101 PRK Questions

 

The San Diego LASIK Institute performs PRK for approximately ten percent of our patients. PRK is an option for some patients who are not candidates for LASIK in San Diego. These are some of the most common questions about custom PRK surgery that our patients have at the San Diego LASIK Institute.  Please visit our alternatives to LASIK page for more information about PRK.

 

 

101 San Diego PRK Surgery Questions, Facts, and FAQ's

A Local Custom PRK Surgery Guide for San Diego

 

Preoperative Questions:

1. What does the acronym PRK stand for?

Photorefractive Keratectomy.

2. When was PRK first performed?

PRK has been performed since the mid 1980s. Once LASIK was invented, LASIK became the most popular procedure due to the faster recovery times with LASIK. In the last several years, PRK has been increasingly performed in the United States again. This is because patients who may not be candidates for LASIK will often do better with PRK.

3. Who is a good PRK candidate at the San Diego LASIK Surgery Institute?

Patients who are not candidates for LASIK surgery in San Diego may be candidates for PRK. PRK is often a better option for patients who have thin corneas or severe dryness. It is important that you be in good medical and ocular health if you are considering PRK at the San Diego LASIK Institute. No website can determine if you are a candidate for PRK so it is best to obtain a free consultation with Dr. Pham.

4. When is PRK an alternative to LASIK surgery?

PRK is a good alternative to LASIK if you have thin corneas. PRK surgery removes less tissue from your cornea so that it is a safer option if you have thin corneas. Also, PRK may be a better option for patients with severe dry eye syndrome. While all laser IntraLASIK is approved for the military, certain people with high risk for eye trauma may choose to have PRK instead. For example, professional boxers or martial artists who may constantly be hit in the eye may consider PRK since there is no creation of a corneal flap in PRK surgery in San Diego. Also, patients with corneal scars, corneal erosions, and other corneal diseases may be treated with PRK when LASIK is not a good option. PRK is also a good option for patients who have had radial keratotomy. We offer PRK at the San Diego LASIK Institute for patients who are not candidates for LASIK as well as patients who are at extremely high risk for ocular trauma due to their professions.

5. How are PRK and LASIK different? 

In order for the excimer laser to change your cornea, it must be able to change the central area of your cornea. The cornea has 5 layers. The superficial layer of the cornea is called the epithelium. Like the epithelium of your skin, the cornea's epithelial layer is constantly changing. In order to permanently change your cornea, we need to change a deeper layer in your cornea called the corneal stroma. LASIK and PRK differ in the method to gain access to the corneal stroma. In LASIK, a flap is created with the Intralase laser. Next the VISX laser remodels your corneal stroma so that you have improved vision without glasses. The flap is then gently repositioned. Since a corneal flap is made, the recovery from LASIK is fast and relatively painless. In PRK, the cornea epithelium is removed to gain access to the corneal stroma. The VISX laser is then used to remodel your cornea. Since the corneal epithelium is removed, your eye will be in pain for a few days after surgery. It will also take longer for your vision to recover.

6. What are the potential drawbacks to PRK surgery in San Diego?

The recovery for PRK surgery is very different from LASIK surgery. Often, patients who have LASIK surgery at the LASIK Institute have very fast recoveries and are performing their normal activities the day after surgery. With PRK, there is some pain and discomfort to the recovery process and it may take a few weeks before you have your best vision. At the San Diego LASIK Institute, we give you medications to help with your healing and to decrease any pain or discomfort from the surgery as much as possible.

7. Can I get a custom treatment with PRK surgery?

Yes, the laser that actually changes the cornea so that you can have improved vision without glasses or contacts is the same regardless of whether you have LASIK or PRK. At the San Diego LASIK Institute, we use the Advanced Custom VISX Star S4 laser system for your treatment. You can have Advanced Custom PRK at the San Diego LASIK Institute.

8. What age is a good age to consider PRK?

Age is just one of the many variables that we examine to determine if you are a candidate for PRK. Regardless of age, we recommend that your eyes are stable and that your prescription is not rapidly changing. Although the minimum age to obtain PRK surgery is 18, we recommend a minimum age of 21 years unless you have long standing stability in your eyeglass prescription.

9. I am nearsighted or myopic, does PRK correct that?

Yes, the FDA has approved several different Laser systems to treat nearsightedness.

10. I am farsighted or hyperopic, does PRK correct that?

Yes, the FDA has approved several laser systems including the VISX laser to treat farsightedness. However, PRK in hyperopic patients has higher levels of regression. It is important to discuss with Dr. Pham the best treatments for your hyperopia at the San Diego LASIK Institute. Many hyperopic patients will do better with LASIK in San Diego.

11. Can my astigmatism be treated by PRK?

Yes, astigmatism can be treated by the VISX S4 Excimer laser used at the San Diego LASIK Institute.

