As a practice that has been performing laser vision correction for over 20 years, one of the most common questions we hear is “what is the difference between PRK and Lasik?” The purpose of this blog is to talk to you about PRK and hopefully dispel some of the rumors
What is PRK?
Formally speaking, PRK stands for PhotoRefractive Keratectomy. Another name for PRK is surface ablation. PRK involves the brushing off of the top layer of the cornea also known as the epithelium. This is then followed by the Excimer laser reshaping the inner layers of the cornea in exactly the same fashion as Lasik. In Lasik however, instead of brushing off this top layer, the top layer is lifted and replaced. At Stahl Eyecare Experts, we lift this top layer in Lasik using the femtosecond laser (originally, this was done with a blade, but we abandoned the blade when it was clear that the laser was much safer).
How quickly will I see results after PRK?
Once the excimer laser reshaping is completed the patient gets off the table with improved vision, however the quality of the improvement is not as quick as Lasik. Because the top layer has been brushed off it now has to grow back and this typically takes 72 hours. During this time the eye(s) can be uncomfortable and the vision can be blurry although typically it is significantly better than when the patient first visited the office. This is in contrast to Lasik; in Lasik, the most common result is 20/20 (or very close to that the day after the procedure)
So why do we ever do PRK if Lasik heals quicker?
If everything were equal, sure, we would prefer the quicker healing of Lasik. However, everything is not equal. For some patients PRK is a safer procedure and this depends upon the shape of the cornea, the thickness of the cornea as well as some other esoteric factors. The great news however is that all major studies that have addressed this issue have found that Lasik and PRK have exactly the same final results. So I encourage my patients to think of PRK as a procedure which heals a little slower but has the same results. At Stahl Eyecare Experts our concern is which method gives you the best vision in the safest possible fashion for the longest period of time.
Can PRK correct my astigmatism?
Rest assured, that whatever Lasik can correct, PRK can correct, although in a slower time period. So, YES, PRK can correct your nearsightedness, your farsightedness and even your astigmatism!
How will the postoperative course be different between PRK and Lasik?
At Stahl Eyecare Experts in New York, our typical Lasik patient takes an antibiotic drop and a steroid drop for one full week after the procedure. Frequently, after the week has elapsed, we encourage our patients to use artificial tears to improve their healing, quality of vision and comfort.
For PRK, it is very common for us to put a contact lens on the surface of the eye immediately after the procedure to aid in the healing of the epithelium. Similar to Lasik, the patient is typically on the antibiotic drop for one week after the procedure. However, we usually will have our patients remain on the steroid drops for one month (or more) after the PRK procedure. Your exact dosage will be individualized to maximize your visual results. In addition, we typically recommend the use of anti-inflammatories like ibuprofen (by mouth), for the 48 hours after the procedure.
Do patients ever have Lasik on one eye and PRK on the other?
Although most patients elect to have the same procedure on both eyes, we do have a few patients that have had Lasik on one eye and PRK on the other. Most of the time, in the cases I have seen, it is the presence of a scar on the cornea from a previous infection which precludes me from doing Lasik on that one eye. As expected in these patients, although Lasik eye heals quicker, once both eyes have healed, the patients do not notice a difference in the visual outcome.
What is the next step?
Come meet with us and let us know your concerns and expectations. We are always happy to work with you to customize a procedure that delivers great results!
