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Refractive Surgery Treatment Spotlight: LASIK vs. PRK

One of our many services at Eye Care Associates of Nevada includes refractive surgery. Refractive surgery provides visual freedom for a wide range of daily activities by reducing your dependency on glasses or contact lenses. Here are a few facts about the different surgical options.


What is LASIK? (Laser-assisted in situ keratomileusis)

LASIK is a refractive surgical procedure that can correct nearsightedness, farsightedness and astigmatism. It requires a microkeratome to create a thin flap of tissue on the front surface of the cornea, followed by excimer laser ablation which reshapes the cornea underneath to your given prescription. After the laser, the flap is gently re-positioned over the site.

LASIK advantages: The main advantage of LASIK over PRK is the maintenance of the very top layer of the surface of the eye – called the corneal epithelium. Because the central portion of the corneal epithelium stays intact, there tends to be less discomfort during the post-operative recovery period compared to PRK. This typically leads to a faster visual recovery and less time on surgical drops.


What is PRK? (Photorefractive keratectomy)

PRK is surgery that also treats nearsightedness, farsightedness, and astigmatism. It requires removal of the central corneal epithelium before reshaping the underlying cornea. Due to the removal of the top layer, it requires the eye to regenerate these superficial cells post-surgically. Some patients may report more discomfort than LASIK during the first few days after surgery. This requires daily follow-ups for the first few days to ensure proper healing as those corneal cells regenerate and connect. It also may take at least several weeks, and in some cases months, for the vision to stabilize.

PRK advantages: One benefit of PRK is the ability to operate on corneas too thin for LASIK. Another benefit over LASIK is the absence of a corneal flap. By eliminating the need for potential space created by a flap, PRK has a lower risk of infection and greater stability compared to LASIK – especially for patients with higher susceptibility to trauma (contact sports, military, etc.). Many doctors also prefer PRK for patients with dry eye. Research shows that goblet cell damage from the LASIK suction ring can cause increased dryness; in addition, disrupting corneal nerves with creating a LASIK flap may also disrupt the feedback loop for producing tears.


What is LASEK? (Laser Epithelial Keratomileusis)
LASEK is a hybrid of PRK and LASIK. Instead of creating a flap with a microkeratome (LASIK) or removal the patient’s epithelium (PRK), LASEK treats the epithelium with alcohol to loosen and separate it from the cornea and is then rolled back. The underlying stroma is ablated with a laser and the epithelial cells are rolled back and repositioned. The benefits of LASEK include reducing postoperative haze, improving time for visual recovery, and decreasing post-operative pain over traditional PRK.


Which do I choose?

A consultation with an eye care specialist at Eye Care Associates of Nevada will allow us to better choose which option to consider. After a careful analysis of your prescription, corneal shape, and other health factors, an eye doctor will provide professional recommendations based on your needs. Some patients may qualify for one procedure but not another due to various factors such as age, pupil size, thickness of the cornea, ocular diseases, presence of a cataract, etc. For more detailed information on our surgical procedures click here or schedule a refractive surgery evaluation today.