PRK (Photorefractive Keratectomy) and Its Cost
PRK (Photorefractive Keratectomy or Flapless Vision Correction) is our most affordable vision correction option. This procedure has been performed successfully throughout the world over the past 20 years. It is the procedure of choice for patients with very active lifestyles, military personnel, and patients with certain eye conditions such as thin corneas. Almost every patient with healthy eyes will qualify for this procedure. For this reason, it is a good choice for your laser vision correction procedure.
What is PRK?
PRK, or photorefractive keratectomy, is a laser eye surgery that works to correct various vision impairments that include astigmatism, farsightedness, and nearsightedness. It involves reshaping the cornea with an excimer laser, which uses a short wavelength light with a cool, pulsing beam to remove tissue. The laser is used on the surface of the cornea where cells are removed to access the cornea as opposed to creating a flap and going underneath it; which is how LASIK eye surgery is commonly performed. Most patients recover from the procedure with 20/20 to 20/15 vision, making it an effective and highly favorable process that is safer than LASIK and has a lower risk of complications during the post-op period as the cells naturally regrow over the surface of your eye.
PRK is similar to LASIK eye surgery, as both reshape the cornea, but differ in advantages, cost, and recovery time. There are three types of PRK surgery, which include traditional PRK, alcohol-assisted PRK, and transepithelial PRK. Traditional PRK removes the corneal epithelium with an amoils brush. Alcohol-assisted PRK uses alcohol to remove the corneal epithelium. Alcohol-assisted PRK is often considered a more gentle procedure that is less abrasive on the eye and has a lower level of discomfort during the recovery process. Transepithelial PRK relies on an excimer laser to remove the corneal epithelium at the same time that the corneal reshaping is being performed for a one-step method that is efficient.
History of PRK
The first type of modern refractive eye surgery was introduced in 1974 and is called radial keratotomy, also known as RK. The procedure involved making small incisions with a scepter on the cornea for those who suffered from nearsightedness(myopia). It increased in popularity and evolved with efficiency until the mid-1980s. Several advancements in technology over the years made for a safer process that offered better, clearer vision.
Since the 1990s, PRK has been performed throughout the world with a high success rate that has allowed it to maintain popularity. It began in the U.S. in 1995 and was the first eye surgery to involve a laser when operating on the cornea, as opposed to a knife. Although patients originally underwent the procedure to repair myopia, the surgery has since improved and can now repair both astigmatism and farsightedness. In fact, Dr. Rothman is on the leading front of surgeons helping patients in their 40’s and 50’s get out of their readers for good!
Candidates for the Procedure
For those who are considering PRK laser eye surgery to correct specific eye conditions, the most ideal candidates include those who have a very thin cornea. Thin corneal tissue implies that there may not be enough tissue to safely operate, eliminating candidates for LASIK because a flap cannot be made. Patients who have scars or irregularities on their cornea are also better candidates for PRK, since a flap is not necessary. PRK is most likely to benefit individuals who suffer from eye conditions that include nearsightedness or farsightedness.
Each patient must be at least 18 years of age with a demonstrated stability in their prescription in order to be corrected to 20/40 or better via eye surgery. They must also have normal, ocular health. The individual must not be pregnant and should have −1.00 to −12.00 diopters of myopia. The size of their pupil should be six millimeters or less once in a dark room.
Those who have certain, pre-existing conditions may not be eligible for PRK laser eye surgery. These conditions include granular corneal dystrophy type II, ocular disease, collagen vascular disease, diabetes, rheumatoid arthritis, or a history of side effects with steroids.
Typically, those who are candidates for LASIK eye surgery are also candidates for PRK. Some patients are only candidates for PRK. On average, 15 percent of patients are not eligible for either procedure.
Advantages of PRK
One of the main risks involved with undergoing LASIK eye surgery is corneal flap complications that occur with the incision that is made. PRK is a more favorable procedure with the elimination of the flap altogether by instead removing the cells with a solution. With PRK, there is less risk involved and it’s often considered a safer alternative. It makes for a safer healing process because the cells can regrow naturally over the eye with time. The elective, outpatient procedure also takes only a few minutes to complete, making it an efficient surgery that is favored for its simple process.
Most PRK patients are also less likely to experience Dry Eye Syndrome after undergoing the procedure as opposed to LASIK eye surgery where prescribed eye drops must be taken for two months following the surgery.
Disadvantages of PRK
Although PRK is considered as efficient and advanced as LASIK, there are disadvantages to the procedure. It can take longer to recover, and vision will not be restored as quickly compared to LASIK eye surgery. The epithelial cells are removed during the procedure, which often take longer to regrow. The regrowth process limits visibility for six weeks to two months. This can make it difficult to read, operate a vehicle, and use the computer during your post-op recovery time. Although the cells can still regrow in just five days, vision will not be restored for several weeks. With LASIK, a flap is created to access the cornea. Once the flap is placed back down, the natural suction of your eye basically seals it, thus healing much quicker.
With PRK, vision may worsen in the days following the procedure due to the cells that are missing. When the cells are missing, patients often experience a scratched feeling on the eye with a raw and painful effect that varies in severity per patient.
For those who are interested in having their vision repaired on both eyes, you may be advised to select two separate surgery dates; with only one eye operated on at a time, when undergoing PRK. This way, you can still carry about your daily activities, relying upon your untreated eye while the first heals. With LASIK, both eyes are usually corrected at the same time.
Patients can also expect redness and an excess amount of tears. Bandage contact lenses may be used over the eyes to offer comfort and keep the surface of the cornea smooth. Prescription eye drops may also be prescribed to offer added moisture during recovery, which can be used for several months afterward. This will work to promote healing and increase the recovery time. Most patients are also prescribed anti-inflammatory agents to reduce swelling that may occur, and offer relief for pain or discomfort.
Patients can expect to have more discomfort or pain than LASIK eye surgery for four to six weeks following the procedure. Those who undergo LASIK eye surgery only experience pain for four to six hours after it is performed.
In sum, complications that are known to occur during the post-op period with PRK include dry eyes, increased sensitivity, corneal haze, glare or halos that are seen, recurrent erosions, or scarring.
Laser Eye Surgery Cost
What Is Price Difference Between the Two Methods of Laser Correction Vision
- Laser eye surgery in Las Vegas can vary in cost.
- The price difference between LASIK (laser-assisted in situ keratomileusis) and PRK (photorefractive keratectomy) can be as much as $1200
- LASIK eye surgery pricing averages between $1,000 to $2,600 per eye to perform.
- The average cost of PRK laser eye surgery is $2,000 to $4,000 for both eyes.
- These procedures are typically paid out of pocket since vision correction surgery is still considered an elective procedure and is not covered by insurance.
- PRK can be more or less costly than LASIK, but will require more visits to the doctor during the post-op period.
- The extra time off work and time for travel to these extra visits might equal or even outweigh the overall costs associated with LASIK.
Vision Outcome Between PRK and LASIK
The overall outcome of both PRK and LASIK eye surgery is essentially the same with long-term or permanent vision improvement. The results that patients experience with PRK and LASIK have proven to deliver a high level of satisfaction. Each procedures is safe, similar, but involve a different corneal exposure method, recovery process and overall cost.