Before LASIK came along, photorefractive keratectomy (PRK) was the most popular refractive surgery procedure for the eyes. While both are considered surgeries, LASIK patients usually have less discomfort and results are quicker. However, PRK is still preferred for those with thin corneas or large pupils.
Although FDA approval did not come until 1995, PRK was available in the early 1980s in many countries around the world. A decade before it was available in the United States, Americans could get PRK surgery done in places as nearby as Canada.
For PRK surgery, an excimer laser aims an ultraviolet light beam at the eye and reshapes the surface of the cornea by removing small tissue pieces. Reshaping the cornea can change the way light is focused on the retina and can thereby improve vision.
The procedure is done in a doctor's office and takes only about one minute per eye. During this time, the eyes are constantly moistened with wetting drops. The healing process usually lasts about three days.
PRK is used to correct the vision of patients who are farsighted, nearsighted or have astigmatism. The cornea is made steeper in farsighted people, is flattened in nearsighted people and is curved back into a normal shape in those that have astigmatism.
If performed as an elective surgery, PRK is usually not covered by health insurance. The typical cost of the surgery is comparable to that of LASIK: surgery on one eye is about $1,800, though it can sometimes be found as low as $1,350 and as high as $2,500, depending on where you live and the surgeon you choose. These fees often fluctuate depending on the cost for the use of the facility, the doctor's fee, pre-operative procedures, the materials used during the procedure, the medicine needed after surgery and followup fees.
Although an excimer laser is always used for PRK, there are many manufacturers of the machine and the machines vary by their amount of refractive error. They must all be approved by the FDA. More than half of the lasers used today are made by VISX.