Lasik or PRK?

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.

Lasik or PRK?

Postby Marsha » Mon Aug 04, 2008 4:01 pm

I had consultations with two Lasik Centers a few days ago. I was suggested to have Lasik with Intralase by one center and PRK by other center due to boardline thin cornea. My cornea thickness were 490 and 494 microns respectively. Any suggestions or opinions about what kind of procedure I should select? Thanks a lot.
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Postby LasikExpert » Mon Aug 04, 2008 4:20 pm

Your corneas are a bit on the thin side, depending upon how much correction you need. See Lasik and thin corneas.

I am personally unabashedly biased toward the surface ablation techniques like PRK, LASEK, and Epi-Lasik. The advantage of PRK is that there is no Lasik flap. No Lasik flap means no possibility of a Lasik flap complication. Although Lasik flap complications are relatively rare, no possibility of a complication is almost always better than a low probability.

PRK has more discomfort and a much longer vision recovery than Lasik. You won't be able to see much for 1-3 days. You will have "functional fuzzy" vision for 1-3 weeks, and the crisp vision you want likely not arrive until 3-6 weeks.

I like to say that for the first month you will wish you had Lasik, and the every day thereafter you will be glad you had PRK. This is a healing time that is impractical for some and for them Lasik may be the better choice.

I'm sure both doctors will provide PRK if you insist, but you need to listen to the doctors and understand why they recommend the different techniques.
Glenn Hagele
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Lasik Info &
Lasik Doctor Certification

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Postby beingbobbyorr » Wed Aug 06, 2008 9:25 am

LasikExpert wrote:I am personally unabashedly biased toward the surface ablation techniques like PRK, LASEK, and Epi-Lasik. ....


I read ...

http://www.usaeyes.org/lasik/faq/epi-lasik.htm

... and was wondering how does PRK remove the Epi layer (if Lasek uses a solution & Epi-Lasik uses a keratome-like blade)?

The engineer in me yearns to see that fine FAQ page be put in a table format with columns for PRK, LASEK, and Epi-Lasik, and rows for:

epithelial layer removal method
typical time til healed
typical time til optimum vision
hours/day & # days of protective contact lenses
risks
degree of discomfort
range of treatable myopia/hyperopia
range of treatable astigmatism
year procedure was FDA approved
doctor training/certification to look for
_________ (other)

.... kind of like your Laser comparison table.
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Postby LasikExpert » Wed Aug 06, 2008 6:40 pm

For PRK, an alcohol solution is applied to the epithelium, which mortally wounds the cells and allows easy manual removal. The doctor use what looks like a tiny hockey stick to slide off and discard the epithelial cells.

For LASEK the exact same procedure is performed as PRK except the epithelial cells are moved aside and then repositioned over the treatment area after the laser energy is applied. The cells are still mortally wounded and will need to be replaced naturally, but the thought is that the cells work like a "bandage" to promote healing. Studies show little solid proof of this theory.

For Epi-Lasik, a blunt plastic "wedge" slides across the cornea, lifting the epithelial cells as a "flap". No alcohol is applied. The cells are still mortally wounded and still need to be replaced. Again, studies show little solid proof that Epi-Lasik is better than PRK in the long term.

The problem with tables is that every patient is unique and symptoms such as discomfort are relative. Many people who have visited our website have stated that there was little discomfort after PRK, yet others said there was much discomfort.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
Site Admin
 
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Joined: Fri May 12, 2006 6:43 am
Location: California


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