TRANS PRK

Correcting Vision with Trans PRK: Recovery and Who It’s Suitable For

Key Takeaway

• Trans PRK (Photorefractive Keratectomy) reshapes the cornea using laser technology without creating a corneal flap, unlike traditional LASIK.
• Suitable for patients with thin corneas, dry eyes, or corneal irregularities.
• Corrects myopia (nearsightedness), hyperopia (farsightedness), and astigmatism effectively.
• Lower risk of flap-related complications compared to LASIK.

Introduction

Laser vision correction has transformed the lives of millions of people worldwide by reducing or eliminating the need for glasses and contact lenses. While LASIK is the most well-known procedure, it is not always suitable for everyone—particularly those with thin corneas, chronic dry eyes, or certain corneal conditions.

Trans PRK (Transepithelial Photorefractive Keratectomy) offers a safe and effective alternative. This advanced procedure uses excimer laser technology to reshape the cornea without cutting or lifting a flap. For many patients, Trans PRK provides long-lasting results with fewer complications.

This article explains what Trans PRK is, how it differs from LASIK, the step-by-step process, who is a good candidate, and what to expect during recovery.

What is Trans PRK?

PRK (Photorefractive Keratectomy) is one of the earliest laser eye surgery techniques, introduced in the late 1980s before the development of LASIK. While LASIK later became more popular due to its quicker recovery, PRK remained relevant because of its permanent results and broader suitability for patients with thin or irregular corneas.

Trans PRK is a modernized, all-laser version of PRK. Instead of using mechanical instruments or alcohol to remove the corneal epithelium, the laser itself performs the removal and reshaping in a single step.

How it works:

• The laser gently removes the corneal epithelium (the thin outer layer).
• It then reshapes the underlying cornea to correct refractive errors.
• The epithelium naturally regenerates within a few days after surgery.

Vision problems Trans PRK can treat:

• Myopia (nearsightedness): up to around -5.00 diopters
• Astigmatism: up to about 2.00 diopters
• Hyperopia (farsightedness): in selected cases

Because no flap is created, Trans PRK is particularly beneficial for patients who cannot undergo LASIK due to thin corneas, dry eye syndrome, or certain corneal shapes.
 

Who Should Consider Trans PRK?

Trans PRK is an excellent choice for people who are not ideal candidates for LASIK. You may be suitable if you:

• Are 18 years or older.
• Have a stable prescription for at least 12 months.
   
• Have thin corneas or irregular corneal shapes.
   
• Suffer from dry eye syndrome that makes LASIK less suitable.
• Do not have corneal diseases (such as keratoconus, recurrent erosions).
• Are not affected by systemic diseases that impair healing (e.g., uncontrolled diabetes).
• Require good vision for careers with strict eye standards (pilots, police officers, military personnel).
• In some cases, patients with glaucoma may also qualify, but only under strict medical evaluation.

Preparing for Trans PRK

Preparation is key to a smooth procedure and recovery. Patients are usually advised to:

1. Stop wearing soft contact lenses at least 3 days before the eye exam and surgery.
2. Stop wearing hard contact lenses at least 7 days before surgery.
3. Wear glasses instead during the preparation period to allow the cornea to return to its natural shape.
4. Arrange time off work (5–7 days) to allow proper healing.
5. Do not drive on the day of the eye exam or surgery—bring someone to accompany you.
6. Avoid perfumes, lotions, hair products, or sprays on the day of surgery, as these can interfere with laser calibration.
7. Do not wear makeup or facial creams on the day of surgery.
8. Bring sunglasses to protect eyes from bright light after the procedure.
9. Eat normally, but avoid caffeine (coffee, tea, energy drinks) before surgery.

The Trans PRK Procedure: Step by Step

The entire surgery usually takes about 15–20 minutes per eye and is performed under topical anesthesia (numbing eye drops).

1. Anesthetic drops applied – No needles, no injections.
2. Laser removes epithelium – The outermost corneal layer is precisely removed by laser.
3. Laser reshapes the cornea – Based on pre-calculated measurements, the excimer laser reshapes the cornea to correct vision.
4. Protective contact lens applied – A temporary bandage lens is placed to protect the eye while the epithelium regenerates.

Unlike LASIK, no corneal flap is created, and no stitches are required. Patients can usually go home immediately after the procedure.

Recovery After Trans PRK

Early Healing Phase

• First 3–5 days: Eyes may feel gritty or watery while the epithelium heals. Vision may be blurry during this stage.
• 1 week: Most patients notice gradual improvement in vision.
• 2–4 weeks: Vision stabilizes significantly.
• 3 months: Final vision results are usually achieved.

Recovery Tips

• Use prescribed antibiotic and anti-inflammatory eye drops as directed.
• Wear sunglasses outdoors to reduce light sensitivity.
• Avoid rubbing your eyes.
• Refrain from swimming, heavy exercise, or makeup for at least 1–2 weeks.
• Attend all follow-up appointments to monitor healing.

Advantages of Trans PRK

• Permanent and stable results with high success rates.
• No corneal flap risks, unlike LASIK.
• Lower incidence of dry eye compared to LASIK.
• Minimally invasive—only numbing drops required, no needles or stitches.
• Suitable for more patients (thin corneas, small eyes, deep eye sockets).
• Fewer restrictions for certain professions (pilots, military, police).
• Quick discharge—patients can return home right after surgery.
• Reduced complications compared to flap-based surgeries.

Limitations of Trans PRK

While effective, Trans PRK is not without drawbacks:

• Slower recovery compared to LASIK.
• Temporary discomfort (burning, tearing, blurry vision) in the first days.
• More follow-up care required in the initial healing period.

Still, for many patients, the long-term safety outweighs these temporary inconveniences.