PRK / LASEK Laser Eye Surgery


PRK / LASEK eye surgery may be performed when a patient isn’t eligible for LASIK

What Is Photorefractive Keratectomy (PRK)?

PRK surgery, also called photorefractive keratectomy, is a refractive surgery that is used to correct refractive errors such as myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. PRK was the first refractive surgery procedure that used an excimer laser to reshape the cornea.

PRK was developed in the 1980s and was approved by the FDA in 1995. The excimer laser was approved for use in refractive surgery in 1988. PRK surgery was popular before the advent of LASIK surgery because it was the only laser vision correction procedure available.

PRK is similar to LASIK surgery in that it uses an excimer laser to reshape the cornea. The difference between PRK and LASIK is that in PRK surgery, the surgeon will first remove the surface layer of the cornea (the epithelium) before performing the laser vision correction. In LASIK surgery, a flap is created on the surface of the cornea and the excimer laser is used to reshape the tissue underneath the flap.

PRK surgery is often recommended for patients who are not suitable for LASIK surgery due to thin corneas or other factors. PRK surgery is also sometimes recommended for patients who have a high risk of developing corneal ectasia after LASIK surgery.

What Is Laser-Assisted Sub-Epithelial Keratectomy (LASEK)?

LASEK surgery is a type of refractive surgery that is similar to PRK surgery. In LASEK surgery, the surgeon will first use an alcohol solution to loosen and detach the surface layer of the corneal epithelium. The excimer laser is then used to reshape the cornea. After the laser vision correction is complete, the epithelium is replaced and will heal on its own.

LASEK surgery was developed in an effort to reduce the pain and recovery time associated with PRK surgery. LASEK surgery is often recommended for patients who have thinner corneas or for those who participate in an active lifestyle.

PRK / LASEK Laser Eye Surgery

LASEK and PRK laser eye treatments reshape the cornea to correct abnormalities in focus, as also happens in LASIK surgery. The difference here is that no flap is made in the cornea. These treatments are far less popular than LASIK, due to the significant pain post-operatively and the more prolonged healing (4 hours for LASIK and 4-7 days for PRK and LASEK).

Surface laser is chosen usually when the patient is not eligible for LASIK due to anatomical reasons.

Surface Laser Treatments

These treatments are sometimes called ‘surface laser’ to distinguish them from the LASIK approach. Most clinics perform LASIK for the majority of treatments and use PRK or LASEK in about 5-10% of cases. PRK/LASEK is especially suitable for those in contact sports or extremely active lifestyles.

In PRK and LASEK, the surface skins cells (epithelium) is removed and the underlying surface is exposed. After the laser application, the surface skin has to heal and this takes 3 to 4 days. It can be fairly painful during the first 3 days and the vision usually takes 3 to 5 days to be fairly clear. Patients often need several days off work.

PRK is usually chosen for anatomical reasons, typically a patient with thinner corneas where you want to avoid creating a LASIK flap. However, with the arrival of very predictable thin LASIK flaps, even some of these patients can now have the benefits of LASIK, e.g. no or little discomfort and very rapid clear vision, usually later the same day for LASIK.

Is PRK / LASEK Treatment Safe?

PRK has been around for 25 years and is a relatively simple procedure compared to Z-LASIK. In expert hands and at a specialist clinic, the risk of complications is very low. But of course, laser treatment IS still surgery and you should approach having vision correction in the right manner.

We believe coming to a single specialist centre, owned by our Medical Director and chief surgeon, has advantages for you. You will see the same people each time and our surgeons are usually available immediately to see and chat with you if you have any concerns. There is no head office that we have to report to. All of our attention is on your clinical care, and offered by clinicians.

Whilst LASIK will be the choice of many people at Focus, PRK / LASEK is sometimes the way to go. We recently for example treated someone who is active in MMA (Mixed Martial Arts) – LASEK was more suited to this particular individual.

PRK Laser Eye Process

The PRK laser eye procedure takes around 15 minutes per eye. This means that you can have both eyes done on the same day and usually go home the same day. Here's what you can expect on the day of your PRK treatment:

What Happens Before PRK Surgery?

You will have a comprehensive eye test with one of our experienced optometrists. If you wear contact lenses, you will be asked to stop wearing them for a minimum of two weeks before this appointment.

You will also have a series of measurements taken of your eyes using our advanced laser eye surgery technology. This is to map the surface of your cornea and help us plan your PRK treatment.

You will then meet with your eye doctor who will talk you through the PRK procedure and answer any questions you may have.

You will be asked to sign a consent form to confirm that you understand the risks and benefits of PRK surgery and are happy to go ahead with treatment.

What Happens During PRK

PRK surgery is usually performed under local anaesthetic eye drops, which numbs the surface of your eye. You will be awake throughout the procedure, but you shouldn't feel any discomfort.

