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In New York City
PRK is also known as LASEK (pronounced LAS-ECK), epi-LASIK.
PRK SURGERY NYC
"I did qualify for PRK. Dr. Rapoport was fantastic. I could not recommend a better eye surgeon. "
MJ / New York
Why Manhattan Eye?
Why PRK Surgery (Photorefractive Keratectomy)?
PRK, or photorefractive keratectomy, is a procedure that reshapes the front of the eye, or cornea, to enable you to see without contacts or glasses. Unlike LASIK, there is no flap created, and PRK can treat higher prescriptions and correct the vision of patients who are not candidates for LASIK.
What Is It?
When light rays travel through your eye- they go through the clear cornea, lens and focus onto the retina and are then transmitted into neuro-electrical signals which are then sent to the brain. If you are nearsighted or “myopic,” your cornea is too steep and/or your eyeball is too long, and the light rays focus in front of the retina. If you are farsighted, or “hyperopic,” your cornea is too flat and/or your eyeball is too short and the light rays focus behind the retina. The goal of PRK is to resurface the front of the cornea to make it flatter in the case of myopia, and steeper in the case of hyperopia, to enable the light rays to focus perfectly onto the retina and for you to see without glasses or contacts correction.
PRK is similar to LASIK in that it changes the shape of the cornea so that the light rays are able to focus directly onto the retina. The main difference is that in PRK, there is no corneal flap that is created. Instead, the top layer of cells, the epithelium, is gently removed. The excimer laser, which is preprogrammed with the specific measurements of your eye, then changes the shape of the cornea. To prevent post-operative haze (cloudiness), a drop called mitomycin C is placed onto the cornea for a short time. A bandage contact lens, which is a soft contact lens that is safe to leave on the eye while sleeping, is then placed, and it helps with the healing of the epithelium, or the top layer of the cornea. This bandage lens is removed in the office 3-7 days after the procedure. The final visual outcome of PRK and LASIK are the same, but PRK has a longer recovery course. The main advantage of PRK over LASIK is that since there is no corneal flap, the cornea has stronger inherent strength.
Link to AAO PRK : https://youtu.be/EoWdquQfAbA
What's the History of PRK?
First introduced in 1987, PRK was approved by the U.S. FDA in 1995. No microkeratome is used to create a corneal flap. Instead, the eye surgeon uses the laser to reshape the cornea one microscopic layer at a time. As public awareness of LASIK grew, PRK lost popularity because of the greater comfort and faster recovery of vision offered by LASIK.
Over the past decade, a newer generation of excimer lasers and more refined techniques have reduced the risks of PRK. Today PRK patients have an easier recovery. This has made PRK a viable option for many patients whose needs would not be met by LASIK.
Who is a PRK Candidate?
There are certain criteria that you are required to meet in order to qualify for LASIK:
Over age 18, preferably older than 21 so that your prescription is stable
Stable prescription for over a year
A glasses/ contacts prescription that can be corrected by PRK- the correctable prescription by PRK is a larger window than with LASIK
You can have regular astigmatism, but not irregular astigmatism- irregular astigmatism can signify other issues (see blog post: https://www.manhattaneyenyc.com/what-is-astigmatism-what-is-regular-or-irregular-astigmatism/)
Your corneas need to be healthy and your overall eye health must be good.
Who is Not a Candidate for PRK?
A prescription that is changing and not stable
A prescription that is above the parameters for LASIK
History of overactive scarring
Certain dermatologic diseases that can affect healing
Uncontrolled dry eye or blepharitis
Corneas that are too thin
A history of recurrent corneal scratches
Eye diseases such as glaucoma, macular degeneration, retinal or corneal scarring
Visually significant cataract
Diabetes mellitus that is poorly controlled
Pregnant or nursing women
Keratoconus (cone-shaped cornea) (see blog post: https://www.manhattaneyenyc.com/what-is-keratoconus-and-how-can-i-treat-it-what-is-collagen-cross-linking/)
Family history of a corneal transplant/corneal disease
How to Prepare for PRK Surgery?
