PRK (Photorefractive Keratectomy) is ideal for people with thin corneas who are not suitable for classic laser eye procedures (such as Femto-LASIK).
This is a special surgical method in which the top layer of the cornea (the epithelium) is rolled back and then repositioned. A large incision in the cornea (and thus the creation of a corneal flap) like in LASIK is therefore not required.
| Method | Laser eye surgery without creating a corneal flap: the PRK procedure. |
| Usage | Nearsightedness (up to -8 diopters), farsightedness (up to +4 diopters), and astigmatism (up to 5 diopters). |
| Procedure | Separation and removal of the superficial cell layer of the cornea, called the epithelium. Ablation of corneal tissue using the excimer laser. |
| Duration | Approximately 15–20 minutes for both eyes. |
| Cost | €1.390 for both eyes. |
The PRK method
Photorefractive Keratectomy (PRK) is a type of laser eye surgery designed to correct refractive errors such as myopia, hyperopia, and astigmatism. The procedure involves the removal of the corneal epithelium (the outer layer of the cornea), followed by the application of an excimer laser to reshape the underlying corneal tissue, allowing light to focus more accurately on the retina. PRK is particularly beneficial for patients with thin or irregular corneas, as it does not require the creation of a corneal flap, which is necessary in LASIK surgery. Recovery from PRK typically involves a protective contact lens placed over the eye and can take several days for the epithelium to regenerate, with optimal vision often stabilizing within three to six months.
The Advantages: Why Laser Eye Surgery with the PRK Procedure?
The greatest advantage is that a corneal incision is avoided. On the one hand, this is gentler on the cornea, and on the other hand, incision-related complications can also be prevented.
In other procedures, the eye must be suctioned to make a clean cut. This temporarily disrupts the blood supply, which in turn poses risks. This is also avoided with the PRK procedure.
Overall, the entire procedure is considered to have very few complications.
Does the PRK procedure also have disadvantages?
The treating physician will inform you in advance about the advantages as well as the risks. This method of laser eye surgery has many benefits, with only a few drawbacks.
In the first 1–3 days after the procedure, stronger wound pain can be expected as the epithelium needs to regenerate during this time. Due to this pain and the accompanying fluctuations in vision, the patient is considered unable to work for about one week. Activities such as driving a car are also not possible immediately after the procedure.
Additionally, regaining visual acuity takes a little longer with PRK laser eye surgery than with other methods.
The Application: Which Patients Benefit from the Method?
For most laser procedures, a minimum corneal thickness is an essential requirement. If this cannot be achieved, the patient is not a candidate for many laser procedures (such as LASIK).
This is precisely where the PRK procedure comes in. It has been specifically developed for people with thin corneas, but the refractive error must not be too severe.
PRK is ideal if you, for example, want to engage in sports without glasses in the future or want to completely dispense with your vision aid in everyday life. It is very often used by extreme sports athletes who want to practice their sport without glasses or contact lenses.
Patient Requirements
- Minimum age of 18 years
- Minimum corneal thickness
- Low degree of refractive error
- No acute eye diseases
Treatment is excluded if patients are not yet of legal age or are pregnant. Additionally, laser eye surgery is not performed during breastfeeding due to hormonal changes.
Up to What Degree of Refractive Error Can the PRK Procedure Be Applied?
The method is suitable for both low myopia and hyperopia. Astigmatism can also be corrected using the PRK/LASEK procedure.
- Nearsightedness (Myopia): up to approximately -6 diopters
- Farsightedness (Hyperopia): up to approximately +3 diopters
- Astigmatism: up to approximately 3 diopters
The Procedure: How PRK Laser Eye Surgery Is Performed
The procedure is performed very gently. As mentioned earlier, no incision needs to be made in the cornea, which avoids complications and reduces risks.
In the following, we outline the PRK procedure in detail.
Step 1: Preparation
At the beginning of the procedure, the patient lies down on an examination table. Their face is cleaned and covered with a plastic film to keep the treatment environment sterile. Subsequently, the eyes are numbed, and an eyelid speculum is used to keep the eyes open during the procedure.
