Advanced Surface Ablation

PRK (Photo-Refractive Keratectomy) was the first procedure performed using the Excimer laser. It corrects vision by reshaping the cornea. The difference between LASIK and PRK is that with LASIK a corneal flap is created and the laser is applied to the inner tissue of the cornea. With PRK, the epithelium (or outer skin of the cornea) is removed and a laser is applied to the surface of the cornea. PRK can be used to correct low to high levels of nearsightedness, farsightedness and astigmatism.
 
To treat nearsightedness, the steep cornea is made flatter by removing tissue from the center of the cornea. This moves the point of focus from in front of the retina to directly on the retina.
 
To treat farsightedness, the flat cornea is made steeper by removing tissue outside of the central optical zone of the cornea. This moves the point of focus from behind the retina to directly on the retina.
To treat astigmatism, the cornea is made more spherical -- like a basketball instead of a football. This eliminates multiple focusing points within the eye and creates one point of focus on the retina. Astigmatism can be treated at the same time as nearsightedness and farsightedness.
 
PRK may be indicated for those who have thin corneas, dry eyes, are over age 18, or have had previous refractive surgery.
 
Realistic Expectations:
 
The decision to have PRK is an important one that only you can make. The goal of any refractive surgical procedure is to reduce your dependence on corrective lenses. However, we cannot guarantee you will have the results you desire. The vast majority of our patients are extremely happy with their vision after PRK and can do most activities without dependence on corrective lenses.
 
PRK is a safe, effective and permanent procedure, but like any surgical procedure, it does have some risks. After PRK, almost everyone experiences some visual side effects. These visual side effects are usually mild and temporary and have a tendency to diminish over time. But there is a slight chance that some of these side effects won't go away completely, including light sensitivity, glare and halos. Serious complications to PRK are extremely rare.
 
Since everyone heals somewhat differently, some patients may over react to the procedure and some may under react resulting in over-correction and under-correction. Once the eye has stabilized (3 to 6 months) you and your doctor can discuss whether a re-treatment could help fine tune your vision if you are over or under corrected.
 
Pre-Operative Instructions
 
Prior to Screening: Please remove soft contact lenses and keep them out 5 days prior to screening/evaluation.
 
Please remove hard/gas permeable contact lenses and keep them completely out a minimum 3 weeks prior to screening/evaluation.
 
Prior to surgery:

• Please remove soft contact or hard gas permeable lenses and keep them completely out 3 days prior to surgery.
• Do not wear makeup (eye creams, face creams or oily makeup remover) at least one day before surgery.
• You may eat and go about your normal routine. We do ask that you limit your caffeine the day of surgery.
• Please arrange transportation for the day of surgery. YOU WILL NOT BE ABLE TO DRIVE YOURSELF HOME.
• We will try and notify you a few days prior to surgery with your arrival time. Times may change up to one day prior to surgery.
• We recommend avoiding alcohol 1 week prior to and after surgery, as this tends to dehydrate the tissues and cause irritation.

Day of Surgery:

• Please bring a certified check or credit card to pay balance of surgery.
• Feeling anxious, nervous or excited prior to procedure is normal. Upon arrival to the surgery center you may be given medication to relax you.
• Please be sure to fill the prescriptions that you were given when you scheduled your procedure and bring them with you DAY OF SURGERY. If you do not bring these with you the day of surgery YOUR SURGERY MAY BE CANCELED.
• Please do not wear hair spray, perfume, or scented deodorant as they might interfere with the laser and affect your outcome.
• No make-up, including concealer, foundation, mascara, etc . . (IF YOU DO SO YOUR SURGERY MAY BE CANCELED).
• Inform your driver that you will be at the surgery center about 1.5 – 2 hours. There is a comfortable waiting area.
• Please do not bring children with you the day of surgery.
• Wear comfortable clothing. We recommend a button up shirt or a loose collar shirt. Dress in layers in case you get cold/warm.
• Do not bring valuables.
• Please remove earrings

Post-Operative Instructions
Day of Surgery:

1. Go home and REST. Quietly sitting or bed rest.
2. Leave your protective glasses in place until you go to bed the evening of surgery.
3. Wear the protective eye shields overnight. The glasses and shields prevent inadvertently rubbing your eye(s) while your eye(s) is healing and preventing the contact lens from falling out.
4. No alcoholic beverages or beer for 24 hours after surgery.
5. Do not sign any legal documents.
6. If a temporary contact was placed on your eye/eyes, DO Not remove it. If it falls out do not replace it.
7. Be sure to report for your post-operative visit tomorrow with Dr. _____________ at_______ am/pm.
8. No swimming, saunas or hot tubs for three (3) weeks. Do NOT wear make-up for five days.
9. Avoid smoke.
10. You may shower, but do not get water directly in your eyes.
11. Resume all of your normal medications.

Begin the following medications:

• Please begin these drops on the day of the procedure. Note: Wait at least two minutes between drops. Please bring all of your drops with you to your appointment.
• Vigamox (or Zymar): Use one (1) drop four (4) times a day for seven (7) days.
• Xibrom (or Acular): Use one (1) drop four (4) times a day for four to five days for pain control.
• Artificial Tears: Use four (4) to six (6) times a day as necessary for contact lens dryness. Use any over the counter preservative free lubricating drops.
• Neurontin: 100mg take one tablet three (3) times a day for the first day. You may increase to two(2) tablets three times a day if your pain is not controlled on the second day.
• Ambien: 10mg take one (1) at bedtime as needed for sleep.

One day after surgery, start one of these drops: FML / Flarex / Lotemax

• One (1) drop four (4) times a day for one (1) week, THEN
• One (1) drop three (3) times a day for one (1) week, THEN
• One (1) drop two (2) times a day for one (1) week, THEN
• One (1) drop once (1) a day for one (1) week.

These drops reduce inflammation and prevent corneal haze. Proper use is very important. Shake bottle before each use.
 
Continue taking the eye drops on your scheduled post op visit days. PLEASE DO NOT STOP THE DROPS FOR ANY REASON. If you have questions or concerns regarding the post-operative medications (drops) please call our office – phone 330-630-9699 – and a doctor or technician will advise you.
 
Day(s) After Surgery

1. You may experience some eye pain after the topical anesthetic wears off. This varies from patient to patient. Some patients experience only mild discomfort (like an eyelash in the eye), while others experience more pain. These are normal side effects of the procedure. The discomfort usually decreases within the first 24 to 48 hours. It is normal for the eye(s) to be red and watery for the first four (4) to five (5) days.
2. We recommend that you DO NOT drive for the first 24 hours following the procedure.
3. You will need to see your doctor frequently until the eye(s) are healed and stable, usually every day for four (4) days. They are at a greater risk for infection while the front surface of the cornea is healing. The risk is greatly reduced by using your eye drops and following all of your doctor’s instructions.
4. Your vision will be somewhat cloudy for a few days, get a little worse typically around day three to five, then start to improve once your contact lens is removed. Changing or fluctuating vision is common, especially if you have had prior RK surgery, for the first 2 months following surgery. Your final results can be determined in three to five months.