Your surgeon will use an instrument called a speculum to open your eye wide. This helps to keep your eye from blinking and moving during treatment.

The next step is to access the corneal tissue. In PRK surgery, the outer layer of your cornea (the epithelium) is removed using a special brush or an alcohol solution. This step is necessary to allow the laser access to your cornea.

Once the epithelium has been removed, your surgeon will use an excimer laser to reshape the cornea. The laser removes very precise amounts of tissue from the cornea, which changes its shape.

After the laser has been used to reshape the cornea, a contact lens is placed over the eye. This helps to protect the cornea as it heals.

You will then be taken to a recovery area where you will be monitored for the next few hours.

What Happens After PRK

After PRK surgery, it is normal to experience some discomfort. Your eye may feel gritty and you may also have a headache. These symptoms can be relieved with painkillers and artificial tears.

Your eyes will also be very sensitive to light, so you should wear sunglasses when you are outdoors.

You will need to have regular check-ups with your surgeon over the next few months so they can monitor your eye health and vision. Most people will achieve the best vision between one and three months after PRK surgery.

During this time, you should avoid:

  • Swimming
  • Rubbing your eyes
  • Wearing eye makeup
  • Doing any activity that could damage your eye

If you have any concerns or questions about PRK surgery, our team are always on hand to help.

Who Is Eligible for PRK Surgery?

PRK surgery is suitable for most people who are looking to correct their vision. To be eligible for PRK surgery:

  • You must be over 18 years of age
  • Your vision must be stable for at least six months
  • You cannot be pregnant or breastfeeding
  • You cannot have any active inflammatory diseases of the eye
  • Your eyes must be healthy and free from any disease or injury
  • You cannot have had any previous eye surgery
  • Your refractive error must be within the range that can be treated with laser eye surgery
  • You must have a very active lifestyle
  • You must have a very thin cornea
  • You must not be taking any medication that could interfere with the healing process

If you meet the above criteria, then you may be eligible for PRK surgery. The best way to find out is to book a free consultation with one of our experienced surgeons.

Who Is Not Suitable for PRK Eye Surgery?

PRK eye surgery is not suitable for everyone. You may not be suitable for PRK surgery if:

  • You are pregnant or breastfeeding
  • You have an active inflammatory disease of the eye
  • Your eyes are not healthy or free from injury or disease
  • Your eye medical history is complex
  • You have had previous eye surgery
  • Your have advanced glaucoma
  • You suffer from uncontrolled diabetes
  • You are taking any medication that could interfere with the healing process
  • You have an unstable refractive error
  • You have a history of scarring
  • You have corneal abrasion
  • You have had a recent eye injury
  • You have dry eyes
  • Your skin is not suitable for contact lenses

If you are not suitable for PRK surgery, our team can offer alternative treatments. Some common alternative treatments include:

  • LASIK surgery
  • Refractive lens exchange surgery
  • Cataract surgery

What Are the Risks of PRK Surgery?

As with any surgery, there are risks associated with PRK surgery. However, these risks are very rare and our experienced surgeons will do everything they can to minimise them. Some of the risks associated with PRK surgery include:

Eye Infection

After PRK surgery, it is important to clean your eyes regularly to avoid infection. Our team will give you specific instructions on how to do this.

If you do develop an infection, it is important to seek treatment immediately. Eye infections can usually be treated with antibiotics.

Corneal Haze

Corneal haze is a rare complication of PRK surgery. It occurs when the cornea becomes cloudy and vision is affected. Corneal haze usually improves over time and does not require treatment. 

Dry Eyes

Dry eyes are a common side effect of PRK surgery. This is because the nerves that help to produce tears are lasered during the surgery. Dry eyes usually improve within a few months as the nerves regenerate. In the meantime, our team can offer treatment to help relieve the symptoms of dry eyes.

Glare and Halos

After PRK surgery, you may experience glare and halos around lights. This is usually a temporary side effect that improves within a few months. In some cases, glasses or contact lenses may be required to help with glare and halos.

How Much Does PRK / LASEK Cost?

Please visit our surgery prices page for more information. If suitable, you may wish to finance the surgery – please visit the pricing and finance section of the page for more information, as we have a variety of options.

Please call Focus Clinic on 0207 307 8250 to book your free consultation.

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Focus Clinic has a remarkable 100% success rate for 20/20 vision. We know of no other clinic that has matched these results. There is a big difference between, for example, 98% and 100% success, especially if you are in the 2%.

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Your 10 Year Guarantee means you can return at any time if you have additional questions on the quality of your vision. If you have distance vision correction for short-sight then any repeat laser eye treatments to correct a return of myopia in the first 10 years are included free of charge.*

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