after PRK can I start putting on make-up?
It is usually ok to put on make-up about 2 wks after PRK. It is recommended to buy new makeup for around the eye to decrease the risk of infection.
44. What is custom PRK?
CustomVue™, Custom PRK, or Wavefront-Guided PRK can now be used to treat imperfections in vision many times more precisely than with standard methods used for glasses and contact lenses. The Wave-scan technology measures the visual imperfections on the surface of the eye at 200 individual points. Treating each of these 200 points individually creates a personalized vision correction that is customized for each specific eye. This treatment can potentially provide vision better than ever achieved with glasses or contact lenses. Previously to the development of this technology, standard laser vision correction could at best achieve the level of clarity offered by glasses. Today, prior to having a laser vision correction, all patients should ask their surgeons if they provide Custom PRK.
45. How good are the outcomes after Custom PRK? What percentage of people get 20/20 vision afterwards?
One year after the CustomVue™ PRK procedure are comparable to those of CustomVue LASIK which has been shown in a clinical study to provide 20/20 or better vision in 98% of individuals.
46. How is night vision after Custom PRK?
Most patients are satisfied with their night vision after custom laser vision correction. Initially there may by some glare and haloes around lights, but this usually improves within the first year.
46. Are expensive PRK centers better?
Expensive PRK centers are not always better. However, there are some low-price centers that do not provide the latest technology in laser vision correction. Make sure to know the technologies used for PRK and ask for them specifically. These include Staar S4 AMO system, Allegretto laser system, Wavefront Technology, pupil tracking, and Iris Registration. Also avoid LASIK-mill type practices that move as many patients through as possible and do not give your particular case enough individual attention.
47. What are the options for PRK financing?
The payment options include cash, financing, and the use of expense accounts. Some vision plans can help pay for PRK as well. Approval for 100 percent financing is usually possible. In addition, the cost of buying glasses and/or contact lenses over-time often adds up to the cost of the payments made for PRK. During your visit with the San Diego Laser-Vision Eye Center PRK surgeon, please feel free to ask us about financing options.
48. Is PRK hard to afford?
The cost of buying glasses and contact lenses for most people can quickly add up to more than the cost of PRK. Considering all the financing options available, today PRK is affordable for a large number of individuals that are interested in being free of glasses and contacts.
49. How important is the choice of doctor for my PRK?
The choice of your surgeon is absolutely crucial. Make sure that your surgeon is an experienced ophthalmic surgeon educated in a reputable university. Also, make sure that your surgeon spends adequate time explaining PRK to you, personally performs your PRK workup, and confirm all measurements. A surgeon without the best pedigree that does not spend sufficient time planning your personalized procedure will be less likely to obtain great results for your PRK procedure.
50. What is pupil tracking?
Pupil tracking makes is possible to perform a truly customized PRK treatment. With custom PRK, it is very essential that the LASER treatment follows the small movements of the eye in order to treat the surface of the eye on 200 specific points. For this reason, an infrared camera is used to track the movements of the eye every few milliseconds and adjust treatment according to the specific position of the eyeball at any given time.
51. What if there is a sudden large movement during my PRK procedure?
If there is a sudden large movement during your procedure that the pupillary tracking system can not adjust for (the rare event of an earthquake for instance), the PRK machine is designed to simply stop and save the treatment plan. After conditions are stable again without movement and the infrared camera is able to track the eye again, the computer can usually re-start the treatment from where it was stopped.
52. What if I blink during the procedure?
There is a small device that will keep your eyes open during PRK. You will not be able to blink usually during your PRK surgery. However, if you squeeze your eyes very hard or move your head, procedure may be halted and re-started shortly.
