LASIK, PRK
LASIK, PRK and Related Treatments
All the Freedom of Contacts, None of the Hassle
Nearly 30 million people worldwide have had LASIK since it’s introduction in the early 90s. Over that interval, technology has evolved such that it is now possible to correct an extremely wide range of optical imperfections, removing the hassles and inconvenience of lenses, and restoring clear, natural vision.
In fact, good candidates for LASIK should expect vision that is at least as good, if not better than what they can see with their best glasses and contacts!
LASIK can correct nearsightedness, farsightedness and astigmatism. LASIK corrects these optical imperfections by permanently reshaping your cornea, so the light that passes through focuses correctly, eliminating the need for glasses or contacts.
LASIK (acronym for Laser Assisted Stromal In-situ Keratomileusis) is a two-step process:
- The first step is to create a thin flap in the outer layer of the cornea. This can be done two ways: Either with a precision instrument called a microkeratome, or a special laser. The flap is opened, like opening the cover of a book.
- Then the excimer laser sculpts the desired optical correction into the underlying collagen. After this, the flap is closed, and seals within minutes, secures within hours. Patients can usually return to their full activities the very next day, even driving for the first time without lenses!
PRK ("Photo-Refractive Keratectomy") is only slightly different. In PRK no flap is created. Instead, the cells covering the outer corneal surface (the epithelium) are removed, and the laser is employed to sculpt the front layers of collagen. The surface lining cells heal over the treated area in about 4 days. A 'comfort' soft contact lens is used during this interval. After surface treatment, optimum visual recovery usually takes several days to a few weeks. Eyedrops are necessary to help guide the healing process, and these usually need to be continued for several weeks or a couple of months after treatment.
LASIK vs. PRK differences:
Performing laser sculpting under a flap, as in LASIK, eliminates the removal of the epithelial cells (as for PRK surface treatment), and thereby dramatically reduces any 'scratchy' sensation, discomfort or pain after surgery. Also, visual recovery is typically faster with LASIK than with surface treatment - virtually immediate in some cases - as the optical integrity of the cornea is preserved. The benefits of LASIK include faster visual recovery, faster healing, less risk of haze or scarring, and less potential discomfort than with surface treatment.
Another perceived advantage of LASIK arises if enhancement or subsequent laser treatment is ever contemplated. After LASIK, re-treatment can usually be rendered simply by lifting the original flap. This is considered easier and more comfortable even than initial LASIK by the majority of patients who have enhancement. After PRK, if retreatment is planned, the epithelium must again be removed as in the initial procedure; with the same healing and recovery considerations. In patients with myopia up to moderate ranges, both PRK and LASIK have shown comparably excellent visual results.
LASIK is for those who:
- want to reduce or eliminate their dependence on glasses or contacts
- are at least 18 years of age
- have had a stable eye prescription for at least one year
- have nearsightedness up to about 9 diopters (that would be written as -9.00 in the prescription) or farsightedness up to about +3.00, with or without astigmatism. LASIK can correct even very large amounts of astigmatism (we've treated as high as 7.50 diopters) if the corneal curvature is symmetric, and the corneas are healthy, not distorted.
- have no cataracts, corneal scarring, or other ocular pathology
Realistic expectations:
The decision to have LASIK is an important one that only you can make. The goal is to eliminate any need for glasses or contacts. At LA Sight, we believe in extreme accountability. That’s why we publish our LASIK outcomes for everyone to see. Our results are superior to published national statistics.
Serious complications with LASIK are extremely rare. LASIK is a safe, effective and permanent procedure, but it does have some risks. However, most of these risks are diminished through careful patient selection. It’s why we do on occasion recommend against surgery for people who seek consultation with us.
There are differences between laser treatment for nearsightedness and that for farsightedness. Treatment for nearsightedness (with or without astigmatism) achieves excellent optical and visual results that are typically stable over a period of many years or decades. With farsightedness correction, the biology of healing often causes some loss of treatment effect over time. We discuss specific concerns pertaining to farsighted correction by LASIK on a linked interior page of our site.
LASIK should not be undertaken lightly; this is not trivial surgery even though it is rather quick, and painless. We recommend careful selection of a LASIK provider and offer advice through our 50 Tough Questions to Ask Your Surgeon and Finding a Good LASIK Surgeon pages.
After your thorough eye exam, we will determine if LASIK is an option for you. If you are a good candidate, you will be given additional information about the procedure that will allow you to make an informed decision about whether to proceed. Be sure you have all your questions answered to your satisfaction (and for starters see our FAQ page). LASIK is a life-changing event, don’t take it lightly. If you’re interested in learning if you’re a candidate, schedule a convenient time for your complimentary consultation with us today!