LASIK Versus PRK: Which procedure is right for me?

PRK and LASIK are the most popular modern methods to correct nearsightedness, farsightedness, and astigmatism, but how do you make the LASIK versus PRK decision?

LASIK is a laser vision correction treatment where nearsightedness, farsightedness, and astigmatism can be corrected by using an Excimer laser to reshape the corneal surface. With LASIK, treatment is performed beneath a very thin flap in the cornea (the cornea is the clear tissue at the front of the eye that light passes through as it enters your eye). PRK is the identical laser vision correction treatment performed directly on the corneal surface (rather than beneath a flap as with LASIK). Both LASIK and PRK treatments provide excellent visual outcomes and freedom from glasses for distance vision for nearly all patients. PRK and LASIK generally provide equivalent visual outcomes. So why would someone choose LASIK versus PRK? Some patients prefer LASIK for its faster healing, and others prefer PRK for its extra safety.

Faster Healing Times with LASIK

One advantage to LASIK is faster healing times. This is the main reason why LASIK tends to be more popular with patients. With LASIK, the area treated by the Excimer laser is covered by a flap of corneal tissue. Because only the edges of this corneal flap need to heal, usually the healing is quite rapid after the procedure. Patients typically will recover within 24 hours so that they are able to resume driving, reading and computer use within 1 day.

As LASIK requires creation of a flap in the cornea, it does weaken the cornea a little bit more than a PRK procedure does. This is usually not a significant risk, unless the patient has an unusually thin cornea or a corneal shape that may suggest instability.

The one (and only) disadvantage of PRK is the relatively longer healing time as compared to LASIK, and it’s definitely an important consideration when comparing LASIK versus PRK. With PRK, patients may require an average of 3-4 days before the surface of the eye has healed. During these first 4 days or so, a bandage contact lens is worn to protect the healing corneal surface. Vision is typically better immediately after PRK, but the best vision does require at least 1-2 weeks of healing. PRK patients will usually return to normal activities within 4-5 days.

Both Procedures are Safe

The main advantage of PRK is its greater relative safety compared to LASIK. LASIK is extremely safe (although no procedure is entirely risk free). Yet as safe as LASIK is, PRK is even safer. Because the laser treatment is performed on the corneal surface with PRK, there is no corneal flap. Without a corneal flap, there are zero risks of flap-related complications. Therefore, PRK has zero risk of a wrinkled flap, displaced flap, incomplete flap, debris under the flap, inflammation under the flap or an imperfect flap. Also, without a corneal flap, more corneal tissue is left intact and the cornea is generally stronger and more stable after the procedure. This also leaves more tissue available for a second treatment or enhancement if it is ever needed. Also, there is some evidence that patients may experience less short-term post-operative dry eye symptoms with PRK compared to LASIK.

Candidates for PRK & LASIK

Every LASIK candidate is generally a candidate for PRK too. Some patients are candidates for PRK only and they may not be LASIK candidates. Examples of patients who may be PRK candidates include patients with thinner corneas, irregular astigmatism, or prior eye surgery. Some patients with certain occupational or sports pursuits may favor PRK if there is a concern about the possibility of future eye trauma. Some patients may not be suitable for either procedure and a thorough exam performed at King LASIK will determine what options are available for each patient. Dr. King offers his Bellevue patients both LASIK and PRK. Approximately 15 percent of patients are not suitable for either procedure.

Patients who prefer LASIK will experience a safer procedure when the LASIK corneal flap is made by a laser rather than by a blade. Although microkeratome LASIK is still commonly offered around the world, the professionals at King LASIK use an advanced femtosecond laser, known as the Intralase IFS, the first of its kind in the Bellevue area and Puget Sound. This allows for unprecedented safety and precision.

Each patient who is interested in laser vision correction is evaluated by Dr. King and he will advise you of your options and recommend whether LASIK or PRK is best for you.

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