LASIK, INTRALASIK, AND PRK
Facts you should know about LASER vision correction:
- Over 14 million refractive LASER procedures have been performed worldwide in the past two decades.
- At one year after surgery, 98% of near-sighted patients and 95% of far-sighted patients treated in FDA trials achieve 20/40 or better vision without glasses.
- Many well-known individuals, from entertainers to athletes have had LASIK (John Tesh, Troy Aikman, and Tiger Woods, for example).
What is LASIK and PRK?
In LASER vision correction, an excimer LASER is used to sculpt the cornea to correct near-sightedness, far-sightedness and astigmatism. In this way, the cornea’s refractive power is changed to correct for the eye’s refractive error.
PRK stands for photo-refractive keratectomy. In PRK, the patient’s refractive error (that is the patient’s eyeglass prescription) is entered into a computer, which relays the data to the excimer LASER. Next, the top layer (or epithelium) of the cornea is removed by the LASER. Then, the excimer LASER quickly vaporizes the stroma, the main layer of the cornea, reshaping it.
This process usually takes under a minute, depending how much tissue must be treated. Once LASER treatment is finished, the cornea is then covered with a bandage soft contact lens, and eye drops are used to decrease inflammation and discomfort. The bandage contact lens is worn for about three days to decrease discomfort and enhance healing and is removed once the epithelium is completely healed. For low prescriptions from +2 to -4 diopters, the long term results for LASIK and PRK are virtually identical.
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LASIK stands for LASER in Situ Keratomileusis. In LASIK, an automated microkeratome, a cutting instrument, makes a thin flap of the top layer of the cornea. A laser ( Intralase) can also be used to make the flap.
The flap is created mechanically using a ketratome or a laser (Intralase). INTRALASIK is LASIK using a femtolaser instead of a microkeratome to make the flap.
The corneal flap is reflected off the cornea by the surgeon. The exposed stroma is then reshaped by the excimer LASER. Once the excimer LASER finishes treatment, the corneal flap is folded back onto the newly treated stromal bed. The flap self-adheres to the treated bed, sealing it and protecting it. Since the stroma is not exposed after the procedure like it is in PRK, there is less discomfort and quicker visual recovery after LASIK. In addition, under the flap, the stroma heals with less scarring than in PRK, resulting in sharper vision faster.
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Should I choose LASIK or PRK?
Which procedure you should choose depends on many factors:
- LASIK is better suited to treating a wider range of refractive errors. For patients with minus 3 diopters or less, both LASIK and PRK give the same visual results when compared at the 6th month post-operative period. Though PRK is FDA approved to treat up to 6 diopters of near-sightedness, it tends to lead to more scarring than LASIK when used at the higher ends of treatment. LASIK, however, can be used for up to minus 12 diopters of near-sightedness. For hyperopia, LASIK is not usually treated for above +3 diopters.
- Both PRK and LASIK take about 10 minutes. And both procedures require only topical drops for anesthesia and lid retractors to keep the eye open. The patient goes home the same day and usually can go back to work within the next 24-48 hours.
- With complete ablation of the surface of the cornea in PRK, there can be more discomfort and a longer visual recovery period when compared with LASIK. In addition, a person may have to administer eye drops for a longer duration after PRK treatment than with LASIK. However, PRK is better for athletes engaging in contact sports or active military since there is no flap complications that can occur years later.
Who is a good candidate?
LASIK is intended to reduce the reliance on glasses or contact lens. Though "perfect vision" can often be attained, a realistic candidate should know that LASIK can usually reduce the need for glasses or contacts, but may not eliminate glasses all together. Also LASIK does not prevent the natural eye diseases, such as cataracts, that may occur that can make a person near-sighted again. Nor does it cure "presbyopia," i.e. the need for reading glasses (see our section on presbyopia and LASIK). A good candidate for LASIK should have a stable refraction, meaning that the patient’s eyeglass prescription has been unchanged in the last 8-12 months. For this reason, people under 18 are not good candidates – i.e., their eyes are still growing and changing. The patient should also be free of diseases such as rheumatoid arthritis, lupus, herpes, diabetes, keratoconus, and should not be pregnant and not be taking medications like Imitrex. Prior to LASIK surgery, every patient will have had a thorough eye examination and medical review by one of our surgeons to determine their suitability. Patients should stop wear soft lenses two weeks prior and rigid lenses 3-4 weeks prior to their LASIK evaluation.
What possible problems can occur?
LASER vision correction has been shown in clinical studies to be safe. However, as in any surgical procedure, problems may be encountered. After LASER vision correction, some patients may report dryness, glare, halos or starbursts, mild redness, light sensitivity, or scratchiness, but these side effects usually diminish over time. Under- and over-corrections can occur necessitating the use of glasses or contacts or re-treatment with the LASER to improve the vision. Infections and the resulting corneal scarring can also reduce vision. Though these complications have been documented, they do not occur in great frequency. FDA clinical trials have found that under one percent of PRK treated patients experienced significant over-correction and under-corrections, infections, corneal haze, and loss of best-corrected vision, and less than four percent of patients experienced night glare.
How much does LASIK cost?
Our prices are among the lowest in the area. Call us today (817) 8613937 for a LASIK consultation.
