Photorefractive Keratectomy (PRK) is a laser eye surgery that corrects vision errors like nearsightedness, farsightedness, and astigmatism. It reshapes the cornea to improve light focus on the retina, reducing the need for glasses or contact lenses. A frequent concern for those considering PRK is the discomfort or pain experienced during and after the procedure. Understanding its sources and management is important for individuals exploring this vision correction option.
Understanding the Source of Discomfort
The PRK procedure itself is not painful. Numbing eye drops are applied before surgery, blocking sensations as an excimer laser reshapes the cornea. This process typically takes less than 10 to 20 minutes per eye.
Discomfort stems from a unique PRK step: the gentle removal of the corneal epithelium, the eye’s outermost layer. This layer protects delicate corneal nerve endings. Its removal exposes these nerves, and pain occurs as the layer regenerates over them during healing.
The Post-Procedure Sensation
After PRK surgery, patients report various sensations as numbing drops wear off, usually 30-90 minutes later. These include a gritty feeling, like sand or an eyelash, along with burning, stinging, or foreign body sensations. Intense tearing and light sensitivity (photophobia) are also common, sometimes accompanied by a runny nose.
Discomfort is most significant within the first 24-72 hours post-surgery. For many, the second day can be the most uncomfortable. While the severity of pain varies among individuals, some describe it as moderate, others as high as seven out of ten. It is also common for one eye to experience more discomfort than the other.
Navigating Recovery and Pain Relief
Acute discomfort after PRK lasts 3-5 days, diminishing as the corneal epithelium heals over exposed nerves. Various strategies and medications are employed to manage this post-operative period effectively. Immediately after the procedure, a therapeutic bandage contact lens is placed on the eye. This lens acts as a protective barrier, reducing pain by shielding the healing surface and exposed nerves from external stimuli and eyelid friction. It is usually worn for about five to seven days until the new epithelial layer has fully regenerated.
Prescribed medications also aid pain management. Oral pain relievers, from over-the-counter options like ibuprofen or acetaminophen to stronger prescription medications (e.g., opioids, systemic NSAIDs), are often recommended. Some oral analgesics may be administered before surgery for better post-operative pain control. Medicated eye drops are also important; these include antibiotic drops to prevent infection, anti-inflammatory drops (such as NSAIDs like ketorolac or diclofenac, and steroids) to reduce swelling and pain, and frequent lubricating artificial tears to combat dryness and irritation. Some studies suggest that bandage contact lenses soaked in medications like ketorolac can effectively reduce pain in the initial post-operative period.
Beyond medications, practical measures can provide additional relief. Resting the eyes as much as possible, especially during the first 24 to 48 hours, helps facilitate healing and minimizes strain. Applying cold compresses to the forehead and eyelids can also soothe irritation and reduce discomfort. Adhering strictly to the surgeon’s post-operative instructions for eye drop application, medication timing, and activity restrictions is fundamental for optimal healing and pain control.