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Types of Laser Eye Surgery: What’s the Difference?

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There are numerous types of laser eye surgery. Because no two people have the same eyes, the treatment recommended by an eye surgeon may differ from person to person.

If you’re thinking about laser eye surgery, you’ve probably got some questions, especially about the different types, such as LASIK or PRK. It’s important to understand the ins and outs of laser eye surgery, from how it works to healing time, to make an informed decision about your eye health.

PRK or Photorefractive Keratectomy

PRK was the first laser eye surgery method, it’s been available since 1988 and was approved by the FDA in 1995. Although LASIK has largely replaced it, it continues to be used to treat people with thin corneas. 

It’s a blade-free technique for treating and correcting myopia (nearsightedness) and astigmatism, but it’s not appropriate for moderate to severe hyperopia (longsightedness).  PRK was the first type of laser eye surgery for vision correction and is the forerunner to the well-known LASIK procedure. Even the same excimer laser that is used in LASIK is used in PRK.

PRK works similarly to LASIK in that it reshapes the cornea, but the reshaping is done on the surface after the epithelial cells are removed. 

One of the main differences between LASIK and PRK surgery is that no corneal flap is created during PRK surgery. PRK may be a better option than LASIK for patients with thin corneas or active lifestyles because there is no corneal flap.

The frontal layer of the cornea is removed at the start of treatment to allow the laser to reshape the stromal layer deeper into the cornea. The laser vaporizes parts of the cornea, guided by an extremely accurate computer, to give it a different shape that is corrected for its vision. A bandage contact lens is used at the end of the laser treatment. 

PRK recovery takes a little longer than LASIK recovery. Whereas LASIK recovery takes only 4-5 hours, PRK recovery can take 4-5 days and the final improvement takes 3-4 weeks.

A surgeon preparing for laser eye surgery on a female patient

LASIK

LASIK is an abbreviation for Laser-Assisted In-Situ Keratomileusis. It’s the most common elective surgery in North America, and it can correct myopia (nearsightedness), hyperopia (farsightedness), and astigmatism.

In general, most LASIK eye surgery patients achieve 20/20 vision or better, which is great for many activities. However, as people age, most will need glasses for night driving or reading.

The success rate of LASIK surgery is high. Complications that result in vision loss are uncommon, and most patients are pleased with the outcome. Certain side effects are fairly common, particularly dry eyes and temporary visual disturbances such as glare). 

However, these usually go away after a few weeks or months, and very few people consider them a long-term issue.

Before performing LASIK, your eye surgeon will take detailed measurements of your eye and evaluate its overall health. You might be asked to take a mild sedative just before the procedure. Eye-numbing drops will be administered once you are comfortably lying on an operating table. 

Then he or she will precisely alter the curvature of your cornea using a special type of cutting laser. A small amount of corneal tissue is removed with each laser pulse, allowing your eye surgeon to flatten or steepen the curve of your cornea.

Your best vision is usually achieved within the first 1-3 months. As your eye heals, potential side effects such as dry eye, halos, and glare usually subside.

After Laser Eye Surgery

In general, LASIK has a pain-free recovery, whereas PRK has been associated with mild to moderate discomfort or pain during the procedure.

Your optometrist will provide post-operative care to ensure that your eyes heal properly. Post-operative care is often included in the cost of your surgery. Your specific post-operative care will be determined by the type of surgery and your needs.

PRK, for example, needs daily monitoring for about a week to allow the epithelium to heal. Expect to have regular follow-up appointments for at least 6 months after surgery to monitor your healing. Your surgeon and optometrist will collaborate to plan your post-operative care.

Overall, each of these techniques performs well in the correction of far and nearsightedness, as well as astigmatism. Because LASIK is ineffective for people with thin corneas, it’s probably the most limited in terms of patient intake.

Ready to Get Laser Eye Surgery?

There are no perfect answers when it comes to laser eye surgery. Consider the factors listed here carefully, weigh your preferences and risk tolerance, and ensure you have realistic expectations. 

Speak with an eye surgeon and get your questions answered. Finally, if it feels right, go ahead and book an appointment today and leave those glasses behind.

Written by Dr. Rod Adams

Dr. Rod Adams is a graduate of the University of Alberta and the University of California at Berkeley School of Optometry. Dr. Adams has been in private family practice since 1997. During this time, he has developed a strong interest in pediatric optometry and laser corrective surgery options.
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