12. Am I too young to have PRK?

Most PRK surgeons recommend that your eyes have refractive stability before PRK surgery.

13. Am I too old to have PRK?

There is no definite age cut off for PRK surgery in San Diego. However, it is important that cataracts and other eye diseases are ruled out in patients over 60.  

14. Does pregnancy affect PRK?

You can have PRK before of after your pregnancy. It is important to not have PRK while you are pregnant or nursing. When you are pregnant, your hormones are at elevated levels and this can affect the stability of your prescription.

15. I take Accutane, should I stop it before PRK?

The San Diego LASIK Institute recommends that you stop Accutane prior to surgery.

16. I have a history of keloids, does that affect my PRK surgery?

Keloid formation is no longer a counterindication to having PRK surgery in San Diego.

18. How long do I have to be out of my contact lenses before I can have my PRK surgery in San Diego?

The San Diego LASIK and PRK Institute recommends that you discontinue soft contacts for 1-2 weeks before your surgery. If you wear hard contact lenses, we recommend that you discontinue your contacts for longer.

19. Why do I have to stop my contact lens uses?

The contact lens changes the shape of your cornea temporarily. Since it sits on the cornea, we need your cornea to return to its normal shape before your PRK surgery at the San Diego PRK Institute.

20. Can I play sports after PRK?

PRK is the ideal refractive procedure for people who have a high risk of contact to their eyes.

21. What about high risk sports like boxing or martial arts?

Custom PRK is the preferred form of laser vision correction for people who are involved in martial arts or boxing.

21. I have a medical condition, can I have PRK surgery at the San Diego PRK Institute?

It depends on the medical condition. We would recommend you discussing your condition with your PRK surgeon to see if it is a possibility.

22. What are some of the reasons why I would not be a good candidate for PRK?

• medical or eye disease
• unrealistic expectations

23. Are most people good candidates for PRK?

Most people are good candidates for Custom PRK in San Diego. The best way to tell if you are a candidate is to have an evaluation with Dr. Pham.

24. I take Imitrex, can I have PRK?

You should discuss this with Dr. Pham.

25. I have strabismus, can I have PRK?

It depends on the nature and extent of your strabismus. Dr. Pham would be happy to evaluate you to see if you are a good PRK candidate in San Diego.

26. I have had previous eye surgery, is PRK an option for me?

PRK may be the preferred treatment for people with previous eye surgery.

27. I have had RK (radial keratotomy), is laser vision correction an option for me?

It is possible to have PRK after RK surgery.

28. What kinds of tests do I have at my initial free PRK consultation at the San Diego PRK Institute?

At the San Diego LASIK and PRK Institute, we examine your refraction, corneal examination, corneal thickness, and advanced imaging of your eye to determine if you are a candidate. We also evaluate your occupational needs and any other concerns with you personally.

29. What is an informed consent?

It is important for you to have all the information regarding the possible outcomes and complications of your surgery. At the San Diego LASIK Institute, we strive to provide you with as much education and information as possible so that you can make an informed decision about your PRK surgery.

30. What are unrealistic expectations?

Unrealistic expectations occur when a patient does not have practical expectations from the PRK surgery. It is important to have an informed consent that addresses the expectations you have with the PRK surgery at the San Diego LASIK Institute.

31. Do you do both eyes for PRK at the same time?

Yes

32. Do you make a flap with PRK?

PRK is flapless laser vision correction. There is no flap that is made when you have PRK surgery.

33. What is LASEK?

LASEK is very similar to PRK. In PRK, the epithelial cells of your eye are removed prior to your laser treatment. In LASEK, the epithelial cells are repositioned onto your eyes.

34. What is advanced surface ablation?

Advanced surface ablation is a group of laser vision correction techniques that do not involve the creation of a corneal flap. PRK, Epi-LASIK, and LASEK all refer to these procedures.

35. What is Custom or CustomVue PRK?

Custom PRK is PRK that is tailored to your eyes individual refractive errors. A wavefront is used to map out your cornea. In several studies, it has shown to have higher patients with better qualitative and quantitative vision. Although Custom laser vision correction is primarily approved for LASIK, it can be used in PRK as well.

36. What is standard or Non Custom PRK?

Standard PRK may be a good option for many patients. It treats your eye based on your prescription only and does not incorporate wavefront technology.

37. How can I afford PRK?

Currently, the San Diego LASIK Institute offers 24 months of 0% financing on approval of credit. Financing has made PRK surgery in San Diego more affordable. We offer 0% financing to make your payments even lower.

38. Are there different types of lasers that a PRK surgeon can use?

At the San Diego LASIK Institute, we constantly evaluate the literature and research which are the best lasers for your eyes.

