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As an experienced ophthalmologist in refractive surgery at Conlon Eye Institute, I understand how challenging it can be to decide between LASIK and PRK, especially when determining the best option for your vision correction needs. In this comprehensive guide, I will explore the differences between these two popular procedures, discuss their advantages and disadvantages, and provide insights to help you make the best decision for your unique needs.

The Key Differences Between LASIK and PRK

LASIK Procedure

During LASIK surgery, the surgeon creates a thin flap in the cornea using a microkeratome or femtosecond laser. The flap is then folded back, and the exposed corneal tissue is reshaped using an excimer laser. Afterward, the flap is repositioned and allowed to heal naturally.

PRK Procedure

In contrast, PRK surgery involves removing the entire outer layer of the cornea (epithelium) using a solution, brush, or laser. The underlying corneal tissue is then reshaped with an excimer laser. A bandage contact lens is placed over the eye to protect the newly exposed tissue and promote healing.

Advantages of LASIK

  • Faster Recovery: Most LASIK patients experience improved vision within hours and can return to daily activities within a day or two.
  • Less Discomfort: Due to the preservation of the corneal flap, LASIK patients typically experience less discomfort and a shorter healing period than PRK patients.
  • Lower Risk of Infection: Since the corneal flap acts as a natural bandage, there’s a reduced risk of infection compared to PRK.

Advantages of PRK

  • Suitable for Thin Corneas: PRK is an ideal option for patients with thin corneas, as there’s no need to create a corneal flap, preserving more corneal tissue.
  • No Risk of Flap Complications: PRK eliminates the risk of flap-related complications, such as dislodging or wrinkling, which can occur with LASIK.
  • Ideal for High-Impact Activities: PRK is often recommended for individuals involved in high-impact sports or professions, as there’s no risk of flap dislocation.

Side Effects and Potential Complications

LASIK Side Effects

  • Dry eyes
  • Flap complications
  • Halos or glare around lights
  • Undercorrection or overcorrection

PRK Side Effects

  • Hazy or blurry vision during recovery
  • Longer recovery time
  • Dry eyes
  • Infection risk
  • Halos or glare around lights
  • Undercorrection or overcorrection

Factors to Consider When Choosing Between LASIK and PRK

When deciding between LASIK and PRK, consider the following factors:

  1. Corneal Thickness: Patients with thin corneas may be better suited for PRK, as LASIK requires sufficient corneal tissue to create a flap.
  2. Lifestyle: Individuals involved in high-impact activities or professions may prefer PRK to avoid potential flap-related complications.
  3. Recovery Time: LASIK generally offers a faster recovery time and less postoperative discomfort, which may be a significant consideration for some patients.
  4. Personal Medical History: Discuss your medical history, including any eye conditions or previous surgeries, with your eye care professional to determine the most appropriate procedure.

Consulting with an Eye Care Professional

An essential step in decision-making is consulting with a qualified eye care professional. They will evaluate your eyes, review your medical history, and discuss your vision goals to recommend the most appropriate procedure.

During the consultation, don’t hesitate to ask questions about the procedures, their risks and benefits, and any other concerns. A thorough understanding of LASIK and PRK will help you make an informed decision.

In my practice, I guided patients: “PRK and LASIK are both proven procedures and equally efficacious in achieving excellent visual results; let’s pick the safest procedure for your eyes! It’s not a contest, it’s what is better for you and your eyes.”

Frequently Asked Questions

A picture of dice in a row with lettering FAQS

Q1: What is LASIK?

A1: LASIK stands for Laser-Assisted In Situ Keratomileusis, which is a popular refractive eye surgery used to correct common vision problems, such as nearsightedness, extreme farsightedness, and astigmatism.

Q2: How does LASIK work?

A2: During the LASIK procedure, a corneal flap is created using a microkeratome or a femtosecond laser. The surgeon then lifts the flap, exposing the underlying corneal tissue. An excimer laser is then used to reshape the cornea by removing a predetermined amount of tissue. Once the cornea is reshaped, the flap is repositioned and adheres naturally without stitches.

Q3: What is PRK?

A3: PRK stands for Photorefractive Keratectomy, another type of refractive eye surgery predating LASIK. Like LASIK surgery, a laser beam is used to correct vision problems such as nearsightedness, farsightedness, and astigmatism. The main difference between the two refractive surgery procedures is how the cornea is prepared for laser treatment.

Q4: How does PRK work?

A4: In PRK, the outer layer of the cornea (the epithelium) is gently removed, exposing the underlying corneal tissue. An excimer laser is then used to reshape the cornea by removing a precise amount of tissue. After the procedure, a soft contact lens is placed on the eye to act as a bandage while the epithelium regenerates.

Q5: Which eye surgery is more appropriate for athletes or those with thin corneas?

A5: PRK may be more appropriate for individuals engaged in contact athletics or jobs that heighten the likelihood of ocular trauma or those with thin corneas or dry eyes since LASIK entails forming a corneal flap, posing increased difficulties.

Dr. Conlon operating with a microscope.

Dr. M. Ronan Conlon started his career in the field of ophthalmology at the same time as the development of refractive eye surgery in Canada. In 1996, he brought laser technology to Canada from Germany, which allowed him to perform laser eye surgery before it was available in the United States. With the establishment of the Conlon Eye Institute, Dr. Conlon has performed more than 40,000 refractive procedures and has advanced his expertise in LASIK and refractive cataract surgery.


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