PRK Surgery

Photorefractive Keratectomy (PRK) is another laser-based procedure for the correction of refractive errors. PRK differs from Femto LASIK and ReLEx SMILE in its surgical steps. In PRK, the outermost layer of the cornea, called the epithelium, is gently removed. An excimer laser is then used to reshape the curvature of the underlying corneal surface according to the patient’s refractive needs. A protective bandage contact lens is placed over the cornea for 3–5 days to allow the epithelial layer to regenerate. Vision gradually improves as healing progresses. Vision is typically not sharp during the first week, and most patients achieve optimal clarity after approximately one month. PRK is an established procedure that predates LASIK and has been safely performed for several decades.

Although PRK is less commonly chosen today due to postoperative discomfort—including eye pain, excessive tearing, and difficulty opening the eyes for 2–3 days—it remains essential for certain patient groups. These include individuals pursuing careers that restrict corneal flaps, such as military personnel, police officers, and pilots, as well as patients who are not candidates for Femto LASIK or ReLEx SMILE due to thin corneas.

Suitable Candidates for PRK

• Age 18 years or older, with stable vision for at least 1 year.
• Patients under age 20 must be accompanied by a parent or legal guardian.
• No significant ocular diseases such as keratoconus, severe dry eye, glaucoma, or retinal degeneration.
• No systemic medical conditions that can impair wound healing, such as:
  - Systemic lupus erythematosus (SLE)
  - Sjögren’s syndrome
  - Psoriasis
  - Other autoimmune disorders
  - Poorly controlled diabetes mellitus ี
• Not currently taking oral acne medications such as **Roaccutane, Acnotin, or Isotretinoin. These medications must be discontinued for at least 1 month before the preoperative evaluation and surgery because they can cause excessive dryness of mucous membranes, including the corneal surface.
  Patients taking medications for chronic illnesses (e.g., diabetes, hypertension, hyperlipidemia, thyroid disorders, or sleep medications) should notify the ophthalmologist on the day of examination, but may continue their regular medications.
• Not pregnant or breastfeeding. (If menstrual cycles have returned for at least two consecutive months, the procedure may be considered.)
• Not currently receiving treatment with psychiatric medications for active psychiatric conditions.
• Have undergone a comprehensive ophthalmic assessment confirming that the eyes are healthy and safe to undergo PRK.
• Have a clear understanding of the PRK procedure and maintain realistic expectations of the surgical outcome.