Part 7: LASIK vs PRK/LASEK? Which laser procedure is best?
Dave Allamby | Oct 30, 2008 | Comments 55
Continuing from yesterday:
Some surgeons recommend PRK or LASEK (both forms of surface laser eye treatment and basically the same) over LASIK. The article referred to by Kay in her original post and advocating LASEK was written by ophthalmic surgeon Sunil Shah, who was one of the creators of that particular approach (and so has some personal interest in writing about it one presumes).
One of the very vocal and respected advocates of surface laser (PRK) over keratome LASIK was Professor John Marshall in London, UK, a founding father of laser eye surgery back in the 80s. Prof Marshall argued convincingly that the cornea was considerable stronger after PRK compared to mechanical (thicker flap) keratome LASIK.
However, the game has changed with the introduction of femtosecond lasers with much thinner flaps. Even Professor Marshall now supports the move to thin-flap LASIK using a dual laser, blade-free approach.
So if a clinic cannot offer dual laser LASIK (and many still can’t) they may offer PRK/LASEK instead. There are some clinical reasons to perform PRK instead of LASIK but the percentage of these cases has shrunk from 10-15% down to around 5% today, with dual laser technology. Patients much prefer femto-laser LASIK over PRK, as the latter is fairly unpleasant for a few days post-op.
In summary, there are definite clinical reasons why we as treating clinics have moved over to wavefront LASIK and using a blade-free dual laser approach. More accurate treatments so better vision, removal of an older mechanical device technology and improved long-term safety.
Filed Under: Clinics • LASIK • PRK • Safety • Technology
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I forgot to add my vision. It's -6.50 on both eyes. 
Hi Dr. Allamby,
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Hi David,
Hope you don’t mind me getting involved in this thread, but I have been advised I have some dryness in my eyes but I think it’s mainly from contact lens wear. When I went to UL (my Contacts were out for24 hours) they advised my tear break up was 6 seconds (I’m not sure what that means?) and that they are only concerned about dryness when it gets into double digits for tear break up. Is this right?
I have been taking flaxseed oil 2 x 1000mg aday for about 6 weeks as advised on the label but I notice you advised Ness to take 4 x 1000mg a day. I have found my eyes have improved with the flaxseed oil but occasionaly still wake up with some dryness (I still wear contact lenses the majority of the time so I do appreciate that isn’t helping but I have switched to Acuvue Moist Dailies which have been great and my eyes are fine when my contacts are in, the dryness is when I don’t have contacts in).
So as I want to have laser eye surgery with yourselves when my eyesight has stabilised, should I take 2x 1000mg per day or 4x 1000mg a day?
Many thanks- I really appreciate all the advice you have given to help me with such an important decision.
Irene
hi Irene
Tear break up time (TBUT) is normally 10 seconds or longer, so yours is too quick at 6 seconds to offer laser eye surgery. Leaving the contacts out for longer before having them tested again is necessary to get a truer measure of the the health of the corneal surface. Not sure about the Ultralase comment as it seems back to front. Having a double digit TBUT is a good thing, not the reverse, so you may have misunderstood that comment? TBUT needs to be longer to provide continuous moisture on the corneal surface between blinks. Laser eye surgery will reduce the tear film further and increase the risk of dryness problems.
You can continue with 2000mg as it will build up with time. This may or may not extend the TBUT to a point where it is safe for LASIK. So you have two issues that need addressing before laser eye surgery is safe for you: the stability of your prescription, and the quality of your tear film.
Best regards, David
Hi Dave,
For some reason I wasn’t able to reply to your response to my initial question. Hope you find this one…
Pupil size 6.1mm L 6.2mm R
Hope this helps
Thanks again
Tom
hi Tom, I want to enter your data into the WaveLight Allegretto. Will get back to you shortly.
Dave
Hi David,
Thanks for your reply regarding my corneal thickness. Thats helped to assure me I can have Lasik. I did have a post above it which I’m not sure if you have missed, so I have re-posted it as I would really appreciate your advice on the below.
