Trans PRK surgery, or Transepithelial PRK, in Paris
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TransPRK: overview
When the eye functions perfectly, light rays are refracted by the cornea and the lens, focusing on a single point on the surface of the retina, where the image is formed before being transmitted to the brain. In some patients, refractive errors occur: the image forms in front of the retina (myopia), behind it (hyperopia), or on different planes (astigmatism).
Regardless of the method, the goal of laser refractive surgery is to modify the curvature of the cornea to provide the necessary correction and bring the image precisely onto the retinal plane. There are two main techniques for this: LASIK and PRK (Photorefractive Keratectomy).
LASIK involves creating a small flap (“stromal flap”) in the corneal epithelium, the outermost layer. This flap is replaced after the laser treatment is performed on the corneal stroma, located beneath the epithelium. This process can weaken the cornea, which may or may not be acceptable depending on the patient’s professional and recreational activities. Certain corneal characteristics also contraindicate LASIK, in which case PRK is preferred.
PRK involves gently peeling the corneal epithelium manually after a brief application of alcohol. The epithelium then regenerates during the postoperative phase. While PRK does not weaken the cornea, it requires a longer recovery period than LASIK and is associated with more postoperative discomfort.
TransPRK, or “transepithelial PRK,” is a PRK variant that overcomes these drawbacks. The corneal epithelium is not removed manually but with the same excimer laser that is subsequently applied to the stroma to reshape its curvature. There is therefore no mechanical contact with corneal tissues, making the procedure less invasive and less traumatic for ocular structures.
TransPRK: indications and recommendations
The TransPRK Procedure
Preoperative instructions
- Begin the prescribed preoperative eye drop regimen two days before the procedure.
- Discontinue any corrective contact lenses: two days before surgery for soft lenses, and one month before for rigid lenses.
- Fasting is not required prior to TransPRK surgery.
- The procedure is performed under local anesthesia and on an outpatient basis, allowing the patient to return home the same da
Procedure details
A conventional PRK procedure takes about 30 minutes for both eyes, with manual removal of the corneal epithelium accounting for a significant portion of this time. TransPRK reduces the total treatment time to about ten minutes, as the laser ablation of the epithelial tissue takes only a few seconds.
After anesthesia with lidocaine drops, the surgeon gains access to the stroma and reshapes it with the same excimer laser. The duration of this second phase depends on the degree of refractive error to be corrected but never exceeds a few seconds.
Once the necessary correction is achieved, a bandage contact lens is placed on the eye. As with other laser refractive surgeries, the procedure is completely safe. An “eye tracker” system ensures precise laser delivery regardless of eye movements.
Post surgery: recovery, pain, and results
After the procedure, the patient can return home with an escort. Vision typically remains blurry for 24 hours. The bandage contact lens is removed by the surgeon four days after the procedure.
Regarding makeup, the main issue is makeup removal, which requires rubbing the eyes. Foundation can be applied the day after surgery, provided the eyes and their contours are not touched. Eye and eyelash makeup can be resumed after seven days, and eyeliner after one month.
The prescribed postoperative treatment must be followed precisely. It generally consists of antibiotic and anti-inflammatory eye drops for 15 days, and lubricating drops for several weeks.
Postoperative pain varies among patients. The advantage of TransPRK is a reduction in both the intensity and duration of postoperative pain compared to conventional PRK. Some patients experience minimal discomfort, while others feel pain around the eyes. In all cases, this sensation lasts about 24 hours and quickly subsides.
Resumption of activities is determined by the surgeon.
TRANS PRK LASER EYE SURGERY : PRICES IN PARIS
For TransPRK, Dr. Camille Rambaud charges €1,500 per eye.
Results
Outcomes with TransPRK are generally excellent and equivalent to those of conventional PRK. The only difference is the method of accessing the corneal stroma. Correction of the visual defect is performed with the same excimer laser and according to the same protocols. The main benefit of transepithelial PRK is a reduction in recovery time and postoperative discomfort.
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Frequently asked uestions about TransPRK
How should the eyes be protected after TransPRK surgery?
As with any other laser refractive surgery (conventional PRK, LASIK, etc.), mechanical protection of the eyes is essential. In the first days, during waking hours, the bandage contact lenses placed at the end of the procedure provide sufficient protection. It is also advisable to wear sunglasses in bright sunlight and, of course, to avoid trauma for at least one month. At night, eyes should be protected with shields to prevent any mechanical contact with bedding or reflex rubbing. During washing, shampoo should be applied with the head tilted back, eyes closed, and the shower jet should not be directed at the eyes.
How is postoperative follow-up organized after TransPRK?
Postoperative follow-up is provided by the operating surgeon. Typically, the patient is seen 4 to 5 days after surgery, when the bandage contact lenses are removed. The final follow-up visit is usually scheduled about two months later to assess the final result.
In addition to these routine visits, the patient should not hesitate to contact the doctor if experiencing abnormal postoperative symptoms, such as significant pain, excessive redness, or sudden loss of vision. It is crucial to rule out complications, which are extremely rare, especially when the procedure is performed by an experienced surgeon. If complications do occur, early management is more effective.
Is it possible to obtain medical leave after TransPRK?
Like the vast majority of refractive surgery procedures, TransPRK is considered an elective procedure by the national health insurance system. Therefore, it is not possible to obtain a medical leave of absence. However, it is advisable to take a few days off work to rest, using personal leave. The duration can be discussed with the physician during the preoperative period and depends mainly on the patient’s occupation.
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This page was written by Dr. Camille Rambaud, an ophthalmologist based in Paris and a specialist in refractive surgery.
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