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PRK Surgery Explained: Pros, Cons, And What To Expect

By Gulnaz Khan
Medically Reviewed by Vance Thompson, MD, and member of the Refractive Surgery Council editorial advisory board on December 07, 2020
Pros And Cons Of PRK Surgery - Learn what to expect before, during, and after PRK laser eye surgery, and the advantages and disadvantages of this procedure.

Photorefractive keratectomy (PRK) is a type of laser eye surgery used to treat nearsightedness, farsightedness, and astigmatism by reshaping the cornea.

What To Expect During PRK

Before surgery

  • Review the risks, benefits, and cost of PRK with your ophthalmologist.
  • Your doctor will review your medical history, test your vision, examine your eyes, and measure your cornea and pupil to determine if this procedure is right for you.
  • You may not be a good candidate if you're under 21, pregnant, nursing, or have pre-existing conditions, including cornea disease, uncontrolled diabetes, cataracts, dry eye syndrome, or advanced glaucoma.

During surgery

  • PRK is an outpatient procedure, and the surgery itself takes less than 10 minutes.
  • Your doctor will numb the eye with anesthetic drops, and use an eyelid holder to keep your eye open during the procedure.
  • The doctor will then use a laser, brush, blade, or alcohol solution to remove the epithelium, or the outer layer of the cornea.
  • You will be asked to look at a target light while a laser reshapes your cornea based on your eye measurements.
  • Your surgeon will put a contact lens over the eye to act as a bandage.

After surgery

  • Ask a friend or family member to drive you home after surgery.
  • Follow your doctor’s aftercare instructions. Rest, avoid strenuous physical activity, and stay away from products that may irritate the eye.
  • Your doctor will prescribe eye drops to prevent infection and aid healing.
  • Wear sunglasses outside—sun exposure can scar the cornea after surgery.
  • You may experience mild eye pain for the first 24 to 36 hours, and short-term blurred vision during the first week. Your ophthalmologist can recommend over-the-counter or prescription eye drops for pain.
  • Schedule follow-ups with your doctor as instructed—it can take up to three months for vision to stabilize completely.

Advantages of PRK

  • An estimated 90 to 95 percent of people who undergo PRK achieve 20/40 vision or better without wearing glasses or contacts. You may still need glasses for reading and nighttime activities, and vision typically declines with age.
  • PRK can achieve the same long term benefits as LASIK.
  • PRK may be an alternative option for people who are not good candidates for LASIK, including patients with thin corneas.
  • Athletes may be better candidates for PRK rather than LASIK. During LASIK, a flap is made in the cornea and can become dislocated by contact or injury.

Disadvantages of PRK

  • Any surgery comes with risks. Complications of PRK may include scarring, infection, cloudiness of the cornea, and a “halo effect” around lights.
  • There is a risk of over or under correction of your vision—this is often remedied with glasses, contacts, or additional surgery.
  • In rare cases, vision may become worse after PRK.
  • Initial recovery time is longer LASIK. Many people notice better vision within days of PRK, but it can take several days for the epithelium to heal and up to three months for vision to stabilize.