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PRK and LASEK for farsightedness: Overview

Photorefractive keratectomy (PRK) and laser epithelial keratomileusis (LASEK) for farsightedness use a laser to reshape the cornea so that light is refocused on the retina. The laser reshapes the cornea accurately without damaging nearby tissues. No surgical cut is needed. Either procedure may be used to correct farsightedness and astigmatism at the same time.

These procedures can be done on an outpatient basis in a surgeon's office or same-day surgery center.

With PRK, surface skin cells of the cornea are removed, and a laser is used to reshape the cornea. The whole procedure, including preparation and surgery, takes about 20 minutes.

With LASEK, the surface layer of the cornea is loosened and pushed to the side. After the laser reshapes the cornea, the surface layer is placed back over the cornea.

PRK and LASEK are sometimes called surface ablation.

How can you care for yourself after photorefractive keratectomy (PRK)?

Activity

  • Ask your doctor when it is okay to drive.
  • Your doctor may advise you to sleep when you get home from surgery. Keeping your eye closed may help your eye heal.
  • You can shower or wash your hair the day after surgery. Keep water, soap, shampoo, hair spray, and shaving lotion out of your eye, especially for the first week.
  • Do not rub or put pressure on your eye for at least 1 week.
  • Ask your doctor when you can wear eye makeup again and get your hair colored.
  • Follow your doctor's instructions for when you can exercise and return to contact sports such as boxing or football. You may need to wear eye protection when you return to contact sports.
  • For 1 to 2 weeks, avoid swimming, hot tubs, gardening, and dusting.
  • Wear sunglasses on bright days for at least 1 year after surgery and avoid too much sun exposure.

Medicines

  • Your doctor will tell you if and when you can restart your medicines. The doctor will also give you instructions about taking any new medicines.
  • If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
  • Follow your doctor's instructions for when to use eyedrops. Always wash your hands before you put your drops in. To put in eyedrops:
    • Tilt your head back, and pull your lower eyelid down with one finger.
    • Drop or squirt the medicine inside the lower lid.
    • Close your eye for 30 to 60 seconds to let the drops or ointment move around.
    • Do not touch the ointment or dropper tip to your eyelashes or any other surface.
  • Follow your doctor's instructions for taking pain medicines.

How well do PRK and LASEK for farsightedness work?

PRK and LASEK work well to reduce mild to moderate farsightedness. But experts don't know how long the effects will last. In the short term, PRK has proved effective in correcting mild to moderate hyperopia.

How do you prepare for a photorefractive keratectomy (PRK)?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

What can you expect as you recover from PRK and LASEK for farsightedness?

You will wear an eye shield, a bandage, or special contact lens for 2 to 3 days after surgery. And your doctor will prescribe eyedrops to reduce inflammation and the risk of infection. You may need to use eyedrops for several months after surgery. Several follow-up visits are needed.

The eye can be quite painful for 2 to 3 days. Your vision will be reduced for several days after surgery, until the surface skin cells heal. Recovering from LASEK surgery may be less painful than from PRK.

After photorefractive keratectomy (PRK): When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have a sudden loss of vision.

Call your doctor now or seek immediate medical care if:

  • You have signs of an eye infection, such as:
    • Pus or thick discharge coming from the eye.
    • Redness or swelling around the eye.
    • A fever.
  • You have new or worse eye pain.
  • You have unexpected vision changes.
  • Your contact lens falls out.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You do not get better as expected.

After photorefractive keratectomy (PRK): Overview

Photorefractive keratectomy (PRK) is surgery to improve your vision. You can have PRK surgery in one or both eyes. The doctor used special tools to keep your eye open. The cells on the surface of your eye were removed or pulled to one side. Then the doctor used a special laser to remove tissue and reshape the outside layer of your eyeball (cornea). Afterward, the doctor placed a contact lens on your eye as a bandage.

Your eye will hurt, burn, or itch for 3 or 4 days after surgery. Your vision may be blurry, your eyes may water, your nose may run, or you may feel like there is something in your eye. But it is important not to rub your eye. Rubbing your eye could damage it.

Do not remove the contact lens in your eye. The doctor will remove this lens 2 to 4 days after surgery.

At first, your vision may be better. But it may get slightly worse. Sometimes it takes a few weeks to be able to see clearly. But you will probably be able to return to work or your normal routine in about 5 days.

It is common to be sensitive to light or to see starbursts or halos for 1 to 3 weeks. Most people will see well in a few weeks. But for some people, it takes 3 to 6 months to get the full benefits of surgery and to see as clearly as possible.

Your doctor will recommend or prescribe pain medicines. The doctor will also give you eyedrops to prevent infection and to help with dryness. Your eye may feel dry for 1 to 3 months after surgery.

Why are PRK and LASEK for farsightedness done?

PRK and LASEK are procedures done to correct farsightedness in otherwise healthy eyes.

They may not be a good choice for people who have more severe farsightedness (high hyperopia). That's because the results are harder to predict and complications are more likely.

These procedures may not be done while you are pregnant. Pregnancy may interfere with the healing of the cornea.

What happens on the day of a photorefractive keratectomy (PRK)?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Follow your doctor's instructions about when to bathe or shower before your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

  • Bring a picture ID.
  • The surgery will take about 20 to 30 minutes.
  • After the surgery, you will have a contact lens on your eye. You will be able to see through the lens, but it will be blurry. Your doctor may tell you to keep your eye closed as much as possible for up to 24 hours.
  • You will get drops in your eye. These will help it heal and prevent infection.

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The content above contains general health information provided by Healthwise, Incorporated, and reviewed by its medical experts. This content should not replace the advice of your healthcare provider. Not all treatments or services described are offered as services by us. For recommended treatments, please consult your healthcare provider.