I have asked your advise previously and you advised for me to wait for my eysight test this year to ensure my prescription in my left eye has stabilised. However, after reading your comments recently I have a few more questions I hope you don’t mind answering for me.
Please could you advise me if my prescription remains stable if I would be suitable for Z-Lasik? And if you consider my prescription as moderate or high myopia?
Also I went to Ultralase for a consultation and the surgeon advised that as my right eye is -5.50 (UL had it as -6.00) I have a 90% success rate of 20/20 vision and my left eye 95% success rate as my prescription is -3.25 with an astigmatism of -1.25 (UL had it -3.75 -1.50). UL also advised I should have elite due to my pupil size being 7.2mm. From what I have seen on Focus website, my prescription would have a good chance of achieving 100% success with Z-Lasik. What are your thoughts – could my prescription achieve 20/20 with ZLasik?
I have considered having surgery with UL as there is a clinic close by but would be happy to travel if I would be receiving better surgery.
I really appreciate any advice you can offer.
Many thanks
Irene
hi Irene, Your prescription falls in the moderate group (-3 to -6). For Z-LASIK, over 99% of eyes see 20/20 (or better) in this range, and all patients had binocular vision of 20/20 or better. Once you have a stable prescription we of course will be happy to see you. Better to be cautious and get the right result.
Best regards, David
hi Tom. We use a residual bed limit of 300 microns, which many clinics now use – thicker that the previous residual bed thickness of 250 microns – and with presumed increased corneal strength and safety post-op. You would need to ask which limit another clinic uses. I have entered your details into the WaveLight Allegretto Eye-Q laser, and fortunately your full prescription can be treated (leaving 301 and 304 microns respectively).
The tissue conservation from the WaveLight treatment profiles is very useful in cases such as yours. We can treat the full amount and still stay over 300 microns in the stromal bed, with a 6mm true optical zone. You would have to confirm with the other clinics as to the residual thickness and the treatment optical zone used. (Treating a smaller diameter reduces the ablation thickness but increase the risk of night vision problems).
Best regards, David
Hi David,
Many thanks for your detailed responses. I will be in touch with you via Focus.
Regards
tom
Thanks Tom. Glad to help. Please call Barbara on 0207 307 8250 and she will be very happy to arrange. Best regards, Dave
Dear Dr Allamby,
I have been thinking of having laser eye surgery for some time and have recently attended a consultation at Optimax.
Optimax said that I was suitable for either lasik or Lasek but said that their surgeons favour lasik.
However, right at the end of the consultation, the optometrist mentioned that he had found some kind of defect on my cornea which, while below the level of the area which would be involved in the lasik, would be likely to cause problems with dryness as I get older. He then went on to say that my eyes are currently significantly dry anyway (this does not surprise me as I have never been able to tolerate contact lenses) and that I could expect that this would get worse after laser surgery. He said that the use of drops afterwards would solve this problem. I am a bit perplexed by this. Should I be concerned about the dryness issue and should it make a difference in my choice of lasik or lasek?
Many thanks.
Ness, Yes you are right to be concerned when there is significant dryness pre-op. It is the one area where post-op problems can arise still. The best way to avoid such issues is not to operate where pre-existing dryness may lead to problems after. I suggest that you get another consultation where you can get a second opinion on the degree of dryness before going ahead with any form of surgery.
It is not unusual at my clinic to spend weeks/months in preparing the eyes so that the tear layer is optimised and there is the maximum available moisture before surgery. It is worth taking this time for a one-off elective procedure.
Best regards
David
Dear David,
Many thanks for this. What you say confirms my suspicions about what was said.
It looks like I will be making the five hour rail journey to Focus!
Ness
hi Ness. My pleasure. I suggest that you start an oral supplement of flaxseed oil, 4000mg per day, taken with food. You can buy 1000mg capsules of flaxseed oil from e.g. Holland and Barrett. It takes 4-8 weeks to work in helping build up the tear film layer in your eyes. So if you do come to us for an opinion start the oil, and we could see you in early March. Keep any contact lens use to a minimum, and don’t wear them for 2 weeks before you come along. That we we can assess the health of your cornea and tears much better.