53. What is iris-registration?
Iris registration is a state-of-the-art PRK technology used at the San Diego Laser-Vision Eye Center that adjusts the LASER treatment to the torsional movement of the eyeball. This technology involves capturing an image of the iris (the blue/green/brown/hazel colored part of the eye) and matching this picture to the picture of the eyeball under the LASER device. Usually when patient go from the standing or seated position to the laying down position, there is a subtle torsional movement of the eyeball. In earlier PRK technologies, it was not possible to adjust the treatment to this subtle torsional movement of the eye. With iris registration it is possible to adjust the PRK treatment not only according to the movement of the eye in the x and y direction, but also according to the torsional movements of the eye. This technology helps provide a more precise treatment. Prior to having PRK scheduled, please be sure to ask if a PRK center offers iris-registration.
54. How long does the effect of PRK last?
Usually, a patient’s vision is improved for years after PRK. A majority of patient do not have any need for glasses to see the distance for years. However, similarly to a normal eye without PRK, the prescription of the human eye can change naturally after PRK. Usually these changes are much smaller than the original prescription.
55. How can change of prescription after my PRK be prevented?
It is very important that your PRK surgeon measures your prescription very carefully prior to having your PRK and to make sure that it has been stable preferably over the last few years. An eye which has not had a stable prescription prior to the PRK procedure is usually one that will continue to change afterwards. In those cases, a prudent doctor would recommend observation of your eye until your prescription stabilizes prior to doing the PRK procedure. It is also prudent to avoid surgeons that will not enquire about your prescription stability over the last few years prior to recommending PRK. While a stable prescription before surgery will not guarantee stability after PRK, it is a very important precaution to take.
56. Will I need reading glasses after PRK?
Usually, as long as you are under 40 you can be free of glasses after PRK for distance and near. However, some time in the 40′s, even people with excellent distance vision will need reading glasses. This is called presbyopia. PRK does not correct presbyopia. However, another option called monovision PRK, can be used to help people see well in the distance and near past their 40s.
57. What is monovision?
Monovisionis a type of vision correction that sets one eye (your dominant eye usually) for the distance, and the other for near. This allows many individuals to be able to function well past their 40s without wearing any glasses for the distance or for the near. Monovision can be done with contact lenses or with PRK.
58. What is modified monovision?
Modified monovision is a type of monovision that makes the non-dominant eye only slightly near-sighted. Modified monovision is for individuals that prefer to have their two eyes’ prescription not very much different from one another. Also, these people’s lifestyle may have a higher demand for intermediate vision as compared to very near vision.
59. Is PRK safe for people who play contact sports or have physical jobs?
Yes. Since PRK does not make a corneal flap, it leaves the structural integrity of the human eye intact. For this reason, after the completion of healing after PRK, it is as safe to participate in sports or physical jobs as it was prior to having the PRK procedure.
60. Is Epi-LASIK different from PRK?
Like LASEK, Epi-PRK is a newer variation of the PRK. Epi-LASIK lifts a very thin epithelial layer off the surface of the cornea prior to the application of the laser. After the laser treatment, the epithelial flap is placed back on the cornea, covered by a bandage contact lens and allowed to heal over the next week. This epithelial flap is much thinner than the LASIK flap and usually heals without a trace.
61. Does Epi-LASIK make a flap that is more similar to LASIK than PRK?
Epi-LASIK makes a much more superficial flap compared to LASIK. After the Epi-LASIK procedure, the elevated epithelial flap heals almost exactly as it was before the procedure. This is similar to PRK where the epithelial layer is removed completely and allowed to re-grow after surgery into it original position. LASIK flaps however, can be identified on the eye even years after having had the original LASIK done. Unlike LASIK which is very comfortable and usually heals within a day giving quick, excellent visual results; Epi-LASIK and PRK can cause some discomfort for about one week. Also visual improvement with Epi-LASIK and PRK can take up to 1 to 6 months.
62. Why should I choose LASEK or Epi-LASIK and not PRK?
The Epi-LASIK procedure and LASEK were both developed in order to decrease the discomfort involved in healing after the PRK. The thinking behind them was that if, instead of removing the epithelial corneal cells, we replaced them on the corneal surface, they would heal more quickly and cause less discomfort. In practice, however, these removed epithelial cells do not always re-attach and at times detach a few days after surgery. While some surgeons subjectively report getting less discomfort with Epi-LASI and LASEK as compared to PRK, we have noticed that the healing time and discomfort with both surgeries is most frequently manageable and not significantly different from each other.
