Photorefractive keratectomy, or PRK, was the first laser vision correction procedure and a predecessor to the LASIK procedure. It is commonly performed on New York and Manhattan patients who, for a number of reasons, cannot have traditional LASIK.
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Some examples of patients who would be good candidates for PRK include:

  • Patients whose corneas are too thin to undergo LASIK.
  • Patients whose corneas have evidence of scarring.
  • Patients whose corneas may be irregular in shape.
  • It is the procedure of choice for patients with corneal dystrophies or recurrent erosions.

The PRK procedure is very similar to LASIK. In both PRK and LASIK, a laser is applied to the eye as a means of improving vision by reshaping the cornea. The main difference is that, in PRK, there is no flap created by the surgeon.

In PRK, optical correction is accomplished with a laser that reshapes the surface of the cornea rather than the tissue beneath a flap. This requires the removal of a thin layer of the cornea’s superficial cells, which may produce varying degrees of temporary discomfort for up to a few days after your treatment. In general, PRK patients report a slower visual recovery than patients who have traditional LASIK.

The side effects and complications of PRK are similar to those reported with LASIK and should be addressed with the same level of concern. Because there is no creation of a flap with PRK, any problems with making a flap are non-existent. However, there is a slightly extended recovery time associated with PRK, as well as additional post-operative visits. Generally, most New York and Manhattan patients feel some discomfort in the first two days after the PRK procedure. By the third or fourth day, the discomfort is gone, and the vision is good enough to resume most normal activities and return to work.

The same excimer laser that is used to correct vision in LASIK is used in PRK (and LASEK) – at Gotham Lasik, Dr. Bonanni only uses the Wavelight Allegretto laser for the best results. Unlike LASIK, PRK and LASEK treatments do not involve the creation of a flap in the cornea. In PRK, the epithelium is removed while LASEK attempts to save this layer.

What is Lasek?

LASEK is a procedure that tries to preserve the surface epithelial layer of the cornea and thereby decrease the healing time of surface laser procedures. It is the PRK procedure with its decreased risks but with the goal of decreased healing time.

This procedure requires the surgeon to loosen the outer layer of the cornea (called the epithelium). Unlike in PRK, the epithelium is not removed. The surgeon instead folds the loosened epithelium back so that the laser can reshape the exposed cornea. After laser application, the surgeon replaces the “flap” of epithelium over the corneal bed and places a bandage soft contact lens on top.

Epi-LASEK is an automated form of LASEK, using a suction ring and plastic blade which separates the epithelium from the underlying corneal tissue. Either LASEK procedure gives the same results.