What is the difference between RK and PRK eye surgery?
Radial Keratotomy (RK) was one of the first surgical procedures widely performed to treat myopia (nearsightedness). It was first developed in Russia, and became popular around the world, especially during the 1980s and early 1990s. The procedure involved using a small corneal blade to make tiny radial incisions emanating from the center of the cornea, similar to spokes on a bike wheel.
Photorefractive Keratectomy (PRK) followed RK and is still used today as a laser alternative to LASIK. Rather than using a blade or keratome to make radial incisions in the cornea, PRK employs an excimer laser to remove small amounts of tissue, causing a similar effect (flattening of the central part of the cornea) to treat nearsightedness.
What are the long-term results of RK?
Many people who had RK during the 1980’s and 1990’s report that their vision remained stable for many years. Others have exhibited a more progressive change in the way they have seen over time. Most patients who had RK were nearsighted before the procedure. Today, many of those patients are farsighted and/or experience fluctuation in their vision throughout the day. It is common that the vision prescription measured in the morning is quite a bit different than it is in the afternoon and evening.
If I experience fluctuation of my vision during the day after RK, will it continue after another surgery such as PRK, LASIK, or lens implant surgery?
Yes, fluctuation of the vision during the day as a result of RK is very common and will continue, even if another procedure is performed. It is very important to inform your surgeon before any follow-on procedures if fluctuation exists. Occasionally, follow-on procedures may still be performed to reduce the amount of vision prescription at the present time, through its various fluctuations. If you experience fluctuation in your vision throughout the day, be sure to ask your surgeon how that will be managed and dealt with after your 2nd procedure.
Are there any other things you should watch out for when considering follow-on surgery after RK?
It is important to be aware that all surgery comes with some risk, and no result can ever be guaranteed. No surgery should be presented in such a way that you are made to believe it will be perfect in every way. If you are led to believe that a follow-on procedure in the setting of fluctuation after RK is going to be “perfect,” it would be important to do additional research and seek out a second opinion.
What types of procedures are used to treat patients that have had RK and their vision fluctuates?
Both surgical, as well as non-surgical options, exist to help patients with a fluctuation of vision after RK. Non-surgical alternatives include soft contact lenses that can be worn during certain periods of the day. In some instances, hard contacts called scleral lenses work very well.
What types of procedures are used to treat nearsightedness today?
The most common procedures used to treat nearsightedness in the United States today are LASIK and PRK. Small Incision Lenticule Extraction (SMILE) is another form of laser vision correction that was approved by the US FDA in late 2016. Lens implants called phakic IOL’s are also used to treat nearsightedness in certain patients, especially those with extreme prescriptions and/or those with thin corneas.
Dr. Gregory Parkhurst has either authored or reviewed and approved this content.