PRK (Photorefractive Keratectomy)
What is PRK?
Photorefractive Keratectomy (PRK) is a refractive eye surgery that corrects vision problems like nearsightedness (myopia), farsightedness (hyperopia), and astigmatism by reshaping the cornea with an excimer laser. Unlike LASIK, PRK does not create a corneal flap, making it suitable for patients with thinner corneas or higher risk of flap complications. In India, PRK is performed in ophthalmology departments at hospitals like Apollo, Fortis, Medanta, and AIIMS, often at affordable costs. Understanding the procedure, costs, recovery, risks, and frequently asked questions (FAQs) is essential for patients in India to make informed decisions.
Why do you need PRK?
PRK is indicated for:
- Refractive errors:
- Myopia: Nearsightedness (-1 to -8 diopters, depending on corneal thickness).
- Hyperopia: Farsightedness (+1 to +4 diopters).
- Astigmatism: Irregular corneal shape (up to 4 diopters).
- Specific candidates:
- Thin corneas (<480–500 microns): Unsuitable for LASIK flap creation.
- Active lifestyles: High risk of flap trauma (e.g., athletes, military personnel).
- Stable vision: Prescription unchanged for at least 1 year; typically for ages 18–40.
- Healthy eyes:
- No corneal diseases (e.g., keratoconus), severe dry eyes, or contraindications (e.g., uncontrolled glaucoma).
The procedure aims to improve vision to 6/6 or 6/9 (normal or near-normal) by removing the corneal epithelium and reshaping the underlying stroma with a laser, reducing dependency on glasses or contact lenses.
Why Do PRK Costs Vary in India?
Costs range from ₹20,000 to ₹80,000 per eye:
- Procedure Type: Standard PRK (₹20,000–₹40,000); TransPRK or high corrections with MMC (₹40,000–₹80,000).
- Hospital/Location: Higher in metro cities (Apollo, Fortis); lower in government hospitals (AIIMS, ₹10,000–₹20,000, if offered).
- Surgeon’s Expertise: Experienced refractive surgeons charge more.
- Additional Costs: Pre-op tests (e.g., topography, ₹3,000–₹5,000), medications (₹1,000–₹2,000), bandage lens (₹1,000–₹2,000).
- Insurance: Rarely covered (cosmetic procedure); confirm with your provider.
PRK Procedure
- Before Surgery Evaluation:
- Assessment:
- Corneal topography: Maps corneal shape and thickness.
- Refraction: Confirms prescription (e.g., myopia, astigmatism).
- Pachymetry: Measures corneal thickness (must allow safe ablation).
- Slit-lamp exam: Checks for dry eyes, corneal scars, or abnormalities.
- Pupil size: Large pupils (>6 mm) may increase risk of glare/halos.
- Blood tests: Not typically needed unless systemic conditions (e.g., diabetes) suspected.
- Medications: Stop contact lenses 1–2 weeks prior (to avoid corneal molding); antibiotic eye drops (e.g., moxifloxacin) 1 day pre-surgery.
- Consent: Risks, including delayed healing, are explained.
- Assessment:
- Surgical Techniques:
- PRK:
- Performed under topical anesthesia (e.g., proparacaine drops), lasting 10–15 minutes per eye.
- The corneal epithelium (outer layer, 50 microns) is removed using a diluted alcohol solution (20% ethanol) or a rotating brush.
- An excimer laser reshapes the corneal stroma by removing precise amounts of tissue (e.g., flattens for myopia, steepens for hyperopia).
- Mitomycin-C (MMC, 0.02%) may be applied for 20–60 seconds in high corrections to reduce haze risk.
- A bandage contact lens is placed to protect the cornea during epithelial healing (removed after 3–5 days).
- Variations:
- TransPRK: Laser removes epithelium and reshapes stroma in one step; no alcohol used.
- LASEK: Epithelium is loosened with alcohol and flipped back (like a flap) before laser treatment; less common.
- Intraoperative Tools:
- Excimer laser: Reshapes cornea.
