PRK vs. LASIK corrective surgery

Discussion in 'Laser Eye Surgery' started by Adam Morrison, Sep 17, 2005.

  1. 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, Sep 17, 2005
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  2. Adam Morrison

    Dr. Leukoma Guest

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

    Dr. Leukoma, Sep 18, 2005
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  3. 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.
    William Stacy, Sep 18, 2005
  4. Adam Morrison

    Dr. Leukoma Guest

    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.

    Dr. Leukoma, Sep 18, 2005
  5. 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

    "Consider and Choose With Confidence"

    Email to glenn dot hagele at usaeyes dot org

    I am not a doctor.
    Glenn -, Sep 18, 2005
  6. Adam Morrison

    Dr. Leukoma Guest

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

    Dr. Leukoma, Sep 18, 2005
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