Best regards
Dave
Hi David,
Hope you don’t mind me getting involved in this thread, but I have been advised I have some dryness in my eyes but I think it’s mainly from contact lens wear. When I went to UL (my Contacts were out for24 hours) they advised my tear break up was 6 seconds (I’m not sure what that means?) and that they are only concerned about dryness when it gets into double digits for tear break up. Is this right?
I have been taking flaxseed oil 2 x 1000mg aday for about 6 weeks as advised on the label but I notice you advised Ness to take 4 x 1000mg a day. I have found my eyes have improved with the flaxseed oil but occasionaly still wake up with some dryness (I still wear contact lenses the majority of the time so I do appreciate that isn’t helping but I have switched to Acuvue Moist Dailies which have been great and my eyes are fine when my contacts are in, the dryness is when I don’t have contacts in).
So as I want to have laser eye surgery with yourselves when my eyesight has stabilised, should I take 2x 1000mg per day or 4x 1000mg a day?
Many thanks- I really appreciate all the advice you have given to help me with such an important decision.
Irene
Dear David,
Many thanks – I’ll start taking the flaxseed oil as you suggest and plan to travel to London in March.
Ness
Hi Dave,
First off, thank you for such an informative, honest and organized source of knowledge on LASIK and other vision correction procedures.
I have a question regarding your thoughts on which lasers offer superior results. I have narrowed down my LASIK procedure between two well known and proven surgeons.
The first uses the new iFS Advanced Femtosecond laser to create the flap, and then uses the CustomVue WaveFront system with the STAR S4 IR excimer laser to make the correction.
The second use the fourth generation Intralase 60Hz Intralase FS laser to create the flap, and then uses the WaveLight Allegretto Wave Eye-Q excimer laser to make the correction.
I know the lasers are only tools, and the skill and experience of the surgeon should be the deciding factor, but assuming both surgeons are equal, which setup do you think will produce the best and safest long-term results.
Thank you in advance!
hi John.
Good question. And you have made the right move in choosing by surgeon as a key factor in your choice. Branding by some clinics tends to downplay the role of the surgeon, whereas of course it is vital to a successful procedure.
Assuming as you have done that you have chosen a great surgeon then, for your visual outcome, it is the excimer laser (which reshapes the cornea) that will have a major effect on your final level of acuity. I would therefor choose the Allegretto Eye-Q wherever possible, as the short answer to your question.
Regarding the femtosecond platform, personally, I would like to see any clinic upgrade to new technology where there is a clear, proven advantage, and I think the iFS is superior to the 60KHz older version – but both will do the job.
Wishing you all the best for your LASIK. I am sure you will be delighted.
Regards, David
Thank you I appreciate your input. I personally prefer the surgeon who uses the Allegretto Eye-Q excimer laser, but am concerned that he is not using the most advanced femtosecond laser. One of my biggest concerns is the creation and subsequent healing of the flap. I may ask him if he plans to upgrade to a different femtosecond laser in the future.
One other question for you. I do moderate to heavy weightlifting several days per week. I have heard that the internal pressure within the eye greatly increases during heavy weightlifting. Would I be at risk for issues with the flap when I resume weightlifting? And how long after surgery would you suggest I wait before going back to weightlifting?
Thank you
Hi John, Heavy lifting does raise the pressure inside the eye, but shouldn’t pose a great risk for the flap. I generally advise patients to wait 4 weeks before very heavy lifting. For regular milder exercise you only need to wait for the first week. Best regards, Dave
Dave,
Thank you for the input on resuming exercise in the gym.
I just wanted to get back to my question on the lasers again. I have decided on the surgeon who uses the Allegreto WaveLight Eye Q excimer laser. I feel very comfortable with his expertise and his clinic. However as mentioned in my first comment, he uses the 60hz Intralase femtosecond laser, not the new iFS or even the Zeimer that you recommend. Am I doing myself a disservice by using older technology on such an important part of the procedure? Do you feel using the 60hz Intralase would expose me to higher risks of flap complications, both during surgery and/or post surgery?
