PRK and Astigmatism

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.

PRK and Astigmatism

Postby helen3 » Wed Aug 02, 2006 8:05 pm

I just concluded my 2nd evaluation, and according to a reputable doctor I am an excellent candidate, for PRK only, due to my astigmatism. However, due to the astigmatism, I have some concerns. Here is my prescription:

O.D: Spherical:-3.50 Cylinder: -2.75 Axis: 30
O.S: Spherical: -2.00 Cylinder: -2.75 Axis: 180

Pupil size: Bright: 4 Dim: 7

I do have dry eyes however the doctor stated that he wasn't concerned. Also, stated the pupil thickness was good.

Please provide me with your feedback on the level of risks/result/complications based on my prescription and pupil size.
Thank you
Helen
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Postby LasikExpert » Wed Aug 02, 2006 9:50 pm

I have a bias toward surface ablation techniques like PRK, LASEK, and Epi-Lasik. I think these procedures benefit tremendously from the elimination of the Lasik flap. With a more difficult correction like yours, I believe the doctor is wise to recommend PRK.

Do not expect a 20-Minute Miracle. Your astigmatism is very high. It is likely that after 3-6 months you will need enhancement surgery to resolve residual astigmatism or even irregularities induced by surgery. It is likely that from the time of your initial surgery to the time of an enhancement you will need corrective lenses to provide the best possible vision. It is also possible that everything will be fine with the first surgery, but be prepared for a long process. You should read about Astigmatism Surgery.

Your pupil size is rather larger and this will be an issue regarding treatment. You need to read Laser Eye Surgery and Pupil Size for more details. Pupil size is especially important with astigmatism correction because the irregularity of astigmatism is at the periphery of the cornea. This is the area that will be exposed as the pupils become larger.

Lasik has a history of inducing temporary dry eyes, but PRK is much less likely to cause dry eye problems. You history of dry eyes is another good reason for your doctor’s recommendation of PRK over Lasik. Your dry eyes need to be treated and fully managed before surgery. Even PRK can exacerbate existing dry eyes and appropriately lubricated eyes is important to healing and good vision quality. You should read Laser Eye Surgery and Dry Eyes.
Glenn Hagele
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I am not a doctor.
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