39. What is iris registration or Advanced CustomVue PRK Surgery?

Iris registration is Advanced Custom LASIK. It incorporates any "torsion" or rotation of your eye at the time of your PRK surgery.

40. What if my eyes move during the surgery?

Your eyes are actively tracked by the laser and Dr. Pham. The Visx PRK excimer laser tracks your eyes in an "X", "Y", and "Z" axis so that your PRK surgery at the San Diego PRK Institute is accurate. If your eyes move out of the appropriate range, the laser will stop its treatment temporarily.

 

Questions about your PRK surgery day at the San Diego PRK Institute.

41. Should I start drops before surgery?

Yes, Dr. Pham recommends you start an antibiotic drop and a steroid the day prior to surgery.

42. Can I wear makeup the day of surgery?

No.

43. Can I wear perfume or aftershave?

No.

44. Should I take my regular medications?

Yes.

45. How should I dress?

You should dress warmly and comfortably for your PRK surgery.

46. Should I bring money or valuables?

Please leave them at home prior to your San Diego PRK surgery

47. Am I given medications to relax at the time of my PRK surgery with the San Diego PRK Surgery Institute?

Yes, we generally give you a 5 mg Valium dose to help you to relax. We can give you an additional dose based on your level of anxiety or your weight.

48. Am I awake during the surgery?

Yes, we need you to stay awake and follow instructions during the surgery.

49. How do you numb my eyes?

We give you a numbing eye drop prior to your PRK surgery.

50. Are my eyes cleaned prior to surgery?

Yes, your eyes are cleaned prior to surgery. Sterile drapes are also applied.

51. What are the steps to surgery?

First, we insert an eyelid retractor to keep your eyes open. You do not have to worry about blinking. Next, we remove your corneal epithelium. The Visx PRK laser is used to do your treatment. A medication is then applied to help with your healing. A bandage contact lens is then placed onto the eye.

52. Is something used to keep my eyes open?

Yes, an eyelid retractor is used to keep your eyes open during the PRK surgery.

53. How should I dress during the PRK procedure at the San Diego PRK Institute?

You should dress warmly and comfortably. The temperature and humidity are well controlled and we do not want you to be cold.

54. What will I feel during my San Diego PRK surgery?

You may feel a little bit of pressure on your eye. The surgery will be approximately five to eight minutes per eye.

55. What else may I feel?

You may feel some "coolness" after the procedure.

56. What happens once the corneal epithelium is removed?

You will be asked to look at a blinking red light.

57. How long is the PRK treatment?

It depends on the degree of nearsightedness, farsightedness, or astigmatism. It can range from just a few seconds to over a minute. Most people have their treatment time under thirty seconds.

58. What happens after the San Diego PRK treatment is done?

A bandage contact lens is placed on your eyes.

59. Do I wear goggles?

Yes. You will wear sunglass goggles right after your PRK surgery. We pick the most stylish and protective ones that we can find. You wear them until the next morning and then can take them off. It is recommended that you wear sunglasses for the first few months after PRK at the San Diego LASIK Institute.

60. How many nights do I have to wear the goggles?

We recommend you wearing them at bedtime for the first 4 nights after your PRK surgery in San Diego.

 

Common Post Operative PRK Surgery Questions

61. What should I do right after the surgery?

You should sleep.

62. What kinds of sensations will I have after surgery?

You may have some light sensitivity and discomfort. Topical and oral medications are given to help to minimize your discomfort.

63. Do I have to take drops after the PRK surgery?

Yes, you have to take antibiotic and anti-inflammatory medications. We will give you a detailed description of the process.

64. When can I shower?

You can shower the day after your PRK surgery. Just keep your eyes away from dirty water and be careful.

65. When can I swim?

Two weeks.

66. What kind of things should I avoid?

Please do not rub your eyes. Please avoid dusty and dirty environments after your PRK surgery for 2 weeks.

67. When can I have strenuous exercise?

Two weeks.

68. When can I return to work?

If your work environment is clean and you avoid strenuous exercise, you can return to work in 4-7 days after your PRK surgery. It depends on your healing process.

69. Can I drive myself in the next day after PRK in San Diego?

It is best to have a driver during your healing process after PRK

70. Can I drive myself home the day of the PRK surgery?

No, you should have a driver. You will be given a valium and should not operate machinery will on valium.

71. How much pain is there after PRK?

The pain level is variable after PRK surgery at the San Diego LASIK Institute. Some people have mild discomfort while others have a considerable amount of pain.

72. How can I decrease my discomfort?

After your San Diego PRK surgery, many drops and oral medications are given to help control your pain. We recommend that you sleep as much as possible. We also recommend using cold compresses to decrease your discomfort.