63. Why should I choose Epi-LASIK and not PRK?
The procedures of Epi-LASIK and PRK are very similar and any patient who is a candidate for one, should also be a candidate for the other.
64. What are some complications of PRK?
PRK, in good hands, is a very safe procedure with very low complication rates. However, it is a surgery and for any surgery there are some possible complications. Some of the more common complications of PRK include undercorrection, overcorrection, regression, dry eye syndrome, glare and haloes with light, corneal haze development, central island, infection, and corneal perforation.
65. What is an under-correction of PRK?
An under-correction is when your prescription is not fully corrected by the PRK procedure. For instance after correcting your nearsightedness, you may still be somewhat near-sighted.
66. What is an over-correction of PRK?
An over-correction is when an eye may have had more correction for its prescription by PRK than needed. For example, an eye that was near-sighted may be left far-sighter after PRK.
67. Is it normal for me to be over-corrected after hyperopic (farsighted) PRK?
Yes. As a matter of fact, you should be somewhat near-sighted initially after your hyperopic (farsighted) PRK correction. This will usually normalize over the next year. Farsighted people are over-corrected by the machine initially because they are expected to undergo regression towards their original prescription over the ensuing months.
68. What is regression of PRK?
Regression means that a patient that has been initially corrected properly by PRK, over the next few months or years, may move towards his or her old prescription. This is more common for farsighted indivisuals (hyperopes).
69. Can over-corrections, under-corrections, and regression be treated?
Yes. They can be treated using a PRK or LASIK touch-up procedure as described elsewhere in this website. However, sufficient time should be allowed for healing and stabilization of the prescription prior to the touch-up.
70. What is corneal haze after PRK?
Patients who have the PRK surgery usually develop a very subtle haze in their cornea that is observable with the ocular microscope. This is more common in people who have a larger correction. This corneal haze usually does not affect vision and improves during the first few years after the PRK procedure.
71. How do you manage corneal haze after PRK?
Corneal haze after the PRK usually does not affect the vision and does not need to be treated. However, infrequently, it may need to be treated with another surgery and application of mitomycin-C medication.
72. Can I get a “flap wrinkle” after PRK?
No. The PRK procedure does not involve creating a corneal flap.
73. Will I have glare and haloes after PRK?
Glare and haloes can be experienced by anyone without glasses, with glasses, or with contact lenses. Glare is more frequent in patients who have had PRK treatment zones that can be smaller than the size of their pupil at times. When light hits the untreated zones, it can scatter and cause more glare and haloes. With today’s latest technologies and wider available treatment zones as well as custom PRK, problems with glare and haloes are uncommon. It is normal to have some glare and haloes initially after PRK, however, these usually improve within the first 6 to 9 months.
74. What is a central island?
Central island is an irregularity in the surface of the eye more commonly caused by older generation “broad beam” lasers. It consists of an irregularly elevated central cornea after PRK which resembles an island. The newer lasers use “scanning” or “tracking” systems making this complication very infrequent. This irregularity can usually be treated with a PRK or LASIK touch-up.
75. How will dry eyes affect PRK and vise versa?
Severe dryness is a contraindication for PRK. However, patients with mild to moderate dryness can do well with PRK. Your eyes will be more dry than usual after having PRK, but for most people this will improve within a year after surgery. It is possible, however, that after having PRK your eyes will be more dry permanently and need ongoing treatment for dryness.
76. Which type of laser vision correction is better for dry eyes?
The surface treatments such as PRK, Epi-LASIK, and LASEK will do better with dryness as compared to LASIK. This is because there is no corneal stromal flap made with these procedures. It is thought that making of the corneal stromal flap for LASIK can affect surface corneal nerves and exacerbate dryness. However, severely dry eyes are not good candidates for LASIK,PRK, LASEK, or Epi-PRK.
