Your patient is a 28-year-old mother of two with stable vision and some irregularities in the shape of her cornea. She wears contacts, but sometimes they irritate her eyes. She has a thin cornea, mild dry eye, and occasionally uses eye drops. She asks, “Am I a good candidate for PRK?”
Yes. PRK may be the best choice because she has a thinner cornea and mild dry eye. Good candidates are older than 21 years, healthy, with stable prescriptions (for at least one year). However, a careful screening is necessary to confirm her eligibility.
Talking Points: PRK is a form of advanced surface ablation that corrects the same vision problems as LASIK, but it may be a better option for people with thin corneas or pre-existing dry eyes. Recovery time is longer and less comfortable than for LASIK. Common side effects include over/under correction, dry eye, and nighttime halos/glare. Rarely, permanent dry eye, glare, or markedly reduced vision can occur. About 92% of PRK patients achieve 20/40 vision or better, and 70% of PRK patients achieve 20/20 vision. PRK works better for low-to-moderate hyperopia than high hyperopia. This patient should be made aware that PRK will not prevent presbyopia, which typically develops around age 40, and she may still need to wear glasses after surgery. Managing expectations is vital to a successful surgery and patient satisfaction.