How Do I Prepare for PRK Surgery? | Lasik Awards

Quick Answer

PRK preparation includes discontinuing contact lenses 2–4 weeks before surgery, stopping certain medications as directed by your surgeon, arranging transportation and home recovery support, stocking supplies before surgery day, and following specific instructions for the 24–48 hours immediately preceding the procedure. The more thoroughly you prepare, the smoother your recovery experience will be.

Detailed Explanation

PRK preparation is not merely administrative — the steps you take before surgery directly affect the quality of your pre-operative measurements, the precision of your treatment, and the ease of your recovery. Treat this as a structured pre-operative protocol, not a checklist to rush through.

4–6 Weeks Before Surgery: Contact Lens Discontinuation

This is the single most time-sensitive preparation step. Contact lenses reshape the corneal surface through mechanical pressure and altered tear film oxygenation. This reshaping — even subtle — affects corneal topography and pachymetry measurements. If measurements are taken while the cornea is lens-distorted, the treatment plan is based on inaccurate data.

Discontinuation guidelines:

Soft contact lenses (spherical): Stop wearing at least 2 weeks before the pre-operative evaluation (some surgeons prefer 3 weeks)
Soft toric lenses (for astigmatism): Stop 2–3 weeks before the evaluation
Rigid gas-permeable (RGP) lenses: Stop at least 4 weeks before the evaluation; some surgeons require longer for long-term wearers
Hybrid lenses (RGP center, soft periphery): Stop 4+ weeks before the evaluation

Do not restart contact lens use after your pre-operative evaluation. Continue wearing glasses until surgery day.

2–4 Weeks Before Surgery: Medication Review

Inform your surgeon of every medication and supplement you take. Several require adjustment before PRK:

Isotretinoin (Accutane, Absorica): This acne medication affects corneal healing and is a contraindication to refractive surgery. Most surgeons require a minimum 6-month washout period after stopping isotretinoin before proceeding.

Amiodarone: This cardiac medication deposits in corneal tissue and can affect excimer laser ablation. Patients on amiodarone should discuss this with both their cardiologist and refractive surgeon.

Hydroxychloroquine (Plaquenil): Can affect retinal function. Relevant to the dilated eye examination during evaluation.

Immunosuppressants: Medications that suppress the immune system (methotrexate, mycophenolate, biologics) may affect corneal healing. Your surgeon will review these individually.

Supplements: Vitamin E, fish oil, and other supplements that affect platelet function or bleeding are generally advised to stop 1–2 weeks before surgery (though bleeding risk in corneal surface surgery is minimal).

Finasteride, dutasteride: Some surgeons note potential effects on tear production. Discuss with your surgeon.

1–2 Weeks Before Surgery: Logistics Planning

Arrange your driver. You cannot drive yourself home after PRK — this is non-negotiable. Vision is immediately impaired, and anesthetic drops affect surface sensation. Plan for a friend, family member, or rideshare pickup.

Request time off work. Most desk workers need 4–7 days minimum. Physical or high-visual-demand roles may need 2–3 weeks. Arrange this in advance — do not wait until the day before surgery.

Childcare and household planning. If you are responsible for young children, arrange coverage for at least the first 2–3 days post-surgery. Your visual and functional capacity during peak recovery is significantly reduced.

Travel restrictions. Avoid scheduling air travel within the first 2 weeks post-surgery if possible. Pressurized cabin air exacerbates dry eye. International travel with no nearby surgeon access is not advisable during early healing.

1 Week Before Surgery: Stock Your Recovery Kit

Have the following ready at home before surgery day:

Preservative-free artificial tears (multiple bottles): You will use these 10–15+ times per day. Stock significantly more than you think you need. Refrigerate a supply — cold drops are soothing.
UV-blocking wraparound sunglasses: Required for all outdoor activity throughout recovery (months, not just weeks).
A sleep mask or eye shield: Prevents inadvertent rubbing during sleep in the first week.
Blackout curtains or a dark sleeping environment: Photophobia is significant in the first week.
Easy-to-prepare food: Cooking while visually impaired is frustrating. Stock simple, no-prep meals for the first 3 days.
Audiobooks, podcasts, or music: Screen use is limited in the first week; audio entertainment helps.
Phone accessible without screen effort: Set up voice commands in advance.

Fill your prescriptions before surgery day. Your surgeon will prescribe antibiotic drops, steroid drops, and possibly topical NSAIDs and oral pain medication. Have all of these ready the day before surgery. You will not want to go to a pharmacy post-procedure.

Day Before Surgery: Specific Instructions

Do not wear eye makeup. Mascara, eyeliner, and eyeshadow residue can contaminate the ocular surface. Stop all eye makeup the day before surgery.
Do not use perfumes, hair products, or cologne the day of surgery. Fumes from products can interact with the excimer laser and affect ablation.
Wash your face and eyelids thoroughly the night before surgery with a gentle, non-irritating cleanser.
Eat a light meal before your appointment. You are not under general anesthesia, but feeling lightheaded or nauseous during surgery is uncomfortable. A light meal 2–3 hours before is appropriate.
Take any prescribed pre-operative medications (such as an oral sedative or antibiotic) as directed.
Get adequate sleep. You will be lying still and fixating on a light during surgery. Being rested helps your ability to remain calm and still.

Surgery Day Checklist

Wear comfortable, easily removable clothing (no pullovers — buttons or zippers preferred)
No eye makeup, no perfume, no hair product
Bring your glasses (you will not wear contacts post-surgery)
Confirm your driver is available
Bring a list of your current medications
Bring your prescription ID card and insurance information if relevant
Arrive at the time your clinic specifies — often 30–60 minutes before the procedure

For recognition of PRK programs that provide thorough pre-operative patient education, visit PRK Surgery Awards.

Important Considerations

Contact lens discontinuation is the step most patients underestimate. The desire to wear contacts until the last possible moment is understandable — but measurements taken on lens-altered corneas can result in miscalculated treatments. Follow the timeline exactly.

Do not drive yourself to or from surgery under any circumstances. The consequences — visual and legal — are not worth the convenience.

Ask questions before surgery day, not during it. The consultation and the days leading up to surgery are the time to clarify every concern. Surgery day is not the moment to ask what the drops are for.

Compliance during recovery begins at preparation. Patients who have stocked their recovery supplies, arranged leave, and planned the first week in advance have materially better recovery experiences than those who did not.

What to Do Next

1. Review your surgeon’s specific pre-operative instructions. Clinics issue written pre-operative instructions — read them in full and follow them over these general guidelines where they differ.

2. Confirm your driver and leave arrangements at least 1 week before surgery. Do not leave logistics to the last day.

3. Understand the procedure itself. What Is the PRK Surgery Procedure Like walks through surgery day step by step.

4. Know the recovery arc in advance. How Long Does PRK Recovery Take ensures you have realistic week-by-week expectations from day one.