Photorefractive Keratectomy (PRK)

What Is Photorefractive Keratectomy (PRK)?

Photorefractive keratectomy (PRK) is a laser vision correction procedure that reshapes the cornea to correct refractive errors — nearsightedness (myopia), farsightedness (hyperopia), and astigmatism. PRK was the first laser refractive surgery approved by the FDA and remains one of the safest and most effective vision correction procedures available.

Unlike LASIK, which creates a corneal flap before reshaping the underlying tissue, PRK removes the thin outer layer of the cornea (epithelium) and applies the excimer laser directly to the corneal surface. The epithelium regenerates naturally within 3 to 5 days. Because PRK does not require a corneal flap, it is the preferred procedure for patients with thinner corneas, certain corneal conditions, or occupations and lifestyles that increase the risk of flap displacement.

At West Boca Eye Center in Boca Raton, Dr. Brent Bellotte performs PRK using advanced excimer laser technology to deliver precise, customized vision correction for each patient.

How Does PRK Work?

Refractive errors occur when the shape of the cornea prevents light from focusing correctly on the retina. In nearsightedness, the cornea is too steep or the eye is too long, causing light to focus in front of the retina. In farsightedness, the cornea is too flat, causing light to focus behind the retina. In astigmatism, the cornea is unevenly curved, causing light to focus at multiple points.

PRK corrects these errors by using an excimer laser — a cool ultraviolet light beam — to remove microscopic amounts of tissue from the corneal surface, reshaping it so that light focuses precisely on the retina. The laser treatment is guided by a detailed map of your corneal topography, allowing Dr. Bellotte to customize the correction to your individual eye anatomy.

Who Is a Candidate for PRK?

PRK may be recommended for patients who:

• Have mild to moderate nearsightedness, farsightedness, or astigmatism
• Have corneas that are too thin for safe LASIK flap creation
• Have corneal surface irregularities, scarring, or prior corneal surgery
• Are involved in contact sports, military service, or occupations where a corneal flap could be displaced by physical impact
• Have been previously told they are not candidates for LASIK due to corneal thickness
• Are at least 18 years of age with a stable prescription for at least 12 months

PRK may not be appropriate for patients who are pregnant or nursing, have active eye infections or severe dry eye, have autoimmune conditions that impair healing, or have very high refractive errors beyond the safe treatment range.

During your evaluation at West Boca Eye Center, Dr. Bellotte will perform a comprehensive eye examination including corneal topography, pachymetry (corneal thickness measurement), and refraction testing to determine whether PRK is the most appropriate procedure for your eyes.

PRK vs LASIK — Which Is Right for You?

PRK and LASIK achieve comparable long-term visual outcomes — both procedures produce 20/40 vision or better in over 95 percent of patients. The key differences are in the surgical technique and recovery:

• Corneal flap: LASIK creates a thin corneal flap; PRK does not. This makes PRK safer for patients with thinner corneas or those at risk of flap displacement.
• Recovery time: LASIK patients typically see clearly within 24 hours. PRK recovery takes longer — vision stabilizes over 1 to 3 months as the epithelium heals and the corneal surface smooths.
• Discomfort: LASIK has minimal post-operative discomfort. PRK patients may experience mild to moderate discomfort for 3 to 5 days while the epithelium regenerates.
• Long-term stability: Both procedures offer permanent correction, though PRK avoids any long-term flap-related concerns.

Dr. Bellotte will recommend the procedure best suited to your corneal anatomy, prescription, lifestyle, and visual goals.

What to Expect During the PRK Procedure

PRK is performed in the office at West Boca Eye Center. Here is what to expect:

• Before treatment: Do not wear eye makeup, lotions, or perfume on the day of surgery. Anesthetic eye drops are applied to numb the eye. If you wear contact lenses, you must discontinue use for a period specified by Dr. Bellotte before the procedure (typically 1 to 2 weeks for soft lenses, longer for rigid lenses).
• During treatment: An eyelid holder keeps the eye open. The surgeon gently removes the epithelium (the thin outer layer of the cornea). The excimer laser then reshapes the underlying corneal tissue with precision guided by your eye map. The laser portion typically takes 30 to 60 seconds per eye. You may hear a clicking sound and notice a faint odor during the laser application — both are normal.
• After treatment: A bandage contact lens is placed on the eye to protect the surface and reduce discomfort while the epithelium regenerates. Anti-inflammatory and antibiotic eye drops are applied. You will need someone to drive you home.

