which has the least risk, PRK or LASIK?

If you are thinking about having Lasik, IntraLasik, PRK, LASEK, Epi-Lasik, RLE, or P-IOL eye surgery, this is the forum to research your concerns or ask your questions.

which has the least risk, PRK or LASIK?

Postby cindylu » Sat Mar 17, 2007 12:54 am

I am looking into the possibility of having my vision corrected with refractive surgery. I am mildly nearsighted. My prescription is -2.00 and -2.25, which isn't too severe. My question is this. According to my prescription, which procedure would you recommend? Of course, I still have to get checked to see if I am a candidate or not. Just need the extra info. I have tried and failed to wear contacts. I did have my optometrist check me for dry eye with the staining test. He said my left eye was moderately dry, right was O.K. However, this is not the cause for my contact discomfort, because my right eye is the one that is most irritated from the contacts. Thanks for any insight you can give! :)
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Postby LasikExpert » Sat Mar 17, 2007 5:57 am

The first step to Lasik is the creation of the Lasik flap. PRK does not have this flap. No flap means no possibility of a Lasik flap related complication during surgery or during your lifetime. Even though the probability of a Lasik flap complication is relatively low, no possibility is almost always better than a low probability.

PRK tends to induce less temporary dry eye and for a shorter period of time.

PRK will have a longer vision recovery period and more discomfort. For the first three months you will wish you had Lasik, then every day thereafter you will probably be glad you had PRK.

Some studies show a slightly better outcome with PRK, however newer results are close enough that they are less conclusive.
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Postby silverflash » Thu Mar 29, 2007 3:41 am

I had ALK in my left eye way back which is basically no-laser lasik. I had 2 Prks on the same eye 10 years later, in 2004 and 2005 and the recovery for me was nasty BUT it was well worth it. I had pain pretty badly after the 2nd day out till the 5th or so. So for three days, expect pain and sleepless nights, at least that's what I had. Mine was largely due to an ill-fitting bandage contact thens i think....

it takes alot longer to heal after prk BUT i feel better having it rather than a flap that can have issues anytime for the rest of my life...
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Postby lvziggy » Mon Apr 02, 2007 5:45 pm

Hi. I just got my second eye done with PRK. I'm sorry to hear your recovery was not so good and that you had so much pain. For me, I would have to say my recovery has not been too bad at all. My surgery, for each eye but 2 weeks apart, was on Thursday. Both times, waking up Friday morning was a little rough, but as soon as I put in the "tylenol drops", my eye felt pretty good. I had a lttle sensitivity to light and just kept the blinds closed in the house during the morning. Then by Saturday nite and even more so on Sunday (probably because I tried to quit using the tylenol drops) I had enough discomfort (I wouldn't really even call it pain) to take a prescription strength Naprosin. But none of it was too bad and today I'm back to work with no problems (other than a little blurriness in the eye I just had done last Thursday.)

Just adding my 2 cents (again).

Alison
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Update

Postby cindylu » Tue Apr 03, 2007 4:41 pm

I went yesterday for my initial consultation for laser surgery. Overall, I felt the doctor answered my questions. However, she did seem to rush through the demonstration. I addressed my dry eye and pupil size concerns. She just stated they were a non-issue. I also asked the doc about the possibility of having PRK instead of LASIK. She said I was an ideal candidate based on my mild nearsightedness and no astigmatism and said I wouldn't want PRK because of the discomfort and slow healing time. Why is it most surgeons recommend LASIK instead of PRK? This surgeon has the exact same charge for both, so it's not more lucrative for her. This surgeon is one of the top docs in my area, has been involved in a FDA clinical trial, performed over 10,000 LASIK procedures and countless others. Should I just trust her advice and go with it?
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Postby LasikExpert » Wed Apr 04, 2007 5:26 am

I think it is fair to say that all doctors want happy patients. They want the "Wow!" effect. They want the patient to not need to come to the three month, and six month follow-up appointments because everything is doing so well. They want the patient to have virtually no pain. They want the patient to have relatively quick vision recovery. They want the patient to rush out the next day and tell all their friends that laser eye surgery is the greatest thing since sliced bread and everybody should use that doctor.

