Patients who wear soft contact lenses or rigid gas-permeable contact lenses should discontinue their contact lens wear at least 3 days or 3 weeks prior to the evaluation, respectively. Prior to the PRK procedure, one or more careful refractions (determinations of eyeglass correction needed) will be completed. Contact lens wearing patients who are believed to have an unstable refraction will be asked to discontinue contact lens wear and return for a repeat refraction in one to three weeks. After calibrating the laser properly, an eyelid holder is placed in your eye to keep it open throughout the procedure.

You will also be given some anesthetic drops to numb the eye and prevent pain.

With the laser, your surgeon prepares the eye by gently removing the epithelium, the eye's protective first layer of cells, which will naturally regenerate itself in a few days. This reveals the next layer of corneal tissue known as Bowman's layer. The surgeon will then smooth the area and proceed with applying computer-controlled pulses of cool laser light to precisely and delicately reshape the curvature of the eye. Deeper cell layers remain virtually untouched.

The entire PRK procedure is usually finished in less than five minutes and is painless. Since a layer about as thin as a human hair is typically removed, the cornea maintains its original strength.

After the procedure you are given antibiotic drops, along with anti-inflammatory agents to promote comfort and reduce any swelling that may occur. You may also be fitted with a bandage contact lens to improve your comfort while your eye is healing. Once the epithelium has healed, usually on the second or third day after the procedure, the bandage contact lens is removed by your doctor. Daily eye examinations are required during this initial healing process to ensure an infection does not develop.

As a PRK patient, you will use steroid anti-inflammatory drops for typically around 2 months under the direct supervision of your eye doctor to complete the healing process.

Post-operatively, most patients will need to be re-evaluated one day, three days, one week, one month, two to three months, and four to six months following the PRK procedure. The bandage contact lens can usually be removed on the second or third post-operative day when the epithelium is healed. Most patients will only require eye drops to control healing during the first 6 to 12 weeks, but other patients may require topically applied medications for up to 6 months or more following the procedure. In general, the greater the refractive error, the more likely the patient is to require eye drop medications for a prolonged period following the procedure.

PRK may be used to treat nearsightedness (myopia), farsightedness (hyperopia), and astigmatism. However, not all Excimer lasers are presently FDA approved to treat all three types of refractive errors. For example, some Excimer lasers are not yet FDA approved to treat farsightedness. Your surgeon can provide this information to you at your request.

PRK is an elective procedure which, like any procedure, has risks and benefits. In general, indications for surgery must include an appropriate level of nearsightedness, farsightedness, or astigmatism, as well as an educated and properly motivated patient with realistic expectations. The best candidate for PRK is an individual who desires to be less dependent on glasses or contact lenses, is willing to accept the risks of the procedure, and understands that an enhancement procedure may sometimes be required. The primary potential risks include postoperative glare, halos or starburst around lights at night, and infection in the cornea with loss of best corrected visual acuity. Fortunately, risks that threaten vision in the eye, such as infection in the cornea, are very rare.

Immediately after the procedure, a bandage contact lens will usually be applied to the eye. This contact lens is worn for the first 2 to 3 days until the surface epithelium is healed. Expect at least a few visits to your doctor during the first 6 months following surgery, with the first visit being one to three days following surgery. When the surface epithelium is healed, the eye will be comfortable, and the bandage contact lens is removed. Eye drops are required to prevent infection and control inflammation following surgery. Your vision will gradually improve. Generally, vision will be good enough to drive a car within two to three weeks following surgery, but your best vision may not be obtained for up to 6 weeks to 6 months following surgery.