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What is TransPRK?

Trans-PRK (Trans-Epithelial Photorefractive Keratectomy) is a type of laser eye surgery that corrects vision problems such as nearsightedness, farsightedness and astigmatism. It is also known as Advanced Surface Ablation (ASA) or No Touch PRK.

Trans-PRK, or transepithelial photorefractive keratectomy, has become widely used in recent years and has led to new developments in surface ablation treatments.

The PRK technique has long proven its reliability in the treatment of mild and moderate myopia and astigmatism. Patients with a thin corneal layer can apply for the Trans-PRK method even if they are not suitable for the LASIK technique or if they do not wish to undergo LASIK.

Trans-PRK Candidates

Trans-PRK may be an option for people who have nearsightedness, farsightedness or astigmatism and want to correct their vision. However, not everyone is a good candidate for this surgery.

The ideal candidates for Trans-PRK are those who:

  • Have had stable vision prescription for at least 1-2 years,
  • Have a corneal thickness that is sufficient to safely remove the epithelium and reshape the cornea with the laser,
  • Have no active eye infections or other eye diseases that could affect healing or outcome,
  • Have realistic expectations of the procedure and its results,

It is important to have a comprehensive eye exam and consult with a qualified eye surgeon before deciding to undergo this surgery.

Trans-PRK Preparation Time

The preparation period for Trans-PRK usually includes several steps to ensure that the surgery is safe and effective. The specific pre-op steps may vary depending on the patient’s eye health, medical history and other factors. There are some general stages that are involved in preparing for Trans-PRK below:

Comprehensive Eye Exam

Prior to Trans-PRK treatment, the physician will order a comprehensive eye examination to assess the patient’s eye health and vision needs. The doctor will measure the patient’s visual acuity, corneal thickness and other factors.

Stop Wearing Contact Lenses

If the patient uses contact lenses, they should stop wearing them for a while before the initial eye exam and surgery. This is because lenses can alter the shape of the cornea and affect the accuracy of the laser treatment. The particular period needs to stop wearing contact lenses depends on the type of lenses the person wears and their doctor’s recommendations.

Medication Adjustment

The patient may need to adjust or discontinue certain medications prior to surgery. Inform your doctor about all regulary used medications so the doctor will be able to advise about any necessary adjustments to the medications.

Stop Eating

The person may need to fast for several hours before surgery, usually at least 4-6 hours before the procedure, to avoid nausea and vomiting during surgery.

Arrange for Transportation

Patients will need someone to drive them home after the surgery, as their vision will be blurry or hazy immediately after the procedure.

How is the PRK / Trans-PRK Performed?

The eye is numbed with anesthetic eye drops to minimize discomfort during the surgery. The outermost layer of the cornea, called the epithelium, is removed with a laser (Trans-PRK) or a special brush (PRK). This step is also called “epithelial debridement”

An excimer laser is used to precisely remove a small amount of tissue from the cornea to reshape it, correcting the refractive error that is causing the vision problem. The laser treatment usually takes only a few seconds, and the patient may feel a slight pressure or discomfort.

After the laser treatment, a soft contact lens is placed on the eye to protect it while the epithelium grows back over the next few days. The contact lens will remain in place until the epithelium has completely healed, which usually takes 3 to 5 days.

After surgery, the patient should follow their doctor’s instructions for post-operative care. This may include using eye drops to prevent infection and promote healing, avoiding rubbing the eye, and avoiding heavy activities that could increase the risk of complications.

The entire PRK / Trans-PRK procedure usually takes about 10 to 15 minutes per eye, and patients can usually return to their normal activities within a few days of the surgery. It is important to attend all follow-up appointments with the ophthalmologist to ensure the eye is healing properly and vision is improving as expected.

During Trans-PRK treatment, patients usually experience little to no pain because the eye is numbed with anesthetic eye drops. After the procedure, patients may experience some discomfort, light sensitivity and blurred vision for a few days while the epithelium heals.

Trans-PRK differs from other types of laser eye surgery, such as LASIK and SMILE, in that a flap is not created in the cornea. Instead, the outermost layer of the cornea (the epithelium) is removed to expose the underlying cornea for reshaping with the excimer laser.

The effect of Trans-PRK is usually permanent, as the cornea is reshaped to correct the refractive error that caused the vision problem. However, the structure of the eyes may change as part of the natural aging process, so some patients may need further vision correction in the future.

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