PRK vs. LASIK corrective surgery

I'm considering undergoing laser surgery for my eyes.
I was told that I'm a good candidate for both PRK and LASIK operations,
so I am in interested in the differences betwen these operations.

To sum my research up, it seems that with PRK there is less chance for
complications (since no flap is cut in the cornea), at the expense of
experiencing (severe) pain after the operation and having the vision
improve gradually.

My question, is this accurate? I was told by a doctor that many
physicians are moving from LASIK to PRK because of the possible
complications -- is that correct? All things being equal (and assuming
I don't mind the pain) which operation is better, in the sense that
there is less chance for complications and future problems?

I'd appreciate any informed opinions, thanks!

Adam Morrison wrote:
> I'm considering undergoing laser surgery for my eyes.
> I was told that I'm a good candidate for both PRK and LASIK operations,
> so I am in interested in the differences betwen these operations.
>
> To sum my research up, it seems that with PRK there is less chance for
> complications (since no flap is cut in the cornea), at the expense of
> experiencing (severe) pain after the operation and having the vision
> improve gradually.
>
> My question, is this accurate? I was told by a doctor that many
> physicians are moving from LASIK to PRK because of the possible
> complications -- is that correct? All things being equal (and assuming
> I don't mind the pain) which operation is better, in the sense that
> there is less chance for complications and future problems?
>
> I'd appreciate any informed opinions, thanks!

I agree with everything you said up to a point, and that point is that
anything above -6.00 tips in favor of LASIK.

DrG

There is a move back toward PRK for thin corneas, or other conditions
that might make LASIK risky. But if you have no such problems, LASIK may
be better, even safer.

w.stacy, o.d.

Adam Morrison wrote:

> I'm considering undergoing laser surgery for my eyes.
> I was told that I'm a good candidate for both PRK and LASIK operations,
> so I am in interested in the differences betwen these operations.
>
> To sum my research up, it seems that with PRK there is less chance for
> complications (since no flap is cut in the cornea), at the expense of
> experiencing (severe) pain after the operation and having the vision
> improve gradually.
>
> My question, is this accurate? I was told by a doctor that many
> physicians are moving from LASIK to PRK because of the possible
> complications -- is that correct? All things being equal (and assuming
> I don't mind the pain) which operation is better, in the sense that
> there is less chance for complications and future problems?
>
> I'd appreciate any informed opinions, thanks!
>

PRK has the following disadvantages: Prolonged healing time with
discomfort. Greater chance of infection during the
re-epithelialization phase. Greater chance of hazing and diffuse
scarring, especially in higher prescriptions. Greater chance of
regression in prescriptions over -6. Prolonged use of corticosteroids
leads to greater risk of steroid-induced glaucoma.

PRK has the following advantages: No risk of DLK or epithelial
ingrowth and other interface problems. Less tissue removal and less
risk of corneal ectasia, and less damage to corneal nerve plexus.
Fewer problems with the epithelium. Better surface optical quality in
most cases -- absence of flap striae. No concern about future flap
complications such as dislodgement.

Some hold that a modification of PRK called LASEK offers some
advantages over PRK. Additionally, PRK is approved by the Navy for its
SEALS, and I believe also by the Air Force for its pilots. LASIK is
only approved by the Army for the infantry.

DrG

DrG has it right with a minor clarification. The amount of tissue that
is removed to effect refractive change is identical in PRK and LASIK,
but the big difference is where that tissue is removed.

With PRK, LASEK, and Epi-LASIK the tissue is removed on the surface of
the cornea, leaving the greatest amount of untouched thickness for
stability of the cornea. In LASIK and IntraLASIK the tissue is removed
at 100-180 microns down into the cornea under the flap, thus
decreasing the amount of stable cornea by that amount.

As someone who has had PRK, I can attest the fact that the first six
months you will wish you had LASIK, and every month thereafter you
will be glad you had PRK.

Glenn Hagele
Executive Director
USAEyes.org

"Consider and Choose With Confidence"

Email to glenn dot hagele at usaeyes dot org

http://www.USAEyes.org
http://www.ComplicatedEyes.org

I am not a doctor.

Thanks for the clarification. What I meant was the the ablation occurs
more superficially with PRK.

DrG