PRK epithelial removal device?

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PRK epithelial removal device?

Postby prkandidate » Fri Jan 18, 2008 6:53 am

Through much reading I have decided on PRK over LASIK.

I know that there doesn't seem to be any advantage to replacing the excised epithelium [LASEK, EpiLASIK], but have seen a couple mentions that performing PRK using an epithelial keratome vs. a brush may result in a quicker healing time, with less risk of haze and more even healing of the epithelium.

Any knowledge as to whether this has been proven/disproven by any recent studies?

In a rather unrelated fashion, what's the thinking on "haggling" a price for PRK. I'm looking at a well known chain, and I think $1700 an eye is too much for PRK, even if it is "custom". Personally, I think $1400 is the right price. Tried to gently feel out the rep and all I got was "Well, we have financing", so if I'm going to try it, I'm going to have to be gauche about it. Bad idea?

Also, the doctor who performed my evaluation (not a surgeon) told me that "custom wavefront" corrected for surgery induced abberation, not endogenous HOA. I questioned this, because my understanding was that even "basic" lasik was designed to compensate for anything caused by the laser, and that "custom" was designed to remove exsisting HOA. He reiterated his position. Is he correct?

Thanks for the great resource in this site.
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Re: PRK epithelial removal device?

Postby LasikExpert » Fri Jan 18, 2008 7:26 pm

prkandidate wrote:... have seen a couple mentions that performing PRK using an epithelial keratome vs. a brush may result in a quicker healing time, with less risk of haze and more even healing of the epithelium.


Proponets of the epithelial microkeratome have suggested this, but the studies are spotty at best. Long term there seems to be no difference in the result. A disadvantage of a microkeratome is that it is affixed to the eye with suction. Although it is very rare and most issues can be evaluated before surgery, the short-term intraocular pressure spike can be problematic for a compromised retina, cause or stir up floaters, etc.

prkandidate wrote:...thinking on "haggling" a price


There is absolutely nothing wrong with asking for a reduction on price. The worst that can happen is that the provider will say no. This seems very reasonable if you are asking one provider to match the actual price of another provider.

prkandidate wrote:Also, the doctor who performed my evaluation (not a surgeon) told me that "custom wavefront" corrected for surgery induced abberation, not endogenous HOA.


Although it is possible that natural or induced HOA can be reduced with custom wavefront-guided ablation, it is not very predictable and overall HOA will increase for most patients. The fact is that the FDA has not approved any laser for the correction of HOA. See our HOA Patient Advisory.
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