Much thanks for any additional input you could offer!
Hi John, Each generation of laser improves on the one before. The iFS runs at 150KHz, so a faster repetition rate than the older 60KHz model. For performance, so the following review:
www.osnsupersite.com/view.aspx?rid=66406
Also Dr Perry Binder (from AMO) describes the improvement as:
“In terms of enhancements to the FS-150, Perry Binder, MD, medical director for Abbott Medical Optics…. “By running at 150 kHz, it allows the user to place the laser ablations closer together individually and row by row. This makes for easier flap lifts, smoother surfaces and overall faster procedures. So, for example, if you chose to use a spot/line separation of 8 µm and want a 9-mm diameter flap, you can complete that flap in 10 seconds, as opposed to about 21 seconds or so with the [previous] 60-kHz laser. Increased speed also decreases the risk of such things as suction loss and decent ration.”
This is a one-off procedure which is non-urgent and elective. You can always wait for the right technology if you feel there is a more advanced solution.
Regards, Dave
Hi David,
I am considering having LASIK Surgery done at Ultralase. The option they are offering is the Ultralase Elite. Realistically, how well does the flap heal and to what strength? The optician at UL told me it recovered to 85% of the original strength however I have read and seen various posts showing gaps in the healing using green dyes.
A friend of mine who works in the Opthalmology department in hospital in Glasgow says there is another technological advancement around the corner that causes less disruption to the eye. Is there any truth in this?
Regards,
Steven
Hi Steven. Thank you for your email. The UltraElite treatment is the only procedure offered at this clinic that I consider a truly modern procedure, and is the only one to consider. It includes a femtosecond laser to create the flap, and aspheric optics that every modern treatment should incorporate. Personally, I rank Z-LASIK as technologically better than UltraElite, with the Ziemer as the better femtosecond laser when compared to the Intralase and I would recommend either the WaveLight Allegretto or the Schwind Amaris for the excimer part of the surgery.
Flap healing does depend on the the depth of the flap, i.e. its thickness, with thinner flaps healing better. We more though rely on the thickness of the residual bed (what is left below the flap after excimer treatment) as the structural component post LASIK, and most modern clinics use 300 microns as the minimum thickness allowable for safety. The entry of green dyes (fluoroscein) was seen previously when epithelial ingrowth was more common, as when using a blade to cut the corneal flap. This fortunately is now a rarity with femtosecond flap creation. I cannot recall a case of ingrowth from a primary LASIK over the past 2-3 years (we only use a femtosecond laser for the flap – there is no option for a blade cut).
I don’t know what advancement your friend is referring to, and I am aware of all the current and pending developments. If you can let me know, I can answer more thoroughly.
Thanks, Dave
Thank you for the reply David. It is looking more likely that I will br going for the Ultra Elite Treatment. I live in Scotland and as far as I am aware nowhere up here offers the Z-Lasik treatment. At my consultation I was told I was suitable for the LASIK but from reading I am now leaning towards the LASEK as from what I can tell the recovery time is the only thing that differs between treatments.
Steven
Hi Steven. LASEK/PRK is also a very good option, although with the longer recovery time of 4-7 days and post-op pain. I don’t think there is any safety difference between the two, but certainly no reason not to go for the surface laser version. I will be having my eyes correct this year (for my developing presbyopia) and will choose LASIK, but it is a personal choice.
WIth best regards, David.
Hi David,
I have been reading your replies to Steven with interest. I have a high prescription too (-10.00 L, -10.50 R) with marginally below average corneal thickness (531 L, 538 R). Two high st chains have recommended Lasik but based on some of your comments on this site I got a 3rd opinion from an independent clinic.(Exeter Laser Eye Surgeons).
Their consultant ruled out Lasik and recommended Lasek for greater residual corneal thickness. However, you talk a lot about how the latest generation lasers such as the ones at Focus use/require less tissue removal. Are the advances so significantly different that they could influence the recommended course of treatment? Exeter seems to have a fairly up to date set of kit but there is a lot of mystery surrounding the best laser – at least to the layman.