77. How do you treat dry eyes after PRK?
The treatment for dry eyes after PRK can include any of the following methods. Preservative-free artificial tears can be used few times a day. Another option is the use of punctal plugs. These plugs close one of the two drains of tears thus keeping eyes better lubricated. Also, Restasis is a medication that is used frequently after PRK. Restasis is thought to increase the baseline tear production of the eyes.
78. Can I get a corneal perforation after PRK?
No sharp instruments are used to perform the PRK, so there is an extremely low possibility of having a corneal perforation.
79. What is a PRK enhancement or touch-up?
A PRK touch-up or enhancement is a refinement of a PRK procedure that has been performed in the past. Over the next few years after having PRK, it is possible that your eye can undergo microscopic changes that can make you dependent on glasses or contact lenses again. This prescription is usually much smaller than your original prescription. Usually this small prescription can be treated using a PRK or LASIK enhancement.
80. What kinds of PRK touch-ups or enhancements are there?
PRK enhancement can be done by with a surface treatment such as PRK, LASEK, or Epi-LASIK. It can also be done by cutting a LASIK flap and thus performing a LASIK enhancement.
81. What type of PRK enhancement do you recommend?
At the San Diego Laser-Vision Eye Center, we recommend surface treatment with PRK, LASEK, or Epi-LASIK for PRK enhancement. Although it is acceptable to make a LASIK flap and perform a LASIK enhancement after PRK.
82. What are the risks of PRK Touch-ups?
Similar to the original PRK procedure and include over-correction, under-correction, infection, corneal haze, etc. If the touch-up is done using LASIK, the risks are similar to those of the LASIK procedure.
83. How many PRK touch-ups can I have?
It is most preferable to have the fewest possible PRK touch-ups, however, there is no absolute limit that applies to everyone. Some people may have too thin of a cornea, or other eye issues after their PRK that may make further enhancements unsafe for them.
84. Can I have PRK if I have keratoconus?
No. Keratoconus and other corneal ectasias are contraindications for PRK. One of the most important things that your doctor needs to do prior to your PRK is to rule out the possibility of you having even very early keratoconus or corneal ectasia. Having PRK can potentially worsen and complicate the course of these corneal diseases.
85. How does my doctor determine if I have keratoconus or corneal ectasia before my PRK?
Your doctor will determine if you have keratoconus or corneal ectasia by performing a very careful examination of your eye with a microscope. He or she will also assess very carefully your corneal thickness as well as the steepness of the front and back of your cornea using very advanced imaging technologies.
86. Can I have PRK if I have diabetes?
Diabetes can cause very serious eye problems. Also it can slow healing and make patients more prone to infections after the procedure. In addition, fluctuating blood sugars can make your prescription fluctuate, making it difficult to correct vision with glasses, contacts, or PRK. At the San Diego Laser-Vision Eye Center we only consider patients with excellent blood sugar control and no other eye complications from diabetes mellitus potential PRK candidates. Every case, however, will need to be discussed with a surgeon and evaluated individually.
87. Can I have PRK if I have a history of herpetic eye disease?
A history of herpetic eye disease is often a contraindication to PRK. Herpetic eye infections can potentially recur and cause irreversible visual loss after PRK. It is extremely important to speak to your surgeon about having a history of herpetic eye disease during your PRK evaluation. Deciding whether or not you are a good PRK candidate with a history of ocular herpes infection is best made by a well-informed, experienced clinician and on a case-to-case basis.
88. What is the risk of infection after PRK?
If postoperative eye-drops are taken correctly and postoperative directions followed carefully avoiding contamination of the eyes during the healing period, the chance of a corneal infection after PRK is extremely low.