73. Why is a bandage contact lens placed?

A bandage contact lens is placed to help you heal well with decreased pain.

74. When is the bandage contact lens removed after PRK?

The bandage contact lens is removed after your corneal epithelium has healed. This typically occurs by the third day after your PRK surgery in San Diego but may take longer.

75. Do I need to have additional appointments after my PRK surgery in San Diego?

Yes, it is very important for you to make your appointments after PRK surgery. Dr. Pham needs to examine your eyes regularly to make sure that you heal well.

76. Why does the recovery process take longer with PRK than with LASIK surgery in San Diego?

In LASIK surgery, a corneal flap is made. The cornea flap is immediately repositioned to allow you to have a very fast recovery. In PRK, no corneal flap is made. Thus, there is an area of your cornea that needs to heal after your PRK.

77. How does vision compare with LASIK after PRK surgery?

The vision after PRK is as good if not better than LASIK surgery for most patients. At the San Diego LASIK Institute, we have a very high rate of patient satisfaction and 20/20 vision after PRK surgery.

78. Why do you recommend that I take Vitamin C after my San Diego PRK surgery?

Vitamin C will help you with your healing process.

79. What is corneal haze?

Corneal haze was much more common when PRK was first used. It is a form of mild corneal swelling after PRK surgery. It is much less common now with the invention of the variable spot scanning lasers as well as the use of Mitomycin-C.

80. What is Mitomycin-C and why is it used for my San Diego PRK surgery?

Mitomycin-C is a medication that is used to prevent corneal haze. With mitomycin-C, corneal haze is rare.

 81. When am I seen again?

We will see you the next day after your PRK surgery at the San Diego PRK Institute.

82. What is the normal postoperative follow-up?

We see you one day, three days after, one week, one month, three months, six months, and a year after your PRK surgery.

83. What are common PRK side effects?

Dryness and glare and halo at night are common side effects.

84. How do you treat or prevent dryness?

You can treat dryness with tear drops. Occasionally, you may need plugs to help you improve your tear flow. We do these FREE at the San Diego PRK Institute. PRK is associated with less dryness than LASIK.

85. What is an enhancement?

Sometimes after PRK, your eye may regress or grow back towards your previous prescription. We may recommend an enhancement if your eye is healthy to correct this. Our enhancement rates are well below 2% while the national average is 10%.

86. What kind of post-operative medications do I take?

You are generally given an antibiotic and an anti-inflammatory medication.

87. What is Restasis?

Restasis is a medication that Dr. Pham may give you to prevent or treat dry eyes after PRK.

88. Which types of patients tend to have dry eyes more?

From Dr. Pham’s experience, patients with a prior history of dry eye, patients in their 40 and 50’s, women, and farsighted patients may have slightly more dry eyes after PRK surgery.

89. What is an under correction?

A treatment that does not fully treat the patient’s correction.

90. How do you treat an under correction?

With an enhancement. Dr. Pham’s enhancement rate is much less than 2%. Her personally checks and refracts your eyes multiple times before surgery.

91. What is an overcorrection?

PRK patients may sometimes be overcorrected initially. In patients under thirty, this may be advantageous. However, for patients over forty, they may not tolerate it. It is generally advised to wait several months before considering a treatment. Overcorrection can resolve over time.

92. Will I have to use reading glasses after PRK?

If you are over forty, you may have to use reading glasses after PRK. However, for most of your distance activities like driving or watching TV you will likely do very well. An option to have both near and far vision after PRK in your forties would be mono vision.

93. Can I wear makeup right after PRK?

Please abstain from mascara use for at least 5 days.

94. Can I eat or drink anything I would like?

Please resume your normal diet. However, please abstain from alcohol use for the first few days after surgery. It is important to avoid alcohol while you are taking oral pain medications.

95. Are there alternatives to PRK?

Yes, they include glasses or contacts, LASIK, and the implantable contact lens.

96. What are the surgical alternatives to PRK?

PRK, lensectomy, the Implantable Contact Lens, and Multifocal Lenses are alternatives that we offer at the San Diego PRK Surgery Institute.

97. Is PRK the main surgical option for most patients at the San Diego PRK Institute?

All laser LASIK is the main surgical option. However, for about 10-15% of patients, PRK will be a safer surgery.

98. When will Dr. Pham recommend the other technologies?

When you are not a candidate for PRK.

99. Does this website have all the information about PRK surgery in San Diego?

Unfortunately, no. There is no website that can address all the questions that you may have about PRK. This website is not a substitute for an examination with a PRK surgeon.

100. What is the best way to learn if I am a candidate for PRK?

Please schedule a free consultation with us.

101. How can I learn more about PRK Surgery in San Diego?

Please call to schedule your FREE PRK consultation.

LASIK Surgery San Diego