I am now confused – the independent clinic provided the most in depth consultation, not least because I was assessed by a surgeon rather than optometrist. Naturally though I would rather go down the ‘less painful’ treatment route of Lasik!
Advice appreciated
Thanks
Tom
hi Tom
Interesting. The WaveLight Allegretto takes the least tissue and can help when margins are tight. Do you know your pupil size measurements taken at the consultation? (in the dark). I can give you a better answer if you can.
thanks
Dave
Hi David,
I have asked your advise previously and you advised for me to wait for my eysight test this year to ensure my prescription in my left eye has stabilised. However, after reading your comments recently I have a few more questions I hope you don’t mind answering for me.
Please could you advise me if my prescription remains stable if I would be suitable for Z-Lasik? And if you consider my prescription as moderate or high myopia?
Also I went to Ultralase for a consultation and the surgeon advised that as my right eye is -5.50 (UL had it as -6.00) I have a 90% success rate of 20/20 vision and my left eye 95% success rate as my prescription is -3.25 with an astigmatism of -1.25 (UL had it -3.75 -1.50). UL also advised I should have elite due to my pupil size being 7.2mm. From what I have seen on Focus website, my prescription would have a good chance of achieving 100% success with Z-Lasik. What are your thoughts – could my prescription achieve 20/20 with ZLasik?
I have considered having surgery with UL as there is a clinic close by but would be happy to travel if I would be receiving better surgery.
I really appreciate any advice you can offer.
Many thanks
Irene
Hi David,
Sorry I forgot to add if you could answer with cornea thickness of around 506 microns if I would be suitable for ZLasik or would I be better off with LASEK?
Thanks again.
Irene
hi Irene, Z-LASIK is fine if the corneal thickness is 506.
thanks
Dave
Hi Dave again,
Thank you for all your responses. I’ve been finding this blog very informative and useful.
One further question I have is how suitable is LASIK for combat sports such as Brazilian Jiu Jitsu and Muay Thai? I am currently not at a level were I am ready to spar but don’t want to rule it out in the future.
I have read various forums stating that people have had LASIK and still spar regularly as it would take quite a heavy blow to dislodge any flap. However they have to give the flap the maximum healing time of 3 months before resuming sparring. I am now in the situation were I am ready to book my surgery but still unsure due to the sports I participate in. I am also aware that the police now use LASIK as well.
Warm Regards,
Kunal
hi Steven, There is a very small, but not zero, risk of the flap being moved late on. Needs sharp direct trauma, which is possible in the contact martial arts you mentioned – finger tips/nails. It is quite reasonable to opt for PRK in this situation. It’s very hard to quantify the risk though. Regards, Dave
Hi!
I am considering having refractive surgery on my eyes. My case is this:
1. Grade: -7.00 both eyes
2. Large pupils: 8 mm
3. i have myelinated nerve fiber in my right eye
4. I’m 26 yrs old
5. Lifestyle: not that active. no sports. My job requires me to sit in front of the computer more than 8 hrs a day though
I was advised by a doctor that I can undergo custom LASIK. But I’ve read in several sites that custom PRK is better for large pupils.
Can you please help?
Many thanks!
JC
hi JC
A -7.00 is usually treatable, as most patients have sufficient corneal tissue. You would need a larger treatment zone to cover your larger pupils. Myelinated nerve fibres not a factor. I would opt for femtosecond LASIK, e.g. our Z-LASIK, for this case, rather than PRK. PRK is not better for large pupils, and your high myopia would need MMC to prevent haze, and could be less accurate than a straight LASIK correction. You want either a wavefront optimised or wavefront guided correction (the results are the same).
Best regards
Dave
Hi, I’m an air traffic controller and my job requires from me that to have a good vision and ability to see an object in long distance. But i’ve myopia,right is ~5, left is ~3. So,I’m gonna make a surgery in laser center in Taiwan on next Friday. When i meet doctor, they checked everything is ok for eye laser surgery and said that you need to make an eye lasik. And actually, one problem was i’m foreign and don’t know chinese! albeit, they explain to me operation procedure, after surgery advice of do’s and don’ts things to me. But unfortunatly i hardly understood what he did say!So i’m gaining some info-s from net!
