PRK surgery

[Marebythesea]

I always said that if God, in his almighty goodness, could perform one miracle it would be to give me good eyesight…he gave me that blessing withLASIK. Sounds kind of dorky, but I started wearing glasses in the third grade; I was so bad I needed glasses to find my glasses. People who have always had their sight just don’t realize what they have and often times take it for granted. I can remember the morning after my procedure waking up my SO with my sobs…he sat bolt upright in bed so worried something terrible had happened with my eyes, but it wasn’t that at all, I was crying because for the first time in my life I didn’t have to reach for my glasses to see across the room. OK, enough of that, the following is what I understand to be the differences between the two procedures:
LASIK
Range of correction is Low to Severe
Functional Visual Recovery 24 Hours because the cornea flap quickly reattaches
Optimum Visual Recovery 1 – 4 weeks
LASIK stands for the laser in-situ keratomileusis (SP?). The LASIK procedure reshapes by removing tissue from the middle layer of the cornea. This procedure utilizes an extremely accurate device called a microkeratome (hansatome) along with the excimer laser. The device is very similar in design to a carpenter’s plane; it’s used to fold away a corneal flap, revealing the middle layer of the cornea, which is then reshaped by the laser. Once that is done, the corneal flap is then repositioned. Natural forces hold the flap in place until surface healing is complete. Both eyes can be done at the same time, but if you like you can opt to have them done during separate visits.
The LASIK procedure offers extremely fast recovery: within two hours after surgery the flap has usually begun to heal. Usually antibiotic eye drops are prescribed along with artificial tears. You must wear eye shields (like goggles) at night to prevent rubbing of your eyes and to prevent them from drying out. Most people resume day-to-day activities within 24 hours. I was back to work the following day and diving within 10 days. I had no pain or discomfort during the procedure and no discomfort or pain post procedure. Within two weeks I had 20/15 vision. The worst part for me was having to wear the goggles.
PRK
Range of correction is Low to Moderate
Functional Visual Recovery 3 to 5 days longer than LASIK because the surface or epithelium of the eye needs time to grow back
Optimum Visual Recovery 3 weeks to several months

The PRK (photo-refractive keratectomy) technique is used for people whose cornea may be too thin to allow for the creation of the corneal flap required for the LASIK procedure. During PRK a small area on the corneal outer surface is polished away. The laser reshapes the corneal surface in exactly the same way as the LASIK procedure. A temporary contact lens is placed over the cornea to protect the treated area and reduce discomfort during the healing process.
After the initial surface healing is complete, usually between 3 and 7 days post procedure the contact lens is removed. Vision gradually improves during the first two weeks, and in most patients stabilizes between four to eight weeks after surgery. Usually antibiotic and steroid eye drops are prescribed along with artificial tears. Many patients opt to have only one eye done at a time because of the recovery period.

The final outcome of PRK and LASIK is identical; the main difference is in the healing time and duration of eye medications. Both LASIK and PRK techniques use the excimer laser; the only difference is how the cornea is accessed. If the cornea is not thick enough for LASIK treatment, then PRK is the recommended treatment. It is my understanding that LASIK requires more technical skill and training than PRK.

I am not aware of any “weakness” created with LASIK.

My procedure cost $1200 -- $600/eye four years ago in Long Beach, CA. I did major shopping around first for the surgeon and then for price…I think I found the best doc for a great price!

 

[H2Andy]

very nce thread... thank you everyone... i have been thinking about this for a while,
and this was very educational

 

[chickdiver]

I havemild halos aswell (large pupils) and was warned ahead of time also. Interestingly, I have lived with an astigmatism my entire life (which was corrected by theLasik) ans the halos are better now than they were before the correction.

 

[plsdiver4377]

I havemild halos aswell (large pupils) and was warned ahead of time also. Interestingly, I have lived with an astigmatism my entire life (which was corrected by theLasik) ans the halos are better now than they were before the correction.

