Will you still need reading glasses after PRK Surgery?

A laser eye procedure called photorefractive keratectomy (PRK) is highly effective in reshaping the cornea to correct nearsightedness, farsightedness, astigmatism, and myopia. As we age, the question of whether PRK will eliminate the need for reading glasses becomes more prevalent.  Understanding the connection between the process and the use of reading glasses is crucial for setting reasonable expectations and making educated judgments on PRK.

The PRK Procedure

In PRK, a laser known as an excimer is used to reshape the cornea to fix refractive problems. Here are the steps involved in the procedure:

1. Epithelium Removal: The underlying corneal tissue is exposed by removing the cornea's thin outer layer (epithelium).

2. Laser Reshaping: The cornea can be reshaped using an excimer laser to flatten, steepen, or smoothen its surface, depending on the severity of the refractive defect.

3. Recovery Time: The epithelium undergoes spontaneous regeneration over a few days, and it may take many weeks to months for complete visual stabilization to occur.

Although PRK is highly effective for farsightedness, how it affects nearsightedness and the necessity of reading glasses depends on several factors, the most important of which are the patient's age and the presence or absence of presbyopia.

How Does Presbyopia Occur?

The capacity of the eye to concentrate on nearby objects is diminished with age, a condition known as presbyopia. It usually becomes more visible as people age, starting in their early to mid-40s. Presbyopia, in contrast to eye conditions like myopia, hyperopia, or astigmatism, is caused by the standard lens of the eye becoming less flexible with age. A pair of reading glasses will be required as the lens hardens and near-object focus becomes more difficult.

While PRK and other laser eye procedures can alter the cornea's curvature, they do nothing to change the internal lens or the eye's flexibility. Hence, PRK can only fix farsightedness and not prevent or cure presbyopia.

After PRK, Will You Require Reading Glasses?

The patient's age plays a significant role in the likelihood of needing reading glasses following PRK , particularly in relation to presbyopia:

1. People Under 40: PRK is a great way to correct refractive faults for younger patients who still need to acquire presbyopia. In some instances, these patients might not even require glasses for distance or close vision. Presbyopia, or the necessity to wear reading glasses, is common among older people.

2. Patients over 40: PRK can correct distance vision (myopia, hyperopia, or astigmatism) in patients in their 40s or older; however, it will not correct presbyopia. These individuals will continue to need reading glasses for near-vision activities such as reading, stitching, or using a smartphone.

3. Monovision PRK: Many patients opt for monovision PRK to reduce their dependence on reading spectacles. This method involves minor refraction of one eye to improve farsightedness and nearsightedness in the other. This may help some people, but it takes time to get used to and is only suitable for some because it changes how they perceive depth.

Why might you still need reading glasses after undergoing PRK?

1. Presbyopia Progression: Regardless of their distance vision, patients over the age of 40 will likely require reading spectacles for near tasks as they age, as PRK does not address the loss of lens flexibility that causes presbyopia.

2. PRK improves farsightedness and hyperopia patients' ability to see clearly at a distance. Consequently, although the end outcome may be sharper distant vision without glasses, the operation does not affect close vision.

3. Prolonged Near Work and Eye Strain: Even though PRK patients may be able to carry out specific near tasks without the use of reading glasses, prolonged activities such as reading or computer work may still result in eye strain or discomfort, necessitating the use of reading glasses for comfort.

Alternatives for Reducing Reliance on Reading Glasses Following PRK

Reading glasses will still be necessary following PRK. However, there are ways to manage presbyopia and lessen reliance on them:

1. Monovision Correction: One method for correcting near vision in one eye is monovision PRK or using contact lenses after PRK. It enables us to see well up close and far away without glasses; however, it could take some getting used to.

2. Multifocal Lenses or Reading Glasses: Many use convenient, all-purpose reading glasses. Correcting near and farsightedness with the same pair of multifocal contact lenses is also possible.

3. Corneal Inlays: A potential solution for individuals who wish to avoid using reading spectacles is to implant small inlays in the cornea of one eye to improve near vision. Nevertheless, PRK does not cover this particular operation.

4. Intraocular Lenses (IOLs) For Presbyopia Correction: Patients who develop cataracts later in life may elect to undergo cataract surgery with presbyopia-correcting IOLs. With these lenses, you won't require corrective eyewear for either near or far vision correction.

5. Utilising State-of-the-Art Laser Techniques: Patients with presbyopia may explore more recent laser procedures, such as SMILE (Small Incision Lenticule Extraction), in conjunction with other treatments.

While PRK surgery does an excellent job of correcting farsightedness and reducing the need for corrective lenses, it's important to remember that reading glasses may still be necessary for some people with presbyopia. Setting reasonable expectations for PRK outcomes and planning for future vision requirements requires understanding this constraint.

For individuals searching for alternatives to reading spectacles, book a free consultation with an experienced ophthalmologist at Eagle Eye Care, who can offer personalized solutions customized to their vision and lifestyle, such as monovision, corneal inlays, or multifocal lenses.