- Bandage contact lens: Protects cornea post-procedure.
- Speculum: Keeps eyelids open.
- PRK:
- After Surgery:
- Observation: 30–60 minutes; same-day discharge.
- Eye care: Antibiotic drops (e.g., moxifloxacin) and steroid drops (e.g., prednisolone) for 1–2 weeks; artificial tears for dryness.
- Pain management: Moderate pain for 2–3 days (due to epithelial removal); managed with oral analgesics (e.g., ibuprofen) and cycloplegic drops (e.g., cyclopentolate).
- Instructions: Avoid rubbing eyes, swimming, or makeup for 2 weeks; wear sunglasses for UV protection.
Recovery After PRK
- Immediate Recovery: Same-day discharge; vision blurry for 3–5 days due to epithelial healing.
- Post-Surgery Care:
- Pain: Moderate discomfort for 2–3 days (due to epithelial removal); managed with analgesics and cycloplegic drops.
- Vision: Improves gradually; functional vision in 1–2 weeks; stabilizes in 1–3 months; 90–95% achieve 6/6 or 6/9 vision.
- Eye care: Antibiotic/steroid drops for 1–2 weeks; artificial tears for 1–3 months (dryness common); bandage lens removed after 3–5 days.
- Activity: Avoid rubbing eyes, swimming, or dusty environments for 2 weeks; normal activities (e.g., reading) in 3–5 days; driving in 1–2 weeks (if vision meets legal standards).
- Light sensitivity: Common for 1–2 weeks; sunglasses help.
- Follow-Up:
- Visits at 1 day, 1 week (bandage lens removal), 1 month, then 3–6 months to monitor vision and healing.
- Refraction: Confirms final vision at 1–3 months.
Most resume normal activities in 1–2 weeks; full recovery takes 1–3 months. Success rate: 90–95% achieve target vision; 5–10% may need enhancement (repeat PRK or LASIK) for residual refractive error.
Risks and Complications
- Surgical Risks:
- Infection (1–2%): Corneal infection (keratitis); treated with antibiotics, may lead to scarring.
- Corneal haze (5–10%): Temporary cloudiness, esp. with high corrections; usually resolves in 6–12 months; MMC reduces risk.
- Under/Overcorrection (5–10%): Residual refractive error; may need glasses or enhancement.
- Post-Surgery:
- Dry eyes (10–20%): Common for 1–3 months; managed with artificial tears; severe cases rare.
- Glare/Halos (5–10%): Night vision issues, esp. with large pupils; usually improve in 3–6 months.
- Delayed epithelial healing (2–5%): Prolongs discomfort; may increase infection risk.
- Corneal scarring (1–3%): Permanent haze; may affect vision, rare with MMC.
- Long-Term:
- Regression (2–5%): Vision changes over years; may need enhancement.
- Corneal ectasia (<0.1%): Rare; corneal bulging if undiagnosed keratoconus; may need cross-linking or transplant.
Report severe pain, sudden vision loss, or redness promptly.
Frequently Asked Questions (FAQs)
Who is a candidate for PRK?
Age 18–40, stable vision, refractive errors within treatable range, thin corneas, or high risk of flap trauma (unlike LASIK); no severe dry eyes or keratoconus.
Can I avoid PRK?
Yes, alternatives include glasses, contact lenses, LASIK, SMILE, or IOL implantation for high refractive errors.
Is PRK painful?
Moderate pain for 2–3 days (due to epithelial removal); managed with medication; less discomfort after epithelial healing.
How soon can I resume activities?
Light activities in 3–5 days; normal routines in 1–2 weeks; full recovery in 1–3 months.
Is PRK covered by insurance in India?
Rarely, as it’s considered cosmetic; confirm with your provider.
Signs of complications?
Severe pain, sudden vision loss, or increased redness.
How does PRK compare to LASIK?
PRK: No flap, longer recovery, more initial discomfort, better for thin corneas; LASIK: Faster recovery, less discomfort, but flap-related risks.