Each eye is usually treated in a separate session spaced days to weeks apart to allow safe recovery monitoring, though both eyes may be treated on the same day in certain cases.

Recovery After PRK

• Days 1–3: Mild to moderate discomfort, tearing, and light sensitivity are common as the epithelium begins to regenerate. The bandage contact lens remains in place. Prescription eye drops are used as directed. Over-the-counter pain relief may be recommended. Rest is advised — avoid screens and reading when possible.
• Days 3–5: The epithelium typically heals enough for the bandage contact lens to be removed at your follow-up visit. Discomfort decreases significantly.
• Weeks 1–4: Vision gradually improves but may fluctuate day to day as the corneal surface continues to stabilize. Medicated eye drops continue. Avoid swimming, hot tubs, and rubbing the eyes.
• Months 1–3: Vision continues to sharpen as the cornea completes its healing process. Most patients achieve their best corrected vision by 3 months. Follow-up visits monitor healing and visual acuity.
• Final outcome: Over 95 percent of PRK patients achieve 20/40 vision or better. Many achieve 20/20 or better. The visual outcome is comparable to LASIK, though the timeline to reach optimal vision is longer.

There are no significant activity restrictions beyond the first week. Most patients return to work within 3 to 5 days, though some visual tasks may remain slightly blurred during the stabilization period.

Risks and Side Effects of PRK

PRK has an excellent safety record with decades of clinical data supporting its efficacy. Possible side effects include:

• Discomfort, tearing, and light sensitivity during the first 3 to 5 days (while the epithelium heals)
• Temporary dry eyes (common, managed with lubricating drops)
• Halos, glare, or starbursts around lights at night (typically temporary, most common in the first few months)
• Corneal haze (rare with modern techniques; mitomycin C may be applied during surgery to minimize this risk)
• Undercorrection or overcorrection (an enhancement procedure can be performed if needed)
• Infection (very rare, prevented with antibiotic drops)
• Slower visual recovery compared to LASIK (expected, not a complication)

When to Contact Your Doctor

Call West Boca Eye Center immediately if you experience:

• Unusual or worsening pain after the first few days
• A sudden decrease in vision
• Significant discharge, redness, or swelling
• Any symptoms that concern you during recovery

Dr. Bellotte and the WBEC team are available to address any questions or concerns throughout your recovery.

Schedule Your PRK Evaluation

If you are interested in reducing your dependence on glasses or contact lenses — or if you have been told you are not a candidate for LASIK — schedule a PRK evaluation at West Boca Eye Center. Dr. Brent Bellotte provides comprehensive refractive surgery consultations to determine the best vision correction option for your individual needs.

West Boca Eye Center is located at 9325 Glades Road, Suite 201, Boca Raton, FL 33434. Call (561) 488-1001 to schedule your appointment.

Frequently Asked Questions About PRK

What is the difference between PRK and LASIK?

PRK removes the thin outer layer of the cornea (epithelium) and applies the laser directly to the corneal surface. LASIK creates a corneal flap before reshaping the tissue underneath. PRK is preferred for patients with thinner corneas or those at higher risk of flap displacement. Both procedures achieve comparable long-term visual outcomes, though PRK has a longer recovery period.

Is PRK painful?

The procedure itself is painless — the eye is numbed with anesthetic drops. After surgery, mild to moderate discomfort, tearing, and light sensitivity are common for the first 3 to 5 days while the epithelium regenerates. A bandage contact lens and prescribed medications help manage discomfort during this period.

How long does it take to see clearly after PRK?

Vision begins to improve within the first week as the epithelium heals. Most patients notice significant improvement within 2 to 4 weeks, though vision may continue to sharpen over 1 to 3 months. Over 95 percent of patients achieve 20/40 vision or better by 3 months after surgery.

Is PRK permanent?

Yes. The corneal reshaping performed during PRK is permanent. However, normal age-related vision changes (such as presbyopia, the need for reading glasses after age 40) will still occur over time, as these affect the lens inside the eye rather than the cornea.

Can PRK be repeated if my vision changes?

In most cases, yes. If vision changes occur over time or if an enhancement is needed, PRK can be repeated provided there is adequate corneal tissue remaining. Dr. Bellotte will evaluate your corneal thickness and overall eye health to determine whether retreatment is appropriate.

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