PRK & TRANS-PRK SURGERY
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WHAT IS PRK SURGERY?
PRK (Photorefractive Keratectomy) is largely the same as LASIK, but here there is no flap cut before the laser surgery is applied. The epithelium is removed manually, or alcohol assisted, and then the laser surgery is done directly on the superficial tissue of the cornea.
Because the epithelium is removed, there is considerable discomfort post-operatively. Recovery time is usually about a month until vision returns to the best possible amount. This procedure however is slightly safer than LASIK because of the lack of a flap. The depth at which tissue is altered in the cornea is less than in LASIK, making the risk for ectasia less. Haze is also a possible complication, but many studies prove that the modern techniques used has largely removed this complication.
WHAT IS TRANS-PRK SURGERY?
With Trans-PRK (Transepithelial Photorefractive Keratectomy) the epithelium is removed with the laser, then the laser is applied to the superficial layers of the cornea exactly as in a PRK. The major difference with the Schwind Amaris laser is that because of the SmartSurfACE technology, the surface is smoother and therefore recovery is much quicker than with other systems.
Recovery time is about a week, as a much smaller area of epithelium is removed. It is the most versatile procedure as all patients that qualify for any other procedure, will qualify for a TransPRK, but not vice-versa.
4. MM TransPRK.mp4
MY TRANS-PRK EXPERIENCE: DR TC BOTHA
In August 2020 I decided to follow through with my own refractive surgery.
Two reasons:
I could see a difference between wearing spectacles and not wearing spectacles (more on this below). This means, for me at least, I had a clinically relevant refractive error, no matter how small.
I put my patients through the process and wanted to experience it for myself. I tell patients it is super safe, let us prove that point.
TransPRK was the obvious choice. No flap. No other surgeon performing the creation of the flap. In fact, no human intervention at all. Just me, all my planning, and the laser. (I thank Dr York for locking the laser on my eyes and taking the responsibility of performing my procedure). No risk of flap complications... CONTINUE READING
PROCEDURE PROCESS: TRANS-PRK SURGERY
This procedure process breakdown summarises what our patients can expect when undergoing TransPRK Surgery.
1. Theatre Booking and Payment
1. Theatre Booking and Payment
Theatre Booking
After your consultation with Dr Botha, you will return to Reception to make your refractive theatre booking.
ALL procedures will be done at our practice.
An exact procedure time cannot be provided at this stage but you will be given an approximate time period for planning purposes.
The day before your procedure, we will contact you to communicate what time you will need to arrive at our practice.
Payment
Medical aids in South Africa see these procedures as aesthetic. Therefore, it is not covered by them.
The cost of your procedure needs to be settled by you beforehand.
2. What to Bring and How to Prepare
2. What to Bring and How to Prepare
What to Bring and How to Prepare
Depending on your procedure, and whether it will involve one or both eyes, it may be necessary to arrange transport after surgery.
This will be confirmed when you make your refractive theatre booking.
NO CHANGE in eating and medication routines is necessary.
Avoid bringing excessive accessories.
Be sure to dress comfortably. The theatre gown provided to you on the day of surgery will be worn over your own clothes.
Please do not wear any mascara or eye make-up on the day of surgery.
Anaesthesia, Eating and Drinking
The procedure is done under TOPICAL ANAESTHESIA. This means that drops are used to numb the eye/s.
The procedure is very quick. As a routine doing more than topical anesthesia is excessive.
As the patient needs to be awake to fixate on a light and give certain feedback, no general anesthesia is used.
If a patient is very anxious, then tablets are given to relax the patient.
You can eat and drink as normal before your procedure.
NO PAIN is felt during the procedure.
Admission Process
Please arrive at Reception at the time provided to you the day before.
You will be given a CONSENT FORM to read and sign before we begin the refractive theatre preparation process.
One of our skilled Ophthalmic Assistants will then begin the procedure preparation process
Even though the procedure itself is usually quite short, the process surrounding the procedure can take some time. Preparation is also slightly different for each patient, therefore waiting times can vary. Please be patient during this process. We do the best we can to make the time in our practice as short and comfortable as possible.
3. Refractive Theatre Process
3. Refractive Theatre Process
Theatre Preparation
Numbing drops will be used to prepare the eye/s for the procedure.
If you are feeling very anxious please communicate this to one of our Ophthalmic Assistants.
Tablets can be provided to help you feel more relaxed.
Operation
Although the procedure is usually the same in its nature, variability in procedure type and techniques used will have different time factors.
You will be awake during the procedure as you will need to fixate on a light and provide certain feedback.
The procedure should be comfortable for you. NO PAIN should be present during the procedure.
You can verbalize if there is any discomfort and we will immediately react to this.
4. Post-Operative Period and What to Expect
4. Post-Operative Period and What to Expect
TransPRK Post-Procedure Information
Walk out with eyes open (no shields are placed over the eye/s) with CONTACT LENSES IN SITU.
DROPS will be prescribed. A SCRIPT will be provided immediately post-operation.
Drops are to be used until finished.
You will receive a BAG with an APPOINTMENT CARD. This card gives the time of your post-operative consultation with Dr Botha the next morning.
The eyes are reviewed on Day 1 and then again on Day 4 to remove the contact lenses placed on the eye/s.
A routine follow-up is usually done 3 months post-operatively. Patients can, however, contact the practice at any time if there are any issues or concerns.
The only constraint post-operatively is NO EYE RUBBING.
Major post-operative expectations / issues:
You will have functional vision immediately post-operatively, however, DRIVING VISION is not immediate.
Pain and discomfort are common on Day 1 and Day 2. Over-the-counter pain tablets are usually sufficient.
On Day 3 you will feel much more comfortable.
On Day 4 you can expect to have vision good enough to drive for short distances. Most patients are able to resume work.
There are usually major vision fluctuations in the first week.
Minor fluctuations can be expected in the first month.
Patients will have dry eyes for a few weeks to months.
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