Photorefractive keratectomy (abbreviated as PRK) is a surgical procedure performed from 1987, considered as one of the oldest methods of refraction laser surgery.
The procedure involves the removal of the upper corneal cell layer (epithelium), followed by the appropriate fashioning of the underlying corneal tissue with the aid of an excimer laser. Such procedures are effective and safe, and above all guarantee the patients a marked improvement in their vision.
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Course of the surgery
At first, the face is cleaned with a disinfectant. The patient is given a local anesthesia in the form of eye drops. The eyelids are painlessly immobilized with the use of a retractor. The patient will gaze at a blinking light above throughout the operation. During the first phase, the upper corneal cell layer (flap) is manually folded back.
Next, the surgeon then removes a thin layer of the corneal surface with a very precise laser beam. The laser fashions and forms the corneal tissue in such a way, to eliminate the vision defect and the curvature of the cornea. The patient does not feel pain- the only thing he may experience is the sound of the laser. The whole procedure is controlled by the surgeon, and he oversees the laser usage with the help of a microscope.
During the final stage of the procedure using the LASEK/PRK method, soft, protective lenses are put in place to protect the eyes following the surgery. The protective lenses are removed by the surgeon after 2-4 days.
Before commencing the procedure, we thoroughly disinfect the patient’s entire face. Next the patient receives anesthetic eye drops, his eyelids are immobilized throughout the procedure by retractors. All of this is completely painless. During the procedure, the patient is asked to look at a blinking light above him.
Folding of the epithelium flap
In the first phase of the procedure, the surgeon manually removes the upper corneal cell layer, known as the epithelium (or flap). In newer generation of treatments (i.e. LASIK or Femto- LASIK) the flap is only folded, and not completely removed.
Correction with an excimer laser
The last phase of the laser vision correction procedure is eye protection with soft contact lenses with high oxygen permeability. They are removed 2-4 days later by the surgeon.
Protection of the eye following surgery
The last phase of the laser vision correction procedure is eye protection with soft contact lenses with high oxygen permeability. They are removed 2-4 days later by the surgeon
The difference between the various treatment methods is the process for removing the epithelium (or flap):
- PRK – the epithelium is completely removed after being softened by an alcohol solution.
- LASEK – the epithelium is folded back to the side prior to the laser procedure. After the laser vision correction, the attempt is made to place the epithelium fold back into place. It is not always possible.
- Epi-LASIK – komórki nabłonka są odłączane od właściwej tkanki rogówki za pomocą mechanicznego mikroskalpela (mikrokeratomu), aby po zabiegu możliwe było ich ponowne nasunięcie.
- No-Touch-PRK – the epithelial cells are detached from the stable corneal tissue with the aid of a mechanical microscalpel (microkeratome), so that the flap can be replaced after the procedure. No-Touch- PRK- the epithelium is precisely removed with the excimer laser before the proper correction is performed, thus the risk of infection is minimal. This is the most precise method of surface laser vision correction.
- EBK – the epithelium is precisely removed by an Epi-Clear knife.
After the operation, the patient notices an improvement in vision, but the eyes should be protected for the rest of the day. The regeneration of the cells following the operation takes about 2-3 days and may cause severe pain, because the upper layer of the cornea is removed. The pain can be relieved by taking painkillers. It is important to remember that the quality of vision may fluctuate during the first weeks or months following the procedure.