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LASIK vs. PRK, laser vision correction, LASEK, epi-LASIK - A State of Sight #6

Isaac Porter, MD explains the differences between LASIK and PRK and the advantages of each procedure in A State of Sight. Many patients will have a choice between LASIK and PRK when they decide to have laser vision correction. In this episode, Dr. Porter outlines the differences that can help patients decide between the two procedures. Some patients with thin corneas may not qualify for LASIK, so their only option is PRK. Others with outer layer corneal haze (anterior basement membrane dystrophy) may benefit more from PRK than LASIK. LASIK may be preferred in patients that are very nearsighted to reduce the risk of haze after surgery.



Welcome to A State of Sight, I’m your host, Isaac Porter from Lowry Porter Ophthalmology and this is your update in ophthalmology and eye care. We are coming to you this episode in high definition. I want to say a big thank you to Mike Esser and Alex Ferguson for all the great video tips over the past month.
 
Today, I want to talk about the difference between LASIK and PRK, which are two of the most commonly performed laser vision correction procedures. LASIK involves creating a partial thickness flap in the cornea and then using a laser to change the shape of the remaining cornea to include the power from glasses or contacts onto the eye. After that, the flap is put back down, the vision usually improves over the next day but can continue to heal or improve over the next 3 to 6 months.
 
PRK is a safer procedure than LASIK because it doesn’t involve creating a flap. With a flap, there can be complications with the flap or inflammation underneath the flap. With PRK the cells are removed from the surface of the cornea and the laser treatment is placed directly onto the surface. Usually over the first week the cells heal and fill back over the surface, they are like our skin, always changing over.
 
Because of this, PRK is a less convenient procedure than LASIK. Afterwards, some people can have pain for 2 or 3 days. It also takes longer for the vision to come back while the surface is healing. Some days can be good other days more blurry. Over time it levels out eventually getting to the same result as LASIK, but PRK takes longer to get there.
 
PRK or LASIK may be more appropriate for different patients as some patients may not qualify for LASIK. When we raise the flap from the cornea only the back remaining layers provide strength for the eye moving forward. Because of this, if a patient’s cornea is too thin we are worried that these back layers will not provide enough support to keep the eye and the prescription stable later in life.
 
Patients with thin corneas may not qualify for LASIK and may need to have PRK. Also, some problems like clouding of the front part of the cornea or recurrent erosions (which can be painful), may be treated at the same time as PRK.
 
Some people may not have a choice between the procedures, but other patients can think about their visual needs and choose one or the other. There are two other procedures similar to PRK, epi-LASIK and LASEK, but I will be able to discuss those further on another episode of A State of Sight.
 
Until next time, if you have any questions about LASIK or PRK please post below, we will be happy to interact with you. Until then, good health and good sight.