PRK surgery was the first ever type of vision correction surgery to be developed. It uses laser technology to reshape the cornea in order to correct short-sightedness, long-sightedness and astigmatism.
Approximately 80% of patients who undergo PRK surgery achieve 20/20 vision or better, with the risk of complications occurring as a result of the treatment being very low.
Prices for PRK surgery start at around £1,100 per eye, but most well-known clinics provide their patients with the option of paying for the procedure on finance to make it more affordable.
What Is PRK Surgery?
PRK surgery, or photorefractive keratectomy, is a type of laser eye surgery used to correct myopia (short-sightedness), hyperopia (long-sightedness) and astigmatism. During PRK surgery, the very top layer of your cornea (known as the epithelium) is removed. A laser is then used to reshape the corneal tissue below to correct your vision defects. The treatment only takes a couple of minutes to perform but produces results that can last a lifetime.
PRK surgery was actually the first ever vision correction procedure in which ophthalmologists reshaped the cornea (the clear ‘window’ at the front of the eye) using lasers. Since, it has inspired the development of a wave of different types of laser eye surgery, including LASIK and LASEK.
Am I Eligible?
You should book a consultation with an ophthalmologist who will be able to determine your eligibility for PRK surgery. In general, individuals who are not eligible for LASIK eye surgery are a suitable candidate for PRK surgery. This includes those who have very thin corneas or who unable to sit still.
You will often be deemed a good candidate for PRK surgery if the following applies to you:
- You are over the age of 18 years old
- Your vision has been stable for at least 12 months (i.e. your prescription hasn’t changed)
- You have no abnormalities or diseases of the eye such as keratoconus or glaucoma
- You have no autonimmune diseases or an autodefficiency
- You are not pregnant or breastfeeding
It takes approximately 15 minutes to perform PRK surgery on each eye. The treatment is carried out on an outpatient basis, meaning you won’t need to stay overnight – you can leave the clinic immediately after the procedure is completed, so long as your surgeon is satisfied that everything went well.
Below we have put together a step-by-step guide about what to expect on the day of your PRK surgery:
- You will undergo a thorough eye examination with an ophthalmologist to make sure you are suitable for PRK surgery. This will include some questions about your eye health and an assessment of the thickness and curvature of your corneas, the moistness of your eyes, and the size of your pupils.
- If you wear contact lenses you will be required to remove them and use glasses instead for at least 3 days before your surgery. This is because contact lenses can change the shape of your cornea. This can cause PRK surgery to become less effective at correcting your vision.
- Anaesthetic drops will be administered to your eyes to numb them. An instrument known as a lid speculum will then be applied to each eye to keep them open during the surgery and prevent you from blinking.
- Your surgeon will gently remove the top layer of your cornea (the epithelium) to expose the corneal tissue below. This will be done using a dilute alcohol solution or with a tool called a ‘buffing device’.
- Your surgeon will then direct an excimer laser over your eye. You will be asked to look at a small target light positioned directly above you, while pulses of ultra-violet light are emitted onto your cornea. This will remove microscopic amounts of tissue, reshaping your cornea to correct your vision.
- Once one eye is operated on, your surgeon will then operate on your other eye immediately after. However, your surgeon may recommend that you leave a gap of several days between each operation.
- A bandage contact lens will be applied over each eye to protect them and allow them to heal.
- You will be taken to a recovery room where you will be asked to rest for a short period of time after the surgery. During this time, your surgeon may carry out some tests to check your eyesight and ensure the surgery went as planned.
- You will be prescribed some general anti-pain medication as well as some topical antibiotics which you must apply to your eyes to prevent infection and keep them clean.
- Your surgeon will give you some post-operative care instructions which you must follow to ensure your recovery from PRK surgery goes well.
- You will not be permitted to drive immediately after surgery, so you must find an alternative form of transport home.
- You will need to attend a follow-up appointment with your surgeon in the week after the treatment. During this appointment, your surgeon will monitor your recovery and check that you are satisfied with the outcome of the surgery.