This is lmuch less ikely to happen with PRK.

You may be eventually happy and tell your friends that the final result was worth the difficulty, but PRK is much less confortable and with a much slower vision recovery than Lasik.

Yes, to some degree Lasik v. PRK is a marketing issue, but do not forget how relatively successful Lasik is. It is legitimate to question why a patient should go through disomfort and delayed vision recovery if the net effect is similar.

If you will be stressed long-term because you have a Lasik flap, then you need to insist on PRK, LASEK, or Epi-Lasik. If having a flap does not concern you at all and your lifestyle does not present any elevated risks, then your doctor's recommendation may be sound.

Bottom line: You need to decide what would be most acceptible for you.
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thanks!

Postby cindylu » Wed Apr 04, 2007 5:49 pm

Thank you for you timely and informative response. Your website has been a valued source of information for me during this process. I think I have more of an understanding about the procedure now and am confident in every aspect except one. I am 35, mildly nearsighted, -2.00 and -2.50. I have read the article you suggested on sudden presbyopia. Am I understanding this correctly? So, If I go ahead with the surgery I may be forced into reading glasses early and or eventually have to wear them in 5-10 years anyway? So what is the advantage of spending thousands of dollars on LASIK, if I am only going to end up back in glasses? I don't think I fully understand this aspect. If this is the case, then what are my options down the road? Is there anything that can be done to avoid being back in glasses? What about contacts? Are patients able to even wear contacts after the procedure? Please help me clarify this. Thanks!
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Re: thanks!

Postby LasikExpert » Fri Apr 06, 2007 5:37 am

cindylu wrote:I am 35, mildly nearsighted, -2.00 and -2.50.

So, If I go ahead with the surgery I may be forced into reading glasses early and or eventually have to wear them in 5-10 years anyway?


Starting in about 5-10 years your ability to focus on objects near will be limited. This is going to occur whether you have Lasik or not. This process is going to occur at the same rate whether you have Lasik or not.

Let's assume your Lasik would provide vision without glasses equal to your current vision with glasses. (That is an assumption, not a guarantee.)

    If you now wear glasses, not contacts:
      With Lasik:
        1) Current: Distance vision without glasses. Near vision is not an issue.
        2) 5-10 years: You need reading glasses to see objects near. Distance vision is not an issue.
      Without Lasik:
        1) Current: Need glasses for distance vision. Near vision is not an issue.
        2) 5-10 years: Need glasses for distance vision. Need bifocals or simply remove glasses for near vision.

    If you now wear contacts, not glasses:
      With Lasik:
        1) Current: Distance vision without contacts. Near vision is not an issue.
        2) 5-10 years: You need reading glasses to see objects near. Distance vision is not an issue.
      Without Lasik:
        1) Current: Need contacts for distance vision. Near vision is not an issue.
        2) 5-10 years: Need contacts for distance vision. Need reading glasses for near vision.
cindylu wrote:So what is the advantage of spending thousands of dollars on LASIK, if I am only going to end up back in glasses?


The question really is for which distance (near or far) do you want to use glasses after 5-10 years?, except the wild card is contact lenses.

You would not be able to conveniently remove contacts when you want to read and put them back in when you want to see distance. Lasik probably has the greatest potential advantage now and later if you normally wear contact lenses all the time.

cindylu wrote:Are patients able to even wear contacts after the procedure? Please help me clarify this. Thanks!


The ability to wear contact lenses is the same before or after uncomplicated Lasik once the full healing process has completed. If you have complications, the ability to wear contacts may be limited.
Last edited by LasikExpert on Fri Apr 06, 2007 9:28 pm, edited 1 time in total.
Glenn Hagele
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thanks!

Postby cindylu » Fri Apr 06, 2007 5:44 am

thank you for your clear cut information! This will help make my decision easier, I think.
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