Is this possible to have better vision than normal people vision ( both eyes are zero) by laser operation?
Please give me some advice for my surgery on Friday, after surgery do’s and don’ts activities?
How much risk does lasik surgery have during operation and after ?
I need to keep staring into computer display for many hours a day due to my work, how can i protect my eye after laser surgery?
hi.. my refractive error is -9.5.. my corneal thickness is 526microns.. which is preferable either LASIK or LASEK? as LASIK is expensive, can i go with LASEK? are there any more postoperative complications with LASEK compared to LASIK?
hi Rosy
Suitability will depend on the size of your pupils in the dark, but they will need to be on the small size. Typically, however, -9.50D with average/thin corneas are not suitable for a full correction. LASEK will give another 0.5-0.75D of treatment compared to LASIK for your prescription and thickness. For LASEK though, you will need MMC drug application at the time of surgery to prevent haze, which adds a little less accuracy compared to LASIK, which I would prefer if possible. If you are happy to be left a bit short-sighted, aiding reading vision, you may be suitable.
Best regards, Dave
Hi,
I have just had a consultation for laser eye surgery and have been told that Lasek is more suitable due to thickness of the cornea. However, the consultant also mentioned that they will insert a soft lens which will be removed after 3 days. I haven’t come across anywhere or your blog talking about temporary lens insertion. Please advise.
Thanks
Pal
Hi Rashpal, Yes it is routine to insert a soft contact lens at the end of a PRK/LASEK procedure, which will be removed in the clinic after 3-4 days. The lens has no power but acts as a bandage while the epithelium (surface skin layer) heals, and helps the eye be more comfortable. The lens stays in night and day and no need to touch or think about it. If it falls out, it isn’t a problem. The eye will still heal but it will be more painful or uncomfortable during the first 3-4 days.
Best regards
Dave
Hi,
I’ve been diagnosed as having miopia at -10.00 diopters, my docter has recommended Lasek, but I’m concerned about the long downtime and the long recovery period after the operation. Would you recommend that I do Lasik, or is Lasek really my best and safest option long term.
Hi Shelly
With high myopia not all are possible to have LASIK due to limitations of corneal thickness and pupil size. The best chance is with a thin flap (e.g. femtosecond laser flap) and a laser than isnt tissue hungry, such as the WaveLight Allegretto. Other lasers could remove more tissue for the same prescription, so worth checking with a WaveLight using clinic.
LASEK is also possible, but usually surgeons use Mitomycin C to reduce haze formation. Still, longer recovery time and time for vision to settle (few months).
Regards
Dave
Hi, I had wavefront lasik about a year ago. I had astigmatism and quite a high pescription. I have had all post op checks and was advised at the time that an enhancement would probably be necessary due to my high prescription. I have now been told that my enhancement will be lasek and that it is better to have lasek as I have already had lasik. My prescription is now about 1.25-1.50 and I still have an astigmatism. Does this sound right ? I just got the sense that it was a cost issue and not entirely about my best treatment.
Hi Donna
At one year after we would normally lift up your existing flap and laser under it as in your original LASIK correction, unless there was not enough tissue remaining to be safe. That may be the reason for offering LASEK. You need to ask your surgeon the reason for opting for LASEK rather than a flap lift.
Thanks
Dave
Dave, I do have capsular opacification & do understand what YAG is. I also have a refractive error & know that if I don’t have PRK, Lasik or Lasek, I will still have to wear glasses. However, I think I still need a little more clarification. Although PRK, Lasik or Lasek would eliminate the need for glasses, would the YAG procedure still have to be done because of the capsular opacification or will one of the refractive procedures fix that problem at the same time?
Hi Josi
Yes, you would still need the YAG capsulotomy, which acts inside the eye. The other laser procedures only work by reshaping the cornea at the front of the eye. Think of the latter as manually focusing a camera to get a sharp image, whereas the YAG treatment is like taking the lens cap off. You would need both to get fully clear vision.