89. Is infectious keratitis after PRK a treatable condition?
Infectious keratitis is a very dangerous and potentially vision threatening complication of PRK. However, most cases of infectious keratitis can be treated using topical antibiotics. After the resolution of the infection, however, there may be scarring that interferes with visual acuity. With the advent of newer antiobiotic eyedrops, it is expected that the current rates of infection will be lower than those reported in the older studies. With strict following of the post-operative antibiotic eye-drop regimen and avoiding contaminants, the risk of infection after PRK can be reduced to extremely low rates.
90. Can I have other ocular procedures such as cataract surgery after having had PRK?
Yes. It is possible to have other ocular procedures after having had PRK. In the common case of cataract surgery, your surgeon will have to take into account the fact that you have had PRK in the preoperative calculations.
91. Would eye-surgeons have PRK themselves?
Yes, and man eye surgeons have had laser vision correction. This is because, in the right hands, PRK is a very safe procedure. As a matter of fact our surgeons have much more frequently seen vision-threatening complications of wearing contact lenses as compared to post-PRK patients. It is for this reason that many ocular surgeons who do not wish to wear glasses choose laser vision correction over contact lenses.
92. What technologies should I ask about from a PRK center?
Ask about Iris registration, Wavescan guided PRK (Custom PRK), Pupillary tracking, and Visx Star S4 or Allegretto PRK machines. We recommend that you make sure any center that gives you a price for PRK uses ALL of the above technologies.
93. Why is it so important to ask specifically for the technologies above before my PRK?
Because a lot of PRK centers simply do not spend the money required to keep up with the latest and best technologies. They may offer the exact same price as another location without offering up-to-date technology. Also they may compromise the quality of your treatment by using outdated technology but offering you a slightly cheaper price.
94. What are some qualities of a great PRK surgeon?
Qualities of a great PRK surgeon are similar to those of a great doctor. Your PRK surgeon should not sound like a salesman or quickly send you to sales-agents. Your surgeon should have a great resume, a great training, great surgical experience, great bedside manner, and great patience in listening to you and answering all your questions.
95. What should I watch out for in a PRK provider?
Watch out for extremely sales-oriented centers that try to go through as many patients as possible. As mentioned above, specifically demand the latest technologies. Also, ask if your surgeon will be around after the surgery to see you in case there are any issues. Many “LASIK-mill” type practices fly in surgeons that will perform your surgery and take a flight away to another state the next day. Naturally, they will be unavailable to address any issues with your surgery.
96. Can my optometrist help with my PRK?
Absolutely. Your optometrist can recommend an excellent surgeon for your PRK procedure and also can help with the pre-operative workup and your follow-ups after surgery.
97. What if my surgeon says bad things about other surgeons in the vicinity?
This is an ominous sign that you may not be speaking to the most ethical surgeon. Similar to other professions, collegial surgeons are usually the best and most ethical ones. A great surgeon and doctor will have no desire to speak negatively about a colleague.
98. What if my surgeon constantly brags about his resume?
You should certainly check the qualifications of your surgeon. However, just like other doctors, a PRK surgeon that speaks more about him or herself than you is one that is focused more on him or herself as compared to your eyes and our PRK outcome.
99. Is there a minimum age for PRK?
There is no absolute minimum age for PRK. As a matter of fact PRK has been used in the treatment of very young people with serious visual problems that can cause long term vision loss. However, for most people, it is wise to at least wait until the age of 18. If you are 18 or 19 years old and intersted in having PRK, we recommend that you make sure your eye prescription has been very stable over the last 3 years at least. Once you are past the age of 20, 1 to 2 years of stability of prescription is usually sufficient.
100. Is it possible to do a multifocal PRK for distance and near vision?
Yes, however, this technology is very new and its future complications and shortcomings, as well as long term results are still unknown.
101. What is CK? Is it a type of LASIK or PRK?
CK or conductive keratoplasty is not a type of PRK. It is a technique of vision correction that has been used with mixed results. It re-shapes the surface of the eye by heating the cornea at specific points. However, results with CK have been variable and very likely to change over time.
