Photorefractive Keratectomy (PRK)

PRK and LASIK are outpatient procedures that correct refractive errors. Refractive errors are problems with light bending properly as it passes into your eyes. They cause blurry vision and dependence on glasses or contact lenses. Your surgeon will use a laser to change the shape of your cornea -- the clear outer layer at the front of your eye. This allows your eye to focus properly and improve vision. After you recover from surgery, you may not need to wear glasses or contact lenses. The quality of long-term vision from PRK is generally the same -- or even better -- as with LASIK.

During PRK, a layer of cells on the surface of your eye is removed and a laser is used to reshape your cornea. As you heal, a normal layer of cells grows back. With LASIK, your surgeon creates a permanent flap on the surface layer of your cornea. With significant eye trauma, the LASIK flap could move or become dislodged. For patients with certain occupations or hobbies -- for instance, for firefighters or boxers -- PRK may be a safer choice. PRK may also be recommended for people with thinner or irregular corneas because it does not disrupt corneal tissue as much as LASIK.

To determine if you are a good candidate for PRK, you will undergo a complete evaluation of your eyes. You should not wear contact lenses the week before your evaluation. A technician will perform a basic eye exam, imaging, and diagnostic testing. Then your eyes will be dilated, and a refractive surgeon will examine them to determine if PRK is a good option for you. You must be 18 or older to be considered for PRK. 

Certain conditions may prevent you from having PRK, for example, having keratoconus or cataracts. In these cases, our surgeons may recommend other refractive procedures. They will help you understand your options to achieve the best possible vision. 

Because PRK is an elective procedure, it is not covered by insurance. Our evaluation exams are free, and the cost of the PRK procedure includes the surgery, all follow-up appointments, and a follow-up procedure if your vision requires fine tuning later. We follow you closely, especially in the year after PRK, to ensure the results meet your expectations. 

If you and your doctor decide PRK is the best choice for you, you can schedule surgery right away, or our office can contact you later to schedule surgery. We will answer your questions and explain how to prepare for surgery, what surgery entails, and the recovery process. If you wear contact lenses, you will be asked to wear glasses instead for several weeks before surgery. You will need someone to drive you to and from your outpatient procedure. 

Your eyes will be examined before surgery to confirm your eye health and your exact vision-correction requirements. You will be given drops to numb your eyes before the surgery, and you may also be given a mild sedative to help you relax. A clear contact lens is placed at the end of surgery to protect your eye as it heals. This will be removed a week after your procedure. Although you can expect to spend two to three hours at the Eye Center, the surgery itself takes just a few minutes. 

After PRK, you will go home wearing your protective contact lenses and sunglasses or protective eye shields. You will need someone to drive you. You may have some eye pain or discomfort for two or three days, but you can take a prescription or an over-the-counter pain reliever. 

Your vision may be hazy after PRK but will improve after three to five days. It may take a month or more before you see full improvement. An initial follow-up appointment will be scheduled for one week after surgery. 

You can expect the results of PRK to last until there is a medical change in your vision. For example, presbyopia -- the loss of reading vision -- can occur as part of the natural aging process, even if you have had PRK.
 

Our vast experience and regular use of the most advanced technology ensure you achieve better vision. Duke PRK surgeons are cornea specialists who have additional training in laser vision-correction procedures including LASIK, implantable contact lenses (ICL), or a clear lens exchange. We also perform PRK enhancements if you have undergone refractive surgery at another center and are not satisfied with the results.

Our doctors work with you from your first evaluation through all your follow-up visits. If you prefer, we can coordinate follow-up care with your local eye doctor. 

Our eye surgeons are board-certified ophthalmologists who are fellowship trained, which means they have completed advanced training in cornea and refractive surgery. Collectively, our surgeons have performed more than 28,000 refractive procedures since Duke began offering them nearly 30 years ago.