Step 2: Opening the Corneal Epithelium
In PRK laser eye surgery, an incision in the cornea with a laser or a knife is deliberately avoided. First, an alcohol-based solution is applied to the eye, which must act for a certain period. Then the surgeon can gently remove the epithelium, the top cell layer of the cornea, and slide it aside with a fine tool.
Step 3: Modeling the Cornea (Excimer Laser)
Just like in other LASIK procedures, the actual “eye laser” process begins in PRK. The doctor adjusts the excimer laser based on the patient’s data and corrects the refractive error by removing corneal tissue. Depending on the type of refractive error (astigmatism, myopia, hyperopia), the cornea is modeled differently.
Step 4: Replacing the Epithelium
Once the laser treatment is finished, the epithelium is pushed back into place. The doctor uses a precision instrument to avoid damaging this sensitive cell layer. Once the top layer of the cornea is back in place, it quickly reintegrates into the corneal structures and serves the eye as a natural wound dressing.
Step 5: Placing a Therapeutic Contact Lens
After laser eye surgery, the upper cell layer of the eye, the epithelium, is pushed back and serves as a wound dressing. Additionally, a type of protective contact lens is placed in the eye. This therapeutic contact lens must be worn for several days.
Frequently Asked Questions
Can complications occur during the surgery?
The surgical risks associated with the PRK procedure are extremely low. When the procedure is performed in an experienced clinic that adheres to all quality standards and utilizes modern technology, complications can be nearly eliminated. Rare potential complications include eye infections, inadequate correction results, and corneal ectasia (a bulging of the cornea).
Is the PRK procedure painful?
Postoperative pain can occur with this procedure and may last slightly longer than with other laser eye methods. This is related to the somewhat longer healing period. However, the pain can be well managed with standard painkillers. The laser treatment itself is performed under local anesthesia of the eyes and does not cause any pain.
Can I become blind from laser eye surgery?
No, blindness as a result of laser eye surgery is impossible. The laser beam only works on the top layer of the eye and cannot penetrate deeper into the eye. Additionally, the eye is precisely measured before the surgery, and the maximum ablation is calculated. This ensures that the deeper layers, including the lens and retina, are not injured.
Healing Time: How Long Do the Eyes Need to Regenerate?
The healing process for PRK laser eye surgery is significantly slower compared to other laser eye procedures. Patients must follow important behavioral guidelines to avoid disrupting the healing process. Under no circumstances should the eyes be rubbed. Additionally, activities such as sports and sauna visits must be strictly avoided during the first 2 to 4 weeks.
When Can I See Clearly Again After PRK Surgery?
It takes a few days after the procedure before you can see clearly again. For some patients, it may take even a few weeks to regain full visual acuity. Therefore, you should be patient until the final result of the laser treatment is achieved. You can support the healing process by strictly following your doctor’s instructions and adhering to the prescribed eye drop regimen.
Do Health Insurance Companies Cover the Costs of PRK Laser Treatment?
Unfortunately, public health insurance companies do not currently cover the costs of laser treatments. However, it is worthwhile for private patients to inquire with their insurance companies beforehand to see if coverage is available. More and more private health insurance providers are including laser eye surgery in their range of services.
Significantly Lower Treatment Costs for Laser Eye Surgery in Turkey
You can save a large portion of the costs by having the PRK procedure performed in Turkey. Unfortunately, most health insurance companies do not currently cover the costs of laser treatments, or only cover them partially. This makes it even more worthwhile to look for good deals on professional laser treatments. In Turkey, there are eye clinics that specialize in laser treatments. They operate under the same medical quality standards but can save you significantly on costs due to the lower living and labor expenses in the region.
Conclusion: Laser Eye Surgery for Eyes with Thin Corneas Using the PRK Procedure
The PRK procedure can now also help patients who were previously not candidates for laser eye surgery due to having a too thin cornea. Thanks to the gentle surgical method, risks and complications are rare. Additionally, costs remain reasonable if you compare offers and choose an eye clinic in Turkey.
PRK laser eye surgery is suitable for all patients who suffer from mild to moderate refractive errors and wish to manage their daily lives without vision aids. Athletes and extreme sports enthusiasts also benefit from the method.