PRK and trans-PRK in Toulon — Photorefractive Keratectomy

PRK (photorefractive keratectomy) is the reference laser technique of refractive surgery, the simplest and the most respectful of the cornea. The surgeon reshapes the cornea directly at the surface with an excimer laser, without cutting a flap. Trans-PRK, its evolution, is 100% laser: the surgeon operates without even touching the eye. PRK corrects myopia, astigmatism, and to a lesser extent hyperopia and presbyopia. It is the operation most often chosen by ophthalmologists who have surgery themselves.

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PRK: the essentials

Principle: excimer-laser surface reshaping of the cornea, no flap
Corrects: myopia (to about -8), astigmatism, partly hyperopia and presbyopia
Best for: thin corneas, dry eyes, jobs at risk of eye trauma (military, combat sports)
Anaesthesia: local drops — painless
Both eyes: same day
Procedure time: under 10 minutes
Recovery: 3 to 5 days (bandage lens removed at day 4)
Dr Bourdon’s fee: €2,400 for both eyes (post-op consultations included)

How does PRK work?

The excimer laser reshapes the surface of the cornea to change its optical power: flattening the centre to correct myopia, or steepening the periphery for hyperopia. Unlike LASIK, no corneal flap is created, which preserves more corneal strength.

Positioning under the excimer laser, head in a comfortable headrest.
Anaesthetic drops and disinfection; a lid speculum keeps the eye open.
The surface layer (epithelium) is gently removed, or vaporised directly by the laser in trans-PRK.
Laser treatment: about 10 seconds (myopia/astigmatism) to 20 seconds (hyperopia).
A bandage contact lens is placed to protect the cornea while the epithelium regrows (removed at day 4).

Recovery and aftercare

The first 3 to 5 days can be uncomfortable (gritty sensation, light sensitivity, watering) while the epithelium heals — this is well controlled with painkillers, a cold mask and artificial tears. Vision is blurry at first and sharpens over a few days, continuing to refine over several weeks. Antibiotic and anti-inflammatory drops are used for 2 to 4 weeks and artificial tears for 1 to 3 months.

Advantages and limits

Advantages: safest technique, no flap, suited to thin corneas and dry eyes, ideal for at-risk occupations.
Limits: slower recovery than LASIK or SMILE (3-5 days), more initial discomfort.

Other techniques: LASIK · SMILE · Phakic ICL implant · PreLex

Frequently asked questions about PRK

Is PRK painful?

The procedure itself is painless under drop anaesthesia. The first 3 to 5 days of healing can be uncomfortable (gritty sensation, light sensitivity), well managed with painkillers, a cold mask and artificial tears.

Why do some surgeons prefer PRK?

Because it does not create a corneal flap, PRK preserves more corneal strength and avoids flap-related complications. It is often the technique chosen by ophthalmologists who have surgery on their own eyes.

When can I go back to work after PRK?

Usually after 3 to 5 days, once the epithelium has healed and the bandage lens is removed. Vision keeps sharpening over the following weeks.

What is trans-PRK?

Trans-PRK is the 100% laser, touchless version of PRK: the excimer laser removes the epithelium and reshapes the cornea in a single step, without any instrument contact.

How much does PRK cost in Toulon?

Dr Bourdon’s fee is €2,400 for both eyes, with post-operative consultations included. Refractive surgery is not reimbursed by Social Security, but many insurers cover part of the cost.

Sources

Article written and reviewed by Dr Hugo Bourdon, ophthalmic surgeon at the Clinique Saint-Michel ELSAN and the Centre Iris – Institut Toulonnais d’Ophtalmologie (281 rue Jean Jaurès, Toulon).