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.   


image21

 

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.   

image22

 

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 free LASIK consultation.

image23