PRK for Myopia: The Before, During, and After Surgery

Are you tired of always having to wear glasses or contact lenses for your myopia? Eye surgery may be the answer for you. Whether you’re researching what options are available, or you already decided PRK is what you want and want to learn more, keep reading.

In this article, we’ll go over PRK for myopia. We’ll divide it into three parts: what to know before the surgery, a step-by-step guide of what happens during surgery, and what to expect after the surgery. We will also answer some common questions:

Before Surgery

PRK eye surgery is a very common option for those who want to correct their vision. This procedure can correct refractive errors like myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. Basically, a refractive error is when your eye doesn’t refract (bend) light properly.

What Is PRK (Photorefractive Keratectomy) for Myopia?

Photorefractive Keratectomy (PRK) is a type of refractive surgery. It uses a laser to correct the vision problems caused by refractive errors. Myopia is a type of refractive error and it’s the most common one. PRK can improve your vision and reduce your dependence on glasses or contact lenses.

This article is addressing PRK for myopia, but if you have a different type of refractive error, you can also join us! I’m sure you’ll learn something. Let’s start off by understanding what is myopia (also known as nearsightedness):

Myopia is when light focuses in front of the retina, instead of on top of the retina. As a result, you have blurry vision. The retina is in the back of the eye and is responsible for translating light into an image that the brain can read.

what is myopia

To correct this, PRK modifies your cornea, which is the front part of your eye. The cornea is responsible for bending (or refracting) and focusing light to help you see.

PRK for myopia gives your cornea a more flat shape by removing a microscopic amount of tissue. This moves the focal point of light further back onto the retina, making vision clear and correcting myopia. The image below is an exaggeration but it illustrates this well:

prk for myopia

Do I Qualify for PRK?

Now that you know what is PRK for myopia, you need to know if you’re eligible to get the surgery. Here are 9 conditions that make you a bad candidate for eye surgery:

  • Your vision is still unstable. This means your eye prescription changed in the past 1-2 years.
  • You’re not an adult. Only people older than 18 years old can undergo eye surgery.
  • You have health problems that can affect healing, like an autoimmune condition.
  • If you have a major condition that affects your eyes, such as advanced glaucoma or cataracts.
  • You have uncontrolled diabetes.
  • You’re a pregnant women.
  • You have an history of eye infections.
  • You’ve already had an eye surgery or eye injuries in the past. This makes you more likely to develop complications after surgery.
  • You don’t have realistic expectations of the final results. You need to completely understand the benefits, as well as the risks of PRK.

To determine if you are a good candidate for PRK, your doctor will examine your eyes. They will look at the overall health of your eyes, your lifestyle, and precisely measure your cornea, pupils, and amount of myopia.

Is PRK Safe for High Myopia?

Yes. PRK for people with high myopia has excellent refractive outcomes with a low probability of complications. Studies show it can correct myopia as high as -11.00 diopters.

How Much Does PRK Cost Per Eye?

The average cost of PRK surgery in the United States is usually between $1,000 and $3,000 per eye.

Most health insurance plans don’t cover laser eye surgery, because they consider it a cosmetic or elective procedure (not medically necessary).

During Surgery

Let’s move on to understanding what actually happens during surgery.

In the weeks prior to surgery, you and your doctor will discuss your vision needs based on your lifestyle. You will also talk about your expectations.

PRK for myopia will allow you to do your everyday tasks without glasses or contacts. However, you might still need to wear glasses for certain activities, like driving at night.

Step-by-step of PRK for Myopia

The surgery in and of itself is pretty quick. It lasts about 15 to 20 minutes for both eyes and consists of four main steps. Here’s what to expect:

Step 1: Getting in Position

In the first step, your surgeon will give you eye drops that numb your eye to ensure a pain-free surgery. You may also receive an oral sedative to help you relax.

A small instrument will then help gently maintain your eyelids open during surgery and keep you from blinking.

Step 2: Smoothening the Cornea

Before applying the laser that corrects your vision, the surgeon will smoothen the surface of your eye by removing the soft outer layer of cells on your cornea (called the epithelium). To do this, they can use a special brush, blade, laser, or alcohol solution.

The outer layer of your cornea (epithelium) has the ability to replace itself and regrow within a few days with no loss of clarity.

Step 3: Excimer Laser

Now is the part that actually corrects your vision. You will have to stare at a target light so that your eye doesn’t move.

The surgeon then reshapes your cornea using a laser. The laser is a special instrument that is programmed with precise measurements exclusively for your unique eye.

prk for myopia
A special brush may be used to remove the outer layer of the cornea (left). Only then, a laser removes tissue from the cornea to reshape it (right).

The deeper layers of your cornea don’t regenerate like the epithelium. If reshaped by a laser, they will stay like that forever. The excimer laser targets these layers.

Step 4: Bandage Contact Lenses

Finally, your surgeon will place a soft contact lens over the cornea of your eye, as a kind of bandage to protect it and help it heal. If you’re getting both eyes done on the same day, the whole process will be repeated on the other eye.

That’s it, your PRK surgery is now complete! You’ll rest your eyes for a few minutes, and then you can go. You will receive detailed instructions for recovery. Here’s an overview of all four steps:

prk for myopia

Is PRK Painful?

