PRK over lasik flaps

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PRK over lasik flaps

Postby DryEye » Wed Aug 01, 2007 7:40 pm

Does it make future surgeries such as cataracts more difficult?
If so, is it not a good idea to do PRK over a flap when one has an option (flap list or PRK post lasik)?
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Postby LasikExpert » Thu Aug 02, 2007 2:17 am

PRK on the Lasik flap will not affect future cataract surgery. The incision created during cataract surgery is at the edge of the cornea or outside the cornea.

Which is most appropriate - Lasik flap lift or PRK on Lasik flap - will depend upon the unique circumstances of the individual patient and the surgeon's preference/skill.
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Postby DryEye » Thu Aug 02, 2007 5:22 pm

What if one's flap became dislodged later down the road somehow for whatever reason (trauma, surgery, etc.)?
I read on an earlier post that listing a flap that had PRK done to it is not recommended.
Thanks
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Postby LasikExpert » Thu Aug 02, 2007 5:31 pm

An ultra-thin flap is more problematic if trauma occurs, whether it was made thin when first created or made thin later by having additional tissue removed. A person who has an unusually high probability of trauma to the eyes should probably avoid PRK on the Lasik flap.
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Postby DryEye » Thu Aug 02, 2007 5:34 pm

What happens if a flap tears or is damaged?
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Postby aspenice » Thu Aug 02, 2007 10:03 pm

Umm, can't PRK be done after Lasik if Lasik wasn't a good surgery choice in the first place? Why would PRK be a bad choice if the eye had trauma?
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Postby JPD » Fri Aug 03, 2007 12:22 am

aspenice wrote:Umm, can't PRK be done after Lasik if Lasik wasn't a good surgery choice in the first place?


Yes

aspenice wrote:Why would PRK be a bad choice if the eye had trauma?


Because PRK will make the flap thinner, and as Glenn stated, a thinner flap is more problematic if trauma does occur.
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Postby JPD » Fri Aug 03, 2007 12:28 am

DryEye wrote:What happens if a flap tears or is damaged?


I'm going on a little bit of a tangent here, but why do you seem so concerned about this? I ask because unless you're a boxer or know you're going to get into a automobile accident sometime in the future, the probability of you having any flap truama is pretty unlikely. For anyone who lives an "average lifestyle" it's not something you need to be worried about, and it seems as though you're a bit over paranoid regarding flap trauma.
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Postby DryEye » Fri Aug 03, 2007 1:27 am

I was asking the "if" scenario as in could it happen during a flap lift?
You bring up automobile accidents - What about an airbag deploying?
Are there statistical studies on people with flaps that have run into problems?
It just seems to me now that I know more about lasik that for all the advertised ease of the procedure there seems to be some inherent long term potential problems with a flap. The first one is the potential problems that may occur with a flap lift (more aberrations, cell ingrowth, etc etc)
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Postby JPD » Fri Aug 03, 2007 3:04 am

DryEye wrote: there seems to be some inherent long term potential problems with a flap.


Oh, absolutely. But it's low risk potential.

Besides, this is the reason PRK IS a better procedure long term. It's the reason Glenn encourages it to newer visitors to this site, and the reason he always says he "prefers no risk to low risk", when comparing the two procedures.

Also, just because PRK is a better procedure long term doesn't mean Lasik is a BAD procedure long term. Just that PRK is better. When done properly, Lasik and the corneal flaps are very safe. Corneal flaps have been around since the 50's or 60's and long term data shows they are safe, as long as they are done properly. That's a big if, and that's the reason you should only have the procedure done by one of the best.

As far as your other questions, I can't answer those, but I will say yes I agree those of us who have had Lasik will always be at a higher risk then those who don't have the flap, when put into those situations you've mentioned. But remember, higher risk doesn't mean high risk. And besides, you've already had Lasik so why dwell on the negative aspects of something you can't change? You need to accept the fact that you can't reverse Lasik, and look at low risk potential as a positive thing rather then negative.
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Postby DryEye » Fri Aug 03, 2007 3:12 am

Thanks
Your right what is done is done for us, but there are many that need not go through the same thing - One reason I believe that only the best surgeons should be allowed to perform lasik.
This Organization is the closest thing to having some sort of national data/monitor for that - Too bad the FDA didn;t realize that when they approved lasik by allowing any doc/surgeon to do it.
I agree going forward it has to be one of the best if one decides to redo it.
The problem is that it is far easier to do a virgin cornea than one that has been touched already.
Glad to see you are (JPD) catching up to my post number amount.
Hopefully, you'll surpass me - I never planned on that one, but this site has helped a ton and continues to do so.
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Postby JPD » Fri Aug 03, 2007 4:46 am

DryEye wrote:One reason I believe that only the best surgeons should be allowed to perform lasik.


I absolutely agree.

DryEye wrote:This Organization is the closest thing to having some sort of national data/monitor for that


I agree this site is an incredible resource for those considering refractive surgery. However, even as good as it is, the surgeon database is incomplete. Glenn even admits that much. For example, based on my research, the two best Lasik doctors in Southern California, and two of the best in the country and world, aren't even listed on this site. I realize that's most likely because they've never attempted to become certified here, but still the two best aren't on the list. Even so, the list of certified doctors here is a great reference.

DryEye wrote:The problem is that it is far easier to do a virgin cornea than one that has been touched already.


Even more of a reason to go to the best. Those guys specialize in correcting other doctors mistakes. Unfortunately they specialize in that out of necessity.

DryEye wrote:Glad to see you are (JPD) catching up to my post number amount.


I'm trying. :)

DryEye wrote:Hopefully, you'll surpass me


I hope that doesn't mean you're wishing my complications persist longer than yours?
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Postby DryEye » Fri Aug 03, 2007 12:33 pm

I think you're already better off than me and have noticed that many of your posts are related to informing/helping others.
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Postby DryEye » Fri Aug 03, 2007 12:48 pm

True on the complete surgeon database - there a few I know of in other states that aren't a part and I am not saying all listed here are the absolute Best - I only looked for the Top handful of names when researching and Glen would know far more than I.
But the site attempts to centralize and answer many important issues and does try to hold surgeons accountable, which is far more than any other site or organization I have found.
Perhaps, someone could create a Top 100 Lasik Surgeon site with research to back it up.
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