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Photorefractive Keratectomy (PRK)

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Title: Photorefractive Keratectomy (PRK)
Author (s): Russell Swan, MD; Mark Mifflin, MD
Date: 01/30/2016
Keywords/Main Subjects: Photorefractive keratectomy; PRK, Refractive surgery; Myopia; Hyperopia; Mitomycin C; Astigmatism
Diagnosis: Myopia, astigmatism
Description: This video demonstrates a standard surgical technique for photorefractive keratectomy at the University of Utah Moran Eye Center with Dr. Mark Mifflin. Below is our standard protocol:

  1. Calibrate and program the excimer laser
  2. Prepare the operative cart with the instruments and supplies necessary to perform the procedure
  3. Prepare the patient with the proper sedation
  4. Instill topical anesthesia, antibiotics and NSAID drops into the operative eye(s) and clean the eyelashes and fornices
  5. Position the patient on the laser table
  6. Drape the eye, being sure to isolate the eyelashes and meibomian glands
  7. Place a locking eyelid speculum to obtain adequate exposure
  8. Center the eye in the operative field by adjusting the microscope and/or head position
  9. Use 8.0mm alcohol well to place 20% alcohol on the epithelium for 40 seconds to loosen it
  10. Rinse the eye with 3cc of BSS
  11. Dry the fornices of excess fluid with a microsurgical sponge
  12. Use Sloane micro-hoe and Mahoney hockey stick to remove epithelium and smooth Bowmans
  13. Use a microsurgical sponge to remove excess fluid from the bed to obtain uniform hydration
  14. Ablate the stromal bed with programmed refraction in the laser
  15. For hyperopic ablations or myopic ablations >-6.0D use MMC (typically 12 seconds).
  16. Copiously flush surface with BSS, particularly if MMC is used
  17. Instill antibiotic and steroid drops
  18. Place bandage contact lens in eye

Format: video
Identifier: Moran_CORE_20259
Faculty Approval by: Mark Mifflin, MD

Russell Swan, MD, ©2015. For further information regarding the rights to this collection, please visit: