WHAT IS PRK?

Imagine being able to work, drive, read the clock, play sports, ride horseback do just about everything without always having to reach for your glasses or contacts. A new eye treatment called PRK (photorefractive keratectomy) could make this a reality for you. If you're a candidate for PRK, Dr. Glinski can reshape the surface of your eye using a laser, so that images focus more clearly. The result can be a dramatic improvement in your distance vision and your lifestyle.

Could PRK Change Your Life?

Being dependent on glasses and contacts can cramp your lifestyle. Glasses fog up, fall off, scratch, and break. Frames and thick lenses interfere with side vision. Contacts can irritate your eyes, especially if dust gets under a lens or you have dry eyes or allergies. Both glasses and contacts can limit your choice of careers or sports. PRK could reduce or eliminate your need for glasses and contacts without weakening your eyes.

Is PRK Right for You?

The success of PRK depends mainly on your eyes. You may be a good candidate for PRK if your vision is stable you have Myopia (nearsightedness) and Hyperopia (farsightedness), no eye problems. You also need to understand the possible risks and be realistic about what to expect.

• PRK works well for most people, but there is no guarantee that you'll have perfect vision or never need distance or reading glasses again.
• PRK does not change your vision overnight. It takes several weeks to months for your eye to heal and your vision to clear completely.
• The procedure is painless, but you can expect to have some discom fort for a few days afterward.

Evaluating Your Eyes

Dr. Glinski will examine your eyes to make sure PRK is right for you. Your eyes will be dilated and your refraction (the way light focuses in your eye) measured. Dr. Glinski will also examine your cornea (the clear covering of your eye), take computerized measurements (corneal topography) of the shape of the cornea, and measure the thickness of the cornea using ultrasound. These and other tests help Dr. Glinski detect any problems that could make PRK the wrong decision for you.

Risks & Complications

Before PRK, you'll be asked to sign a consent form. Dr. Glinski will discuss the following, as well as other possible risks of PRK, with you.

• A haze may develop in the cornea during the first few weeks after surgery. Normally, this clears quickly. If it does not, vision can be cloudy for months. Only rarely is the haze permanent.
• There is a very small risk of infection, which could scar the cornea and decrease vision.
• Vision could worsen or astigmatism (irregular curvature of the cornea) or farsightedness develop. Variable vision is also possible, but unlikely.
• The pressure inside the eye may temporarily rise as a result of the eyedrops used after surgery.
• Some people are more sensitive to glare or see halos around lights, but this is rarely troublesome.
• A second treatment could be needed if near sightedness is not sufficiently corrected.

CORRECTING YOUR VISION WITH PRK

How clearly you see depends in part on the shape of your cornea. During PRK, Dr. Glinski uses an excimer laser to reshape the surface of the cornea. This allows light to focus more clearly in your eye and brings your vision closer to normal. Because the amount of tissue to be removed is calculated by a computer, the procedure is extremely precise. Not all eyes heal at the same rate, so usually only one eye is corrected at a time. This allows you and your doctor to evaluate the results before treating the second eye.

The Normal Eye

In the normal eye, the cornea is a rounded curve. Light rays pass through the cornea and the pupil to the lens, which refracts, or focuses, the light onto the retina (a light-sensitive tissue inside the eye). The resulting image is clear.

Myopia (click here for more information about myopia)

Myopia is the medical term for nearsightedness. Myopia occurs when an eye is too long for the cornea's curvature. Light rays entering the eye do not form a sharp focus on the retina at the back of the eye. Instead, they focus further forward, producing a blurred image. The term 'nearsighted' means that you can see "near" objects clearly without your glasses, but objects further in the distance are blurry. There are varying degrees of myopia or nearsightedness.

Astigmatism (click here for more information about astigmatism)

Many patients with myopia have some degree of astigmatism, or ovalness to their corneas. Astigmatism occurs when the cornea is shaped more like a football than a basketball. As a result, patients with astigmatism experience distortion or tilting of images because of unequal bending of light rays entering the eye. Patients with high degrees of astigmatism have blurred vision not only for distant objects, as with myopia, but for near objects as well.

Hyperopia (click here for more information about hyperopia)

Hyperopia is the medical term for "farsightedness" It occurs when an eye is too short for the cornea's curvature. Light rays entering the eye focus behind the retina, and as a result a blurred image is produced. Farsighted individuals, however, can use their focusing muscles to pull the image forward onto the retina. When the focusing muscles weaken with age, presbyopia occurs. In a young person with severe hyperopia, or once presbyopia sets in, at a later stage, distant objects are seen more clearly than near objects.


WHAT IS AN EXCIMER LASER?

An excimer laser is a concentrated beam of ultraviolet light that can be precisely focused. The beam is so accurate that it can cut notches in a human hair. And because the excimer laser doesn't generate heat, the surrounding tissue is rarely damaged.

Your Excimer Experience

You're awake during treatment, but your eye is numbed with drops so you feel no pain. You lie flat in a reclining chair so that your eye is aligned with the laser beam. Your eyelid is held open with a special instrument. Your doctor first removes the top (epithelial) layer of your cornea. Then you look at a light to keep the laser beam centered over your eye. You'll hear a sound as the laser reshapes the surface of your cornea. The laser treatment typically takes less than one minute. You'll probably be in and out of the laser center in about an hour.

How the Laser Reshapes Your Eye

To correct myopia, Dr. Glinski uses the excimer laser to reshape the curve of the cornea. Your refraction is entered into a computer, which calculates the depth and the pattern of tissue to be removed. The laser then delivers a programmed number of overlapping pulses of ultraviolet light. Each pulse removes a microscopic layer of the cornea over the pupil. More pulses are directed at the center of the cornea to flatten the curve. Overlapping the pulses creates a smooth surface. When the center of the cornea is flattened, light rays are focused more directly on the retina and images are clearer.

YOUR RECOVERY AND FOLLOW- UP

After treatment, Dr. Glinski places a soft contact lens on the surface of the eye. Your vision will be blurry at first, but it should start to clear in 3-4 days. Dr. Glinski will remove contact lens at that time and will monitor your recovery over the next few months. You can probably expect maximum improvement in your vision within 1 month after PRK.

Do's

• Arrange for a ride home after PRK. You won't see clearly enough to drive.
• Wear sunglasses when you're outdoors. Your eye may be sensitive to bright light until it heals.
• Use your eyedrops exactly as directed and keep all follow-up appointments with Dr. Glinski

Don'ts

• Don't rub or bump your eye.
• If your doctor gives you a protective contact lens, don't touch it. If it falls out, don't try to reinsert it. Call Dr. Glinski at (405) 636-1508
• Don't plan to return to work for a few days.
• Don't drive until your vision clears.
• Don't go swimming, sit in a whirlpool or a hot tub, play active sports, or wear eye makeup until advised by doctor.

Evaluating your Progress

Your follow-up care begins right after treatment. Dr. Glinski will check your eye frequently at first to make sure your cornea is healing properly. If over age 40, reading glasses may be necessary.