With all the excitement surrounding LASIK in the refractive eye surgery community, people are often confused when they hear of another procedure also offered by most clinics called PRK. Since PRK is the older technology, why should anyone choose to have that, and in a PRK vs LASIK scenario, which procedure would actually win?
Indeed, PRK (photorefractive keratectomy) was the first kind of laser eye surgery invented for vision correction, and it is the precursor to the popular LASIK procedure.
Like LASIK, PRK works by reshaping the cornea using an excimer laser, allowing light entering the eye to be properly focused onto the retina for clear vision. The real difference is in the first step employed during both the procedures.
In the case of LASIK, a thin flap is created on the cornea and is lifted to expose the corneal tissue lying underneath. Once the cornea has been reshaped, the flap is replaced with an excimer laser.
During the PRK process, the epithelium (outer layer of the cornea) is removed and discarded before reshaping the corneal tissue underneath with an excimer laser. The epithelium repairs itself (grows back over the corneal surface) within a few days after surgery. So this is the “flapless” option.
The final results of PRK and LASIK are comparable. Price-wise, they’re in the same bracket too.
The difference is mainly in the healing time. The epithelial tissue that is removed during PRK surgery needs a few days to re-grow and cover the surface of the eyes. And until then there is some risk of contracting an eye infection or finding vision a bit hazy for a few days to a few weeks. All these problems heal naturally enough, and quite according to the surgeon’s expectations, but compared to LASIK, the PRK process definitely calls for more post-operative maintenance.
LASIK offers the convenience of very quick recovery. Vision stabilizes fast and patients can live normal, ordinary lives almost right away. They can fly in airplanes, take vacations, have alcohol and do pretty much anything else within the limit of `normalcy’ and not feel any negative repercussions from the eye surgery.
Then why choose PRK at all?
A lot of patients and their surgeons agree to go with PRK instead of LASIK because the surgery does not create a corneal flap (which contains both epithelial and the deeper stromal tissues), and the entire thickness of the underlying stroma is available for treatment. This is of particular benefit if the patient’s cornea is too thin because not much of the corneal tissue will be removed while creating a flap in the LASIK style.
The second big reason – and this is where your profession comes in – is that PRK is a “flapless” operation. If the nature of your job is such that there is a high risk of blunt force trauma to the eye, you could dislodge the flap created during LASIK. Correctional Officers and certain professional athletes (MMA fighters, boxers, wrestlers) are good examples.
Generally, patients who are very active in sports that are contact or high-impact related — like martial arts, wind surfing, kite surfing etc. — may develop an injury to the eye or have a much higher risk of injury. For them, PRK is usually the safer option.
As such, the decision does not have to be made until the results of the initial consultation are in. Once the surgeon knows the status of your eye condition, you can have the PRK vs LASIK discussion and make a wise, responsible decision that is best for your vision.