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PRK Recovery Time
The recovery time from PRK surgery is often longer than recovery from LASIK eye surgery. It can take a few weeks for your eyesight to show improvements, and several months for your vision to fully recover. Despite this, 80-90% of patients achieve 20/20 vision after undergoing PRK surgery. Below is a timeline that outlines a typical recovery from PRK surgery:
- 1 - 3 days: You will experience mild irritation and some discomfort, as a result of light sensitivity and your epithelium being removed.
- 4 days – 1 week: Your vision may be a bit hazy or blurry, but you should be seeing at least 20/40 vision. Discomfort should have subsided by now.
- 1 week – 3 months: Your vision will continue to get better, as your epithelium grows back and is smoothed out. You may experience starbursts and halos at night, but this will soon fade away.
- 3-6 months: You should have returned to your normal lifestyle, and your vision should be clear and stable.
Although the success rate for PRK surgery is high, like with any operation there are some complications that can occur as a result of the treatment. Potential complications include:
- Dry eyes: this is quite common, as PRK surgery is known to make the eyes drier than what they were before treatment. This can be easily treated using lubricating eye drops.
- Worsening of vision: very rarely, some patients experience a permanent decrease in the quality of their sight following PRK surgery, in which their vision appears hazy. This is most common in those with very high short-sightedness or astigmatism.
- Over-correction: this occurs when your refractive error is corrected more than was intended. For example, if you had short-sightedness before PRK surgery, overcorrection would lead you to become long-sighted after the surgery. Over-correction can be treated using a second course of laser eye surgery.
- Under-correction: this happens when your refractive error is corrected less than was planned. For example, if your long-sightedness was under-corrected during PRK surgery, you will still be slightly long-sighted following the procedure. Like with over-correction, under-correction can be treated using a laser eye surgery touch-up.
- Recurrent corneal erosions: this occurs when part of the epithelium (which has grown back following PRK surgery) can slip off. While very rare, it can be painful causing your eye to sting and water for up to several hours. Once a corneal erosion has occurred, it tends to re-occur over several months. Recurrent corneal erosions can be treated using medication and further laser eye surgery.
- Corneal ectasia: this occurs when your corneal tissue becomes weak, causing your eye to bulge outwards and distorting your vision. Corneal ectasia is a very rare complication of PRK surgery, and can be treated using methods similar to those used to treat keratoconus.
Your ophthalmologist will talk through all of the complications that can arise from PRK surgery, and will discuss with you how they are treated. If you experience any of the issues mentioned above, it is important to visit your ophthalmologist or GP as soon as possible for medical advice.
PRK Surgery Cost
The average cost of PRK surgery in the UK is approximately £1,780 per eye, although the price does vary between clinics. There are actually not that many clinics that offer this treatment in the UK today. This is because newer and more technologically advanced versions of laser eye surgery are preferred by surgeons, such as LASIK eye surgery, due to their shorter recovery time. Nonetheless, the table below shows you the cost of PRK surgery from some leading eye surgery clinics:
|Clinic||Starting Price (Per Eye)|
|London Vision Clinic||£2450|
If you are worried about paying for PRK surgery in one lump sum, most clinics provide their patients with the option to pay for the treatment on finance. This makes the surgery more affordable by breaking up the cost into small monthly payments. These are paid back over a fixed period of time, typically between 12 months and 24 months. Most finance agreements will involve a fixed interest fee (APR) which will be added onto each monthly payment, yet some clinics do offer interest-free finance options. To find out more about paying for PRK surgery on finance, visit our laser eye surgery cost page.
Is It Available On The NHS?
Unfortunately, PRK surgery is not available on the NHS to those who want to have the procedure to correct a refractive error, such as long-sightedness or short-sightedness. This is because there are other treatments available which can successfully correct these conditions, such as prescription glasses or contact lenses. However, there are exceptional circumstances when PRK surgery is provided on the NHS. This includes those with a sight-threatening condition whose vision can be saved by having the treatment. If this refers to you, you should visit your GP or optician who will pass you on to an NHS eye care specialist if they believe you might be a suitable candidate.