When you come in for your PRK, or photorefractive keratectomy, expect to stay for a 2 hour evaluation. Your prescription will be measured in many ways, and the curvature of your cornea will be measured using an auto-keratometer, as well as a Pentacam, or a topographer. The Pentacam is very important because it shows all the irregularities of the cornea. You are allowed to have regular astigmatism, but having irregular astigmatism precludes you from being a candidate for PRK. The corneal topographer will show this information. Your eyes will be dilated and the entire health of your eye assessed. You need to have a healthy eye to be a candidate for PRK and this includes not having any corneal scars, corneal dystrophies. glaucoma, visually significant cataracts, macular disease, and other conditions. A family history is also important, since having a family member with a history of a corneal transplant or keratoconus can preclude you from being a candidate as well. A personal history of eye infections such as bacterial or viral infection can exclude you as well.
If you wear contact lenses, it is important that you stay out of your contacts for a certain amount of time so that your cornea returns to its original shape, and thus the measurements are accurate and optimized. If you wear soft contact lenses without astigmatism, please stay out of contacts for 10 days. If you wear soft contact lenses with astigmatism correction, please stay out of contacts for 14 days. If you wear hard contact lenses (rigid gas permeable lenses), please stay out of the lenses a week for each decade of hard contact lens wear.
What Should I Expect During and After Surgery?
Both LASIK and PRK are performed at a laser center. You will be offered an oral relaxing medication to take ahead if time if you choose. No systemic anesthesia is required. You will start antibiotic drops 2 days prior to the procedure. If you choose, you will take the oral relaxing medication 1 hour prior the procedure, and bring the other medication with you if you choose to take a 2nd dose. Numbing drops, along with antibiotic and steroid drops, will be placed in your eye. An eyelid opener is placed and the excimer laser, which has been preprogrammed with the specific measurements of your eye, then changes the shape of the cornea. A bandage contact lens is placed onto the eye, and this is safe to sleep in. You will sleep in special eye goggles to protect the eyes the first few nights. Once the epithelium, or top layer heals, the bandage contact lens is removed in the office.
The first few days after the procedure, your vision is blurry and the eye can feel a little scratchy. Lubricating eye drops can help during this time. Most patients go back to their normal visual activities in a few days. Exercise is limited the first we days and contact sports and swimming are limited for a month.
WHY CHOOSE MANHATTAN EYE?
PRK Surgery with Dr. Rapoport in NYC
At Manhattan Eye, we perform customized imaging and testing to ensure you have the safest and most precise treatment. Additionally, a very in-depth discussion is held regarding possible treatments, depending on what your lifestyle requires. Dr. Rapoport brings her expertise on the IntraLase laser and VISX as well as the latest technology in custom laser correction to create an customized plan for each individual patient.
SCHEDULE A VISIT
“I've been essentially blind my whole life and recently decided to get elective eye surgery. I unfortunately did not qualify for Lasik, but did qualify for PRK.
Dr. Rapoport was fantastic - she explained all my options in detail and was very diligent in giving me instructions pre/post operations - even when I asked twice/three times. She's always available to talk and super empathetic. I could not recommend a better eye surgeon!”
What about LASIK or PRK? Click to enlarge. LASIK and PRK Laser Eye Surgery in NYC usually costs between $2,000 and $3,000 per eye, depending on your prescription and the shape of your eye.What are the restrictions after PRK surgery? ›
Avoid strenuous activities or contact sports, such as boxing or football, for 2 to 4 weeks after surgery. If you return to playing contact sports, consider wearing goggles or other eye protection. For 1 to 2 weeks, avoid swimming, hot tubs, gardening, and dusting.How long is recovery after PRK? ›
PRK recovery times will vary by patient. However, most people can expect a full recovery within 2 to 4 weeks after surgery.How long does it take to see 20 20 after PRK? ›
PRK can accurately correct nearsightedness. Approximately 90% of PRK patients have 20/20 vision without glasses or contact lenses one year after the surgery.What is the success rate of PRK eye surgery? ›
What Is PRK's Success Rate? PRK laser eye correction boasts a high success rate. According to the FDA, the average success stands at roughly 95%. That means most individuals who have undergone the PRK procedure enjoy significant improvement in their vision without using corrective lenses.Is PRK surgery worth it? ›
The results from PRK are just as good as the results from LASIK are. Over 95% of patients achieve 20/20 vision or better. The recovery period is longer after having PRK, but it's worth it for excellent vision!How many days after PRK can I watch TV? ›
In the first 24 hours after PRK, it's important that patients avoid any activities that may result in eyestrain. This includes reading, using the computer, watching TV or movies, and so forth. By resting your eyes for the first day, you will improve your overall healing experience.How long do you have to wear sleep goggles after PRK? ›
*You may experience burning, watery eyes, or scratchiness and irritation as soon as 30 minutes after your procedure. It is helpful to keep your eyes closed as much as possible. * Wear sunglasses even indoors if light bothers you. *Wear goggles while sleeping for 1 week.
