Patient Expectations


Lt Col Reynolds
Before undergoing PRK, patients usually meet with a member of their provider’s team to discuss what to expect during and after the procedure. Dr. Flemings, what can you tell us about patient expectations?

Lt Col Flemings
Well, Dr. Reynolds, when a patient meets with their provider’s team, their medical history is evaluated and their eyes are tested. In most cases, these tests include measuring corneal thickness, refraction, and pupil dilation. Once the evaluation is complete and the patient has been approved for PRK, the procedure can be scheduled.

Although it varies from one provider to another, in most cases, patients who wear rigid gas permeable contact lenses are advised not to wear them starting three to four weeks before the date of the evaluation. These contact lenses change the shape of the cornea and affect the measurement of topography, refraction, and wave front exams. Other types of contact lenses should not be worn for a specified period before the procedure. The provider gives specific instructions based on the patient’s condition.

On the day of the procedure, the patient is usually advised to eat a light meal before going to the provider’s facility. All prescribed medications should be taken as normal, and no eye makeup should be worn that day. Patients should be sure to arrange transportation home from the procedure, as they will not be able to drive.

The actual procedure is done under local anesthesia, and takes about 10 minutes for both eyes. During the procedure, the provider uses an excimer laser to reshape the cornea. This laser removes a thin portion of the epithelium and reshapes the cornea by removing precise amounts of the corneal stroma. The epithelium repairs itself within a few days of the procedure.

A bandage contact lens is applied immediately after the procedure. This contact lens is usually worn for the first three to four days to allow the epithelium to repair itself. Once the surface of the eye has healed, the bandage contact lens is removed.

Patients should expect to visit their provider several times during the first six months after surgery, with the first visit being the day after the procedure. Vision may fluctuate between clear and blurry for the first few weeks following PRK, and some patients may need to wear glasses for night driving or reading until their vision stabilizes.

Dry eyes in the days following the procedure are common, although they often don’t feel that way. In most cases, patients are given several medications, including antibiotic drops, artificial tears, and medication to reduce inflammation. It’s not unusual for eye drops to cause a slight burning sensation or momentary blurring of vision. Patients should never use any drops not approved by a provider, and it’s important to understand the proper use of each medication before leaving the clinic.

Vision may fluctuate or worsen while the contact lens is in place, but then improve around five to seven days after surgery. It’s important to keep in mind that a person’s best vision may not be obtained for up to six months following PRK.