Advanced Surface Ablation is one kind of photorefractive keraectomy or PRK procedures. PRK is an older procedure than LASIK procedure, almost with the same outcomes and long term visual results, with only drawback of slower recovery of vision and comparatively more discomfort.  ASA possesses all the benefits of the PRK with added benefit of faster timeframe of visual recovery, compared to the basic PRK procedure.

How Is It Better?

ASA is one kind of PRK procedure, but has faster recovery, but how is it achieved? The key difference is the improved surgical method, which is much advanced compared to the method available, when the PRK developed for the first time.

How ASA Works?

The standard ASA procedure involves treatment of the surface of cornea and it does not involve the process of making the flap. Excimer laser is used in this procedure and has the capability of tracking the eye and perform reshaping of the cornea’s front surface, through wavefront customized treatment and it plays vital role in this procedure. After the surgery, a soft contact lens is placed over the eye, temporarily to support the process of healing, for a few days.

ASA Procedure

The procedure is simple, as very advanced technology is used and it lasts in just a few minutes. The procedure involves the following steps.

  • Initially, the surgeon starts the procedure with the anaesthetic drops and is applied to the eye to provide enough comfort during the surgery.
  • Then the cornea surface or epithelium is removed gently, with the help of automated and soft brush.
  • Then reshape of the eye is attempted in the treatment through laser, according to the prescription of the patient.
  • After reshaping, rinsing of cornea is performed using a physiologically balanced and chilled solution, immediately.
  • At the end of the procedure, a contact lens would be placed with a clear bandage over the eye. This bandage has to be retained until regeneration of the epithelium and it takes a several days.

After the Procedure

Right after the procedure, shielding is placed over the eyes as the vision becomes blurry immediately after the procedure, you need someone to come along with you to drive you back home, from the medical centre and the rest of the day, you need to relax at home. Discomfort from mild to moderate levels is possible and it may continue for 2 to 3 days. The surgeon provides all the necessary guidelines and instructions to get this discomfort managed after completing, after the surgery.

Recovery Period

The most interesting part is that the patient can resume day to day and regular activities, in 2 to 3 days. Medicated drops have to be continued for several weeks, post the surgery. For first few months after the surgery fluctuations of vision are possible. The complete vision takes a few months after the treatment of ASA.

Eligibility for ASA

  • The candidate must be more than 18 years of age.
  • The patient should attain prescription of stable eye for at least last one year.
  • Wide pupils are needed.
  • One should not have any issues related to health, as they may affect the eyes.
  • The patient cannot undergo LASIK technically, because of corneal dystrophy or glaucoma or problems of eye pressure.
  • The corneas are too thin to undergo LASIK surgery.


So far ASA has already enhanced numerous lives of people. And still, it is important to understand the expectations in realistic scenario and the decision must be based on them. The first point is the eligibility and it is determined by your doctor, who decides whether you are a good candidate or not based on the results obtained after special tests, through state-of-the-art technology. After successful surgery, the patient can get back to the normal activities, with no dependence over corrective lenses.


Intense complications are extremely rare after the ASA surgery. It is an effective and permanent procedure, performed safely. However, certain risks and complications are possible, based on various factors. Most of these and in fact all these risks and complications can be reduced through careful determination and selection of the procedure through pre-operative testing, protocols followed during the surgery and enough post surgery care.

ASA as Advanced or TransPRK

The technology keeps advancing in the medical industry, like for any other industry in the world. Advanced surface ablation surgery has improved to the next level and is known as Trans advanced surface laser ablation, which is also technically same as TransPRK surgery procedure.

ASA or TransPRK procedure is an improved version of ASA with the key difference in the way corneal surface or epithelium is removed. In basic PRK procedure, corneal epithelium adhesion gets loosened through pressure applied with a sponge over the central cornea, as alcohol is assisted in this procedure. This procedure involves 20% of ethanol to be applied to the cornea for less than a minute, using a BVA sponge. In TransPRK, the basic technical difference is that the excimer laser performs refractive error correction through no-touch and well-controlled procedure. It removes the corneal epithelium and stroma, both in just one step. Removal of tissue of about 60 micro meters from the periphery and 55 micro meter of epithelial tissue from the central cornea is made very easy and simple, compared to mechanical debridement process, which can be more complication ridden and cumbersome two step procedure.

The difference of technology between ASA and advanced ASA is almost the same in terms of outcome, however, the advantage of this advanced procedure is in the postoperative period. This procedure enables the patient to get back to the regular activities earlier than the basic PRK procedure. The degree of comfort is also the same in both these basic and advanced procedures. Many surgeons prefer the TransPRK procedure, as it is advanced technically and it is more beneficial to the patient, with faster recovery period. According to the experts, TransASA is quicker to perform and has faster recovery time. Since less physical pressure is applied in this procedure, the problem of infectious keratitis is less likely to occur.