Pain after PRK surgery can vary widely.
Increased sensitivity to light, tearing (watery eyes) and burning are common and expected in the first few days. It is normal to have more pain in one eye than the other. The eyes will often feel like they have sand in them and water significantly, until day 3 or 4 after surgery.
Your vision will be blurry for several days following the procedure, but your eyesight should improve as the days and weeks pass. Most patients experience optimal visual acuity between 1 – 3 months after having PRK laser eye surgery.
It will not harm your eyes or their recovery from surgery if you try to use your eyes immediately. However, most patients feel more comfortable closing their eyes for the first few hours after surgery. The following day, you should be able to use your electronics, however it is common to experience some blurred vision.What happens 2 weeks after PRK? ›
You shouldn't worry about this, as blurry vision is very common in the first one or two weeks following surgery. Your sight gradually improves in the few weeks after the procedure. It takes anywhere from two to six weeks for the cells to smooth and allow for clear vision.
During the first 24 hours after PRK, it is important to rest your eyes and avoid any activities that can lead to eye strain. This includes watching TV, reading, using the computer, etc. Keeping the visual demands on your eyes to a minimum for the first day or so after PRK will make for a smoother healing experience.What is vision like immediately after PRK? ›
You may be farsighted immediately following surgery, which will cause "hazy" vision, especially up close. Expect your distance vision to clear before your reading vision. If you are over 40, your age will determine when and if your reading vision will return.Can you go outside after PRK surgery? ›
In the first few days after having PRK surgery, you should avoid direct sunlight at all costs. This will help with your healing process and reduce your discomfort. If you have to go outside, wear sunglasses along with a hat with a brim to protect your eyes from sun exposure.What is the downside of PRK? ›
Disadvantages of PRK
Infection, scarring, cloudiness of the cornea, and a “halo effect” that appears around lights. Over or under correction of your vision. In this case, glasses, contacts, or additional surgery can remedy the problem. Although extremely rare, it's possible for vision to worsen after PRK.
Patients who are younger than 18 years are not good candidates for PRK surgery. At 18 your cornea also reaches a mature age. Your eye is now developed and stable. Your vision must be stable as well.What happens if PRK fails? ›
Thin-Flap LASIK Enhancement
If your PRK procedure is not successful, this may be an option for you. Also known as the sub-Bowman's keratomileusis, LASIK uses thin flaps to keep the stromal tissue intact to decrease the risk of corneal ectasia.
LASIK/PRK and Age
In actuality, the only age requirement for the laser vision correction procedure is that patients be at least 18 years of age. This is because an individual's vision may continue to change and not fully stabilize until after age 18. Adults of all ages undergo LASIK/PRK each year.
Does PRK last forever? As the excimer laser used in the procedure permanently reshapes the cornea, the newly created shape will last forever. The subsequent clear vision should remain as well.
Full recovery after PRK takes about a month. With PRK surgery, we prescribe medicated eye drops that help keep your eye moist during the healing process. You may also be given pain medications to keep you comfortable. Most patients after PRK eye surgery don't need glasses as they achieve 20/20 vision.Can I drive at night after PRK? ›
Issues with Night Vision and Contrast Sensitivity
This will last for a few weeks. In the first few days and weeks after surgery, it's a good idea for PRK patients to avoid driving at night. Instead, getting rides from friends and family members or taking public transportation will be much safer.