No. You receive eye drops that numb your eyes so that you don’t feel any pain during the surgery. However, once the drops wear off after surgery you may experience some discomfort like soreness, slight burning and stinging, or that sensation that you have when something is in your eye.

Taking a nap and just relaxing for a few hours right after surgery helps to avoid most of this discomfort.

After Surgery

Right after the surgery, you may experience some discomfort or even mild pain. Your vision will probably be blurry. This should gradually improve with time. Using pain-relieving eye drops makes the healing process easier.

The cornea takes about 3-4 days to heal. You should avoid intense activity (like contact sports) for up to a week after surgery. Driving is not recommended.

You will need to wear sunglasses outside for as long as your doctor tells you to. Sun exposure after surgery may lead to serious complications.

You will need to use eye drops to lubricate your eyes, avoid infections and reduce inflammation, as prescribed by your doctor.

Expect to take several days off work while you recover. After a few weeks, you should be able to continue most daily activities.

The complete healing process lasts about a month. Your vision will slowly get better each day. Ideally, you’ll see your doctor regularly to make sure your eyes are healing correctly and handle any complications that might appear until your eye fully recovers.

Can Myopia Return After PRK?

Yes. Studies have reported an estimated 10% to 20% of patients request to repeat PRK for myopia because they reported a gradual partial or complete return to the myopic state.

This seems to be more common among people with high myopia. This study concluded that:

The percentage of eyes within +/- 1.00 D of emmetropia (perfect clear 20/20 vision) 8 years after PRK was 78.3% in the low myopia group, 68.8% in the medium myopia group, and 57.1% in the high myopia group.

How Many Years Does PRK Last?

Everyone is different so there’s no definitive answer to this question. The effects of PRK on the cornea are permanent. However, your vision can change after surgery due to age-related reasons.

PRK surgery cannot prevent the natural deterioration of eyesight that comes with your eye aging.

Is PRK Worth The Risk?

Like with any surgery, PRK for myopia has a risk of more serious complications. These can be temporary or permanent and include:

  • Glare and halos around lights, especially at night.
  • Your vision may seem a little more cloudy or “ghosted” than before, even if you can see better.
  • Dry eyes: As with any eye surgery that reshapes the cornea, this is the most common complication. It’s generally temporary, but can become permanet.
  • Infection: PRK basically leaves your cornea with an open wound until it heals itself, so your eye will be more vulnerable to bacteria.
  • You may develop worse vision than before (due to undercorrection or overcorrection). You would then need to go back to using glasses or contact lenses. Or have additional surgery.
  • Blindness: There’s a tiny risk of damage that leads to partial or total loss of your vision.

Most complications are temporary and can be treated. Your eye doctor should help you consider the risks and rewards of PRK for myopia.

According to this review of patient satisfaction:

Although 91.8% of the patients were satisfied or very satisfied with their surgery, 96.3% considered that their main goal had been reached, and 95.7% would still choose to have surgery if they had it to do over.

What Is Better: PRK or LASIK?

With PRK, the outer layer of the cornea is removed, but then it regenerates itself after the surgery. This is the main difference from LASIK, where the surgeon creates a permanent flap in the deeper layers of the cornea.

prk vs lasik

PRK is more suitable for people who have thin corneas. It can also be a good choice for those who have dry eyes since the flap method can make dry eye complications worse.

PRK is also a better option if you practice contact sports regularly or have a very physical job that puts you at higher risk of eye injury. With LASIK, being hit or bumped in the eye can move the flap out of place, even after it’s healed. This can be very problematic. The additional step needed to create the flap is the reason why LASIK can be considered riskier.

As to the outcomes of both types of surgery, this review compared PRK and LASIK and concluded that the two approaches have similar results after a period of one year. However, LASIK has a much shorter recovery time and less pain. This is because the flap acts as a natural healing agent.

Overall, LASIK is more popular than PRK. Your doctor needs to evaluate your vision, eye health, overall health, lifestyle, and expectations to help you determine which method is the best for you.

The Conclusion on PRK for Myopia

In this article, we went over everything you need to know about PRK for myopia. While it has a high success rate, it’s important to know what to expect.

To be a good candidate for PRK surgery, you need to have overall good eye health and a stable lens prescription. The surgery itself is pretty quick and you feel no pain. After that, your doctor will keep up with you during recovery to ensure everything goes well. When compared to LASIK, PRK is safer but has a more challenging recovery.

Now that you understand how PRK works to correct myopia, the next step is to talk to a doctor you trust and discuss the best option for you, as well as any concerns you may have.

Have any questions? Don’t hesitate to leave them below in the comments!

Hugo Moreira

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Every single article in Myopia Daily is fact-checked to ensure the information is high-quality, medically accurate, and meets industry standards.

I have extremely strict sourcing guidelines and only cite from the most respected sources, including recent scientific research, peer-reviewed medical journals, government agencies, scholarly articles, certified optometry websites, and up-to-date textbooks.

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My passion for promoting eye health in communities around the world fuels me to create content that is factually reviewed not only by the most up-to-date scientific research but also by everyday expertise from my personal experience with being nearsighted since I was a child.