Monday, March 21, 2011


Laser Eye Surgery Question: I went for a LASIK consultation and the eye doctor told me I am a good candidate for either PRK or LASIK. Which type of laser eye surgery is better?

Here are some considerations for you to know and understand about PRK vs. LASIK. First, the long term clinical studies comparing PRK and LASIK show that the ultimate visual results of both types of laser treatment are virtually identical. However there are some subtle differences as well as some not so subtle difference.

Patients who have LASIK may have very slightly reduced contrast sensitivity in dim illumination. “May” is the operative word here. If one uses extremely sensitive clinical measuring methods they can sometimes find a slight reduction in “low contrast” vision. Often it is so slight that the patient does not notice it except in the testing conditions or in very extreme instances of reduced contrast situations such as driving at dusk in the rain. Thus it is a limited problem for most patients.

The real differences between PRK and LASIK are based on the fact that PRK is a “surface laser treatment” and LASIK is a “lamellar laser treatment”. PRK is performed on the surface of the cornea whereas LASIK is performed between the layers of the cornea. To do a LASIK it is a 2 step procedure-one to create the “layer” or “flap” and one to apply the laser. To do a PRK is a single step procedure, just applying the laser. Thus, whenever you have a multi step eye surgery procedure THERE IS A GREATER POSSIBILTY OF RISKS, SIDE EFFECTS AND COMPLICATIONS. Fortunately the risks, side effects and complications of LASIK are relatively few and minor if you are indeed a good candidate and under the care of a top laser surgeon. So, PRK does offer a safer risk profile because it is a single step procedure. However one of the not so subtle differences is that because it is a lamellar procedure, LASIK does not disturb the surface of the cornea during treatment. This provides patients with a much faster visual recovery and significantly less discomfort than PRK. This is why from a consumer perspective patients have tended to want LASIK eye surgery more than PRK. They can get back to pretty much normal activities within a couple of days without any real pain-just some mild discomfort-and with good vision. Most LASIK patients are able to pass a drivers test with 24-48 hours of their laser treatment. PRK patients often experience moderate discomfort that can last a few days and depending on the degree of their prescription can take a week or so to achieve good functional comfortable vision. The simple answer to the question “Which is better PRK or LASIK?, is to choose a reputable a laser  surgeon who takes the time necessary to evaluate you properly and guide you through the right decisions in selecting the best type of laser eye surgery.

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