Lasik or PRK?

[ahumblestudent]

Hi everyone, I am 23 years old and have stable -7.0 prescription on both eyes, my corneal thicknesses are 574 and 578 microns, which is above average, my left pupil is 6.4X6.6mm and my right pupil is 7.9X8.1 mm. My doctor recommends LASIK for me but I don't want to deal with any flap-related injuries in the future so I am also considering PRK, but I heard rumors that PRK cant be done for vision worse than -5.

1. Am I still eligible for PRK?
2. What kind of result can I expect?
3. Does PRK cause more halos/glares/starbusts/poor night vision than Lasik?
4. Anything else I need to know?

Thanks!

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[20DOC20]

Your rx is outside recommended safe parameters for PRK. Listen to the recommendations of your doctor.

 

[CopperStripes]

I had PRK done because my corneas were too thin for Lasik. One of my eyes was in the 6 range, and my ophthalmologist didn't say anything about my vision being too bad for PRK. I'm very happy with the outcome (it's been about a year). I would have done Lasik if I could though. Even for a very active person, flap disasters are uncommon enough that Lasik's a risk worth taking for the short recovery time and overall excellent results.

 

[jrychlik]

I am not sure why PRK would be unsafe for a rx higher than -5 as its generally used more than LASIK for patient with higher prescriptions and/or thinner corneas. As well as patients who have deep scars, irregular corneal topographies and huge pupils.

It has actually been reported that PRK has a lesser chance of halos'starburts afterwards because it can take less corneal tissue during the procedure, in turn, the ability to create a bigger treatment zone.

One optometrst I know told me that there was a 'recent' article proving that PRK vision is actually better than LASIK after everything is said and done.
I cant find the study to prove it and lost contact with that OD also but im sure through googling you can throw something up. I believe the study was done with patients who has 1 eye LASIK and 1 eye PRK.

 

[clarkbar]

I had over a seven in both eyes and the doctor still operated. Is there anyway to inquire about compensation for damages? The MDs are tight and lawyers are looking for a quick buck.

 

[vamp]

I wouldn't recommend Lasik, I had it done when I was 20 and I was happy with the results at the time with 20/15 vision, but I experienced regression and now require a "touch up" to improve vision again.

 

[DrVinzKlortho]

Hi everyone, I am 23 years old and have stable -7.0 prescription on both eyes, my corneal thicknesses are 574 and 578 microns, which is above average, my left pupil is 6.4X6.6mm and my right pupil is 7.9X8.1 mm. My doctor recommends LASIK for me but I don't want to deal with any flap-related injuries in the future so I am also considering PRK, but I heard rumors that PRK cant be done for vision worse than -5.

1. Am I still eligible for PRK?
2. What kind of result can I expect?
3. Does PRK cause more halos/glares/starbusts/poor night vision than Lasik?
4. Anything else I need to know?

Thanks!

1. Technically yes you are eligible for PRK (assuming your orbscan/pentacam/topography and all other testing look fine) however I do not recommend having PRK if you are over a -5 or -6.
2. If you are correctable to 20/20 or even 20/15 then technically you can reach that post-operatively although it cannot be guaranteed. With PRK you have to wait for the epithelium to grow and heal so expect a substantial amount of pain during the healing process along with fluctuating, blurry vision.
3. Yes. during the healing process with PRK you will have more glare, halos and starbursts. However the big concern with having PRK and an Rx like yours is the increased risk of post-surgical corneal haze.
4. If you do decide to proceed with PRK I would highly recommend that you have oral Vit-C 1-2g daily as this has been shown to help reduce post-operative corneal haze. Flap related complications are severely decreasing, especially with the use of advanced flap creating lasers. No procedure can give you 100% guarantee that you'll reach 20/20 or better or have no post-operative complications. However lasers like the intralase can help decrease some of these complications. Because of your Rx you automatically have an increased risk of needing an enhancement down the line. This doesn't necessarily mean the procedure was a failure: your Rx can change throughout your lifetime for example.

 

[310]

I wouldn't recommend Lasik, I had it done when I was 20 and I was happy with the results at the time with 20/15 vision, but I experienced regression and now require a "touch up" to improve vision again.

This is probably because you had it done at age 20. Prescriptions and, in turn, LASIK results, tend to stabilize later in the 20s.

 

[jrychlik]

1. Technically yes you are eligible for PRK (assuming your orbscan/pentacam/topography and all other testing look fine) however I do not recommend having PRK if you are over a -5 or -6.
2. If you are correctable to 20/20 or even 20/15 then technically you can reach that post-operatively although it cannot be guaranteed. With PRK you have to wait for the epithelium to grow and heal so expect a substantial amount of pain during the healing process along with fluctuating, blurry vision.
3. Yes. during the healing process with PRK you will have more glare, halos and starbursts. However the big concern with having PRK and an Rx like yours is the increased risk of post-surgical corneal haze.
4. If you do decide to proceed with PRK I would highly recommend that you have oral Vit-C 1-2g daily as this has been shown to help reduce post-operative corneal haze. Flap related complications are severely decreasing, especially with the use of advanced flap creating lasers. No procedure can give you 100% guarantee that you'll reach 20/20 or better or have no post-operative complications. However lasers like the intralase can help decrease some of these complications. Because of your Rx you automatically have an increased risk of needing an enhancement down the line. This doesn't necessarily mean the procedure was a failure: your Rx can change throughout your lifetime for example.

Im just curious, do optho's in the states use mitomycin C for patients undergoing PRK ?

 

[DrVinzKlortho]

Im just curious, do optho's in the states use mitomycin C for patients undergoing PRK ?

Yup, typically 20-45 seconds depending on Rx.

 

[clarkbar]

That agent is a severly toxic chemotherapy drug. Like people that take chemotherapy doses, you will have permanent side effects. Dr.s use it so you dont clog their laser chair again if you get corneal haze, which is your eye trying to protect itself from the trauma.