PRK

Photorefractive keratectomy (PRK) is a laser eye surgery that reshapes the cornea to correct refractive errors, primarily myopia with or without astigmatism, and to a lesser extent hyperopia. Developed in the 1980s, PRK was the first widely used excimer laser procedure for vision correction and remains an option when flap-based procedures are less suitable.

During PRK, the corneal epithelium—the outer cell layer—is removed either with a chemical solution or by mechanical debridement. An excimer laser then ablates a precise amount of stromal tissue to change the cornea's curvature. Because no corneal flap is created, PRK avoids flap-related complications common to LASIK.

Recovery typically involves a longer healing period than LASIK. Eye discomfort may persist for several days, and vision can fluctuate for weeks as the epithelium regrows. Patients use prescribed antibiotic and steroid eye drops, and a bandage contact lens may be used during healing. Final vision improves gradually over weeks to months.

Candidates are adults with a stable prescription, adequate corneal thickness, and realistic expectations. PRK is often recommended for very thin corneas, active contact sports, or occupations where a corneal flap could be problematic. It is less suitable for those with untreated dry eye or certain corneal diseases.

Risks include corneal haze, infection, dry eye, glare or halos, under- or overcorrection, and rarely regression of the refractive effect. Most patients experience improved vision, but some may require enhancements later.

Compared with LASIK, PRK avoids a corneal flap and preserves more structural tissue but entails longer recovery and more transient discomfort. Long-term outcomes are comparable for appropriately selected patients.

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