Hope that clarifies! Best regards
Dave
I had the Nydek lasik surgery done in 1998 (opted for monovision). In October 2009 I had cataract surgery on both eyes & opted for the ReStore lenses. Now I’m told that due to haze/scar tissue that formed on the capsules holdig the lenses in place, I have to have additional surgery such as YAG capsulatomy, PRK or Lasik/Lasek (not sure which he said) because glasses/contact lenses can’t improve my vision. The ultimate choice is mine. Overall, which procedure do you think would be the best choice, especially taking safety/side affects/results into consideration. I am a 61 yr. old female. My doctor advised that there’s a higher risk of retinal detachment using the YAG capsulatomy procedure vs the other procedures. That procedure is not this first choice.
Dear Josi
If you have capsular opacificaction (of the bag holding the lens) then the procedure you need is YAG laser capsulotomy. You will only need PRK, LASIK or LASEK if you have a refractive error, i.e. you still need glasses to improve your vision.
Best regards
Dave
I have had previous RK 8 cuts. And now have astigmatism and vision is getting blurry in one eye, the other eye is good. I have been told Lasik is not a good option. Is PRK or Lasek an option? What may be the complications. I seem to be getiing a little hesitation from some doctors.
Hi Vincent
RK can lead to a somewhat unstable cornea and LASIK is not a good idea as can leave the flap in wedge shaped pieces (‘pizza slices’). PRK is a better option. About 50% of RK patients drift into longsight by 10 years after the procedure, so getting blurry near vision, or blurry both near and distance vision. The results are less predictable than virgin PRK so hence the hesitation. Also you are lasering away some collagen fibres from an already weakened cornea, which may or may not be significant. Any doctor will want evidence that the cornea is not still changing shape or refraction.
Best regards
David
I can’t decide between wave-front lasik and prk. The doctor said chances of being back in contacts/glasses is 1 in 10,000 with lasik and 1 in 100,000 with prk. I don’t really do sports, so theres no real chance of contact with my eye. I have done all kinds of research and don’t know which procedure is best. My fiance is having prk b/c he is a wrestling coach. Everyone seems to be pushing me towards regular lasik..I have thick corneas, so prk isn’t necessarily neccessary, right? I think I’m overthinking this!
Hi Gina
The final vision will be the same between PRK and LASIK. The chance of returning to glasses is about 1/100 for both procedures, not the figures you were quoted.
Safety is the same. 98% of our treatments are blade free wavefront LASIK, from patient’s preference – no pain, little downtime. Yes, generally we only do PRK for some contact sports people, thin corneas and some very high prescriptions.
The choice though is a personal one too – so up to yourself!!
Regards
Dave
Hi Alenoosh
I have explained this pretty well in my blog postings. Outcomes are the same. We do 96% femto LASIK and 4% PRK and only do the latter in cases of thin corneas.
Dave
Hi
What is the main difference between femto-lasik and PRK ? Which one do you suggest for your patients most ?
My doctor has told me that I’m a good candidate for eye correction surgery , but this clinic does not perform femtolasik surgery but they do PRK. In this case , I want to know if the difference between femtolasik and PRK is really big ( I mean will my cornea become more thinner than with femtolasik ) ? I’m kind of worried about this since I have read about cornea problems after surgery.
Thanks in advance for your guidance.
Alenoosh Baghumian
Hi, would there be any visual difference with LASEK over LASIK? WOuld you still perform LASIK with intralase for someone involved in contact sports such as boxing?
Thanks,
Paul
Hi Paul
For short-sight corrections without significant astigmatism, the result at 6 months post-op will be the same. WIth higher astigmatism, I prefer to perform LASIK over LASEK as the chance of enhancement is higher and this is more easily done with LASIK. For contact sports, it’s a good question. For boxing I tend to go with LASEK/PRK unless it is recreational with always using face guards and upper weight gloves where you could argue a case that the flap contacts risks are low, plus adhesion for femtosecond flaps have been shown to have significantly higher adherence at 10 weeks post-op in animal studies.
Best regards
Dave