LASIK/PRK/SMILE patients are frequently advised to wear eye protection, like goggles or even a set of shades, overnight during the first day or two of recovery. However, I have never heard of any restrictions on sleeping on one's side following LASIK/PRK/SMILE. There are no limits after that.Do you have to keep your eyes closed after PRK? ›
To limit discomfort, we recommend that patients take a nap for a few hours when they return home from surgery. Keeping the eyes closed prevents any pain that is caused by repeated blinking, and it also keeps the eyes well-lubricated.How do you shower after PRK? ›
We generally encourage patients to wait at least 24 hours before showering or doing anything else that might cause unnecessary eye strain. It is important that your eye remain free of foreign containments, such as water or make-up, in the immediate hours following the procedure.Do I have to wear sunglasses indoors after PRK? ›
As light sensitivity resolves, sunglasses no longer need to be worn indoors, but they should continue to be worn outside, at least until the eyes have completely healed.Does PRK reduce night vision? ›
PRK (photorefractive keratectomy) and LASIK (laser-assisted in situ keratomileusis) are both used to correct common vision problems like nearsightedness, farsightedness, and astigmatism. While there is a misconception that surgery permanently changes night vision, your eyesight should return to normal after recovery.Why does PRK hurt so much? ›
One common side effect of PRK is acute postoperative pain due to the removal of corneal epithelium during the procedure.How soon can I go back to work after PRK? ›
Most people undergo PRK on a Friday, and use the weekend to rest and recuperate. Depending on your visual requirements, you could return to work in 3 to 5 days. Eye Drop Recall Alert!Can you move your eyes during PRK? ›
One of the most common questions we hear is: “What if I move my eye during LASIK or PRK?” The good news? This is highly unlikely. In fact, even if you do move your eye, it would not cause damage.
Your eyes will be just the same colour after treatment as before because the laser only affects the cornea, which is the clear window at the front of the eye. The treatment only affects the curvature of the front of the eye, and no energy passes past the top layers of the cornea.Is PRK cheaper than LASIK? ›
Because this process is older and less time-consuming, PRK is typically less expensive than LASIK; however, it can still be costly because insurance is not likely to cover it.How much is PRK? ›
The cost of PRK surgery usually ranges between $1,000 and $3,000 per eye — with an average of $2,300 — according to our survey of medical centers with upfront pricing. Like any elective medical procedure, your final price will vary from office to office.How much does PRK cost in the US? ›
The breakdown PRK cost per eye is between $1800 to $2800. The cost of PRK surgery in the USA is dependent on the level of technology used and doctor experience.Is PRK more successful than LASIK? ›
Both techniques are equally effective in permanently correcting your vision. The main difference is the recovery time. LASIK takes a few days or less to see clearly while PRK takes about a month. The final results won't differ between the two if the procedure is done properly by a licensed, experienced surgeon.Who is best for PRK? ›
General Candidacy for PRK
Ideal candidates for PRK are people who experience refractive errors (myopia, hyperopia, astigmatism) and would like to achieve great vision without the reliance on corrective lenses. They should be in good health overall and understand the risks and benefits of PRK.
The newest generation of the PRK procedure is known as LASEK (laser-assisted sub-epithelial keratectomy). LASEK provides a safe and effective option for laser vision correction for persons who desire less dependence on their glasses and contact lenses but who are not appropriate LASIK candidates.How many times can you do PRK? ›
If you choose to have a second PRK procedure, there's nothing to worry about. Subsequent/follow-up surgery is usually the same as the original procedure in that the entire epithelium will be removed to allow access to the underlying cornea in order to reshape it.How much cornea is removed in PRK? ›
The flap in LASIK is typically about 20% of the corneal thickness, leaving 80% of the corneal tissue to work with. In PRK, the surface layer of cells that is removed is less than 10% of the corneal thickness, leaving more available tissue to work with. Thus, PRK can be the only option for patients with thin corneas.Why is PRK the best? ›
This makes patients with thin corneas very hard to work with during LASIK. The preferable procedure is PRK since it does not leave a flap on your cornea. Thus, it is much safer and more effective than LASIK in the long run. PRK may take longer to heal than LASIK, but the results are the same.
DEGREE OF REFRACTIVE ERROR
The best candidates for PRK have an eyeglass prescription that isn't extreme. This means, if you are nearsighted, you may have myopia of up to –8.00 diopters. If you are farsighted, your hyperopia may be up to +3.00 diopters. Your level of astigmatism may be as high as +4.00 diopters.
In the first day or so after PRK, vision in the treated eye may be good. As the top surface layer heals, your vision may actually get slightly worse. This is expected and due to the slightly “bumpy“ nature of the new epithelium under the bandage soft contact lens.Can PRK surgery fail? ›
Although the accuracy of refractive surgical procedures is increasing, it is not uncommon to consider retreatment after PRK when there is a residual refractive error such as over/under correction, regression, aberrations and decentration, that interfere with the patient's quality of life.