Lifestyle changes post-surgery?
Avoid rubbing eyes for 2 weeks, use prescribed drops, wear sunglasses for UV protection, avoid swimming for 2 weeks, and attend follow-ups.
Conclusion
PRK is a safe, effective alternative to LASIK for correcting refractive errors, particularly for patients with thin corneas or active lifestyles, offering a high success rate with stable outcomes. India’s top hospitals (Apollo, Fortis, AIIMS) provide affordable, expert care, though insurance coverage is limited. Understanding the procedure, costs, recovery, risks, and FAQs helps patients approach surgery confidently. Consult a refractive surgeon for personalized guidance and optimal outcomes.
Looking for Best Hospitals for Photorefractive Keratectomy
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we are not promoting any hospitals we sourced all the details from google and hospitals website, please verify and start with your surgery here we go the list includes government, budget and superspeciality hospitals accreditation bodies are the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and the Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₹) | Maximum Price (₹) |
|---|---|---|
Agra |
40,000 |
90,000 |
Ahmedabad |
50,000 |
1,00,000 |
Ajmer |
40,000 |
90,000 |
Aligarh |
40,000 |
90,000 |
Allahabad |
40,000 |
90,000 |
Amritsar |
45,000 |
95,000 |
Aurangabad |
45,000 |
95,000 |
Bangalore |
50,000 |
1,00,000 |
Bareilly |
40,000 |
90,000 |
Belgaum |
45,000 |
95,000 |
Bhopal |
45,000 |
95,000 |
Bhubaneswar |
45,000 |
95,000 |
Bikaner |
40,000 |
90,000 |
Chandigarh |
50,000 |
1,00,000 |
Chennai |
50,000 |
1,00,000 |
Coimbatore |
50,000 |
1,00,000 |
Dehradun |
45,000 |
95,000 |
Delhi |
50,000 |
1,00,000 |
Dhanbad |
40,000 |
90,000 |
Durgapur |
40,000 |
90,000 |
Faridabad |
50,000 |
1,00,000 |
Ghaziabad |
50,000 |
1,00,000 |
Gorakhpur |
40,000 |
90,000 |
Guntur |
45,000 |
95,000 |
Gurgaon |
50,000 |
1,00,000 |
Guwahati |
45,000 |
95,000 |
Gwalior |
40,000 |
90,000 |
Hyderabad |
50,000 |
1,00,000 |
Indore |
45,000 |
95,000 |
Jabalpur |
40,000 |
90,000 |
Jaipur |
50,000 |
1,00,000 |
Jalandhar |
45,000 |
95,000 |
Jamshedpur |
45,000 |
95,000 |
Jodhpur |
40,000 |
90,000 |
Kanpur |
40,000 |
90,000 |
Kochi |
50,000 |
1,00,000 |
Kolkata |
50,000 |
1,00,000 |
Kollam |
45,000 |
95,000 |
Lucknow |
45,000 |
95,000 |
Ludhiana |
50,000 |
1,00,000 |
Madurai |
45,000 |
95,000 |
Mangalore |
45,000 |
95,000 |
Meerut |
40,000 |
90,000 |
Moradabad |
40,000 |
90,000 |
Mumbai |
50,000 |
1,00,000 |
Mysore |
50,000 |
1,00,000 |
Nagpur |
45,000 |
95,000 |
Nashik |
45,000 |
95,000 |
Navi Mumbai |
50,000 |
1,00,000 |
Noida |
50,000 |
1,00,000 |
Patna |
40,000 |
90,000 |
Pune |
50,000 |
1,00,000 |
Raipur |
45,000 |
95,000 |
Rajkot |
45,000 |
95,000 |
Ranchi |
40,000 |
90,000 |
Surat |
50,000 |
1,00,000 |
Thane |
50,000 |
1,00,000 |
Vadodara |
45,000 |
95,000 |
Varanasi |
40,000 |
90,000 |
Visakhapatnam |
45,000 |
95,000 |
Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.