Dr. Woolfson deliberately overshot my left eye to correct for my astigmatism, it worked like a charm. I have found that if the halos are really irritating me while driving I just turn the interior light on and that helps quite a bit.

 

[chickdiver]

Dr. Woolfson deliberately overshot my left eye to correct for my astigmatism, it worked like a charm. I have found that if the halos are really irritating me while driving I just turn the interior light on and that helps quite a bit.

I don't even notice them, unless I am really trying to pay attention- it's MUCH less noticeablethan the astigmatism was!

 

[plsdiver4377]

I don't even notice them, unless I am really trying to pay attention- it's MUCH less noticeablethan the astigmatism was!

My wife didn't understand what I was talking about when I told her that I had halos. Apparently she's had them her entire life and she thought they were normal. I never had them while I wore contacts even though I was one of the types that abused my eyes by wearing them 24/7 for up to 3 months at a time, so they were something new to me. I'm just glad that I can do all the sports I like without wondering if/when I going to go blind from losing a contact.

 

[Marebythesea]

I'll be having an evaluation for interlasik this Thursday. I haven't commited to the proceedure yet. Didn't know about the scar issue, but I like the fact that no knife blade touches the eye and that recovery time is very short. One other post here mentioned that they had a halo effect with their night vision after the lasik. I will diffenently ask about that! Has anyone had their eyes corrected for two (2) different focal lengths, one for close-up, the other for distance? Thanks.

It’s my understanding that a lot of the night vision problems were based on old technology. People with large pupils or with high prescriptions often have some night vision disturbances without having had refractive surgery. Earlier excimer lasers had small treatment zones so that when a person's pupil would dilate beyond the treatment zone at night they would experience a halo or starburst around headlights. Because of my high prescription, like Walter I was legally blind, I was at risk for night vision problems, but they never materialized. The new excimer lasers now have a larger treatment zone to combat this problem. I’ve been told that during the first few weeks of healing following the procedure people may be more aware of some haloing but that it almost always subsides and will rarely be worse than any disturbances prior to treatment. My night vision was actually better following LASIK.

I contemplated having my eyes corrected for two (2) different focal lengths but decided I just wanted to SEE…I now have to wear reading glasses…royal pain! I go through glasses like water! I made my decision at that time because the physician who did my procedure was working on the LASIK clinical trials for farsightedness and astigmatism. I don’t know why I haven’t had it done, but I do need to go back for another procedure…

Best of luck, I am very excited for you and Jessica!

 

[firediver293]

I am considering eye correction surgery and have asked in a previous post about divers' experiences with LASIK. I am also a candidate for PRK, and am wondering if anyone has had this procedure done instead of LASIK, and what the outcome was.

THANKS!

-Jessica

Jessica,

I had PRK done on both eyes in September of last year. Everyone else has done a pretty good job on this thread outlining the major differences. Summed up - LASIK cuts a flap of cornea allowing the possibility (although very small) of the flap detaching. Something I didn't want to deal with in remote parts of the world (either with the military or while diving). Stateside not a big deal as medical facilities are a dime a dozen. PRK does the laser work on the top of the cornea to correct the shape. A bit more pain and recovery, but more stable cornea when it is done.

My biggest concern was could I dive? Doctor said not only could I dive when it was done, but I would be able to SEE when I dive. Best thing in the world. Went from 20/200 to 20/15 within minutes. Highly recommended. Well worth the money, discomfort, and time.

Good luck.

 

[chickdiver]

FYI- the largest area the lasers can currently treat is 8mm. My pupils are 8.5mm (which is quite large). You are more likely to have large pupils if you have light colored eyes (blue or green). My halos are almost unnoticeable to me- much like plsdiver's wife, I didn't know that everyone didn't see that way due to the astigmatism I had.

 

[nusspli]

Well I did it! I had LASIK done last Friday, and I was seeing 20/20 the next day! Everything is going well, and I'm planning my next dive trip to The Keys in April, so hopefully I'll be plenty healed by then.

-jessica