Photorefractive Keratectomy: Indications, Surgical Techniques, Complications, and Results

Abstract

Photorefractive keratectomy (PRK) has increasingly achieved excellent results in low to moderate myopia and hyperopia with refinements in new laser technology, surgical technique, and postoperative management. However, PRK has been largely abandoned for laser in situ keratomileusis (LASIK) over the past 2 years. The apparent advantages of LASIK — minimal discomfort, the growing acceptance of bilateral simultaneous surgery, rapid corneal healing, good uncorrected visual acuity within 24 to 48 h, rapid stabilization of refraction, little stromal haze, and minimal postoperative medications and follow-up — have resulted in experienced refractive surgeons abandoning this technique and new surgeons learning only LASIK. Despite the obvious disadvantages surgeons who have been performing PRK for many years recognize it as an excellent technique with few serious complications for refractive errors up to 10 to 12 diopters (D) of myopia and +4D to +5D of hyperopia which still holds an important place in their refractive repertoire. A number of comparative studies have failed to demonstrate any real superiority of LASIK over PRK except in the first few weeks postoperatively.