Photorefractive keratectomy (PRK) and laser epithelial
keratomileusis (LASEK) for
farsightedness use a
laser to reshape the
cornea so that light is refocused on the
retina . The laser reshapes the cornea accurately
without damaging nearby tissues. No surgical cut is needed. Either procedure may be used to correct farsightedness and
astigmatism at the same time.
These procedures can be done on an outpatient basis in a
surgeon's office or same-day surgery center.
With PRK, surface skin cells of
the cornea are removed, and a laser is used to reshape the cornea. The whole procedure, including preparation and surgery,
takes about 20 minutes.
With LASEK, the surface layer of the cornea is loosened and pushed
to the side. After the laser reshapes the cornea, the surface layer is placed
back over the cornea.
PRK and LASEK are sometimes called surface ablation.
What To Expect After Surgery
You will wear an eye shield, a bandage, or special contact lens for
2 to 3 days after surgery. And your doctor will prescribe eyedrops to reduce
inflammation and the risk of infection. You may need to use eyedrops for
several months after surgery. Several follow-up visits are needed.
The eye can be quite painful for 2 to 3 days. Your vision will be
reduced for several days after surgery, until the surface skin cells heal.
Recovering from LASEK surgery may not be as painful as with the PRK
Why It Is Done
PRK and LASEK are similar surgeries and are done for
similar reasons. Your doctor will let you know if you need PRK or LASEK instead of the more common LASIK procedure. One reason may be that you have a thin cornea.
The American Academy of Ophthalmology considers both surgeries safe
and effective for mild to moderate farsightedness. PRK has been
approved for use in the United States in people age 21 and older who have
mild to moderate farsightedness.1
PRK or LASEK may not be appropriate for people who have more
severe farsightedness (high hyperopia), because the results are harder to
predict and complications are more likely.
Both are elective, cosmetic procedures, done to correct
farsightedness in otherwise healthy eyes.
These procedures may not be done during pregnancy, because
pregnancy may interfere with the healing of the cornea.
How Well It Works
PRK and LASEK effectively reduce mild to moderate
farsightedness. Little is known about the long-term effectiveness of either
In the short term, PRK has proved effective in correcting mild to
One problem commonly associated with PRK is clouded vision
(sometimes referred to as haze). Most eyes treated with PRK have some
clouding of the cornea as a result of healing. Your doctor may prescribe a medicine that will help take away the haze. But sometimes the haze won't go away.
Other complications of PRK may include:
Night vision problems, such as halos (often
described as a shimmering circular zone around light sources such as headlights
- Glare, or increased sensitivity to bright
- Double vision (diplopia), usually in one
- New astigmatism.
- Regression. As the cornea heals,
cells may fill in the area that was reshaped by the laser, causing at least
some of the farsightedness to come back. Regression may also occur if the
treated area thickens as part of the healing process. Regression may occur up
to 2 years after surgery. Medicines are sometimes used to control and limit
Serious but rare complications may include:
- Elevated pressure inside
the eye (intraocular pressure) and
PRK is considered safe. Serious complications are rare. But PRK is a relatively
new procedure, and it may have long-term side effects or complications that are
not yet known.
LASEK has similar risks to PRK. Also, there is a risk of
the epithelial flap coming loose after surgery and causing pain.
What To Think About
If you are thinking about having surgery to improve farsightedness,
discuss the different options (LASIK, PRK, LASEK, LTK, CK, and
intraocular lens implants) with your doctor.
Although PRK and LASEK are viable options for correcting
farsightedness, LASIK is the preferred procedure because of its quicker
healing time and quicker visual recovery.
Both PRK and LASEK are cosmetic procedures. The cost of
refractive surgery varies. Many insurance companies do not cover the cost of refractive surgery.
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
American Academy of Ophthalmology (2007). Refractive Errors and Refractive Surgery (Preferred Practice Pattern). San Francisco: American Academy of Ophthalmology. Also available online: http://one.aao.org/CE/PracticeGuidelines/PPP.aspx.
Primary Medical Reviewer
||Adam Husney, MD - Family Medicine
Specialist Medical Reviewer
||Christopher J. Rudnisky, MD, MPH, FRCSC - Ophthalmology
Current as of
||October 16, 2012