What are the advantages and disadvantages of one over another? I am scheduled to have Lasik next week and my surgeon suggested Lasik but never even mentioned the others. Thanks.

Mary,

I live in Henrietta, NY and had Lasek, 1 eye on 1/16 and the other on 2/4. There are many reasons why you might want to consider Lasek/PRK over Lasik, but it would help if you post your refractive measurements and corneal thickness(at least these numbers if not all from you pre-op testing).

I can tell why I choose Lasek. I researched for a year before having surgery, mainly reviewing this site, one run by Dr. Jerry Horn and Surgical Eyes. If you haven't reviewed SE, you should. It made me think long and hard about refractive surgery, but I came to the conclusion that the vast majority of folks there who had poor outcomes were either poor candidates or had surgery 2 years ago or more.
I decided on Lasek to avoid any flap complications, dry eye and to retain more corneal tissue. I was -6 and -6.25 w/ about .75 astigmatism, 6.0/6.5 pupil and 550 corneal thickness. Lasik would have left me with about 270-280 microns of thickness after the surgery and I was not comfortable with this. With Lasek/PRK, I choose to have longer recovery and more pain, there is a slightly higher chance of infection and haze. As Dr. Trattler has posted many times, vitamin C can help and I have been taking it since 2 months before surgery. Also, the new lasers produce a smoother ablation which has made Lasek/PRK an option for hight myopes.

My results, right eye(done 1st) is 20/20 and the left is about 20/35. I'm able to not were glasses at all times and see very well, especially in daytime and bright light. Night time things are a tad blurry and I have slight halos at night w/ little starbursting. The right eye gave me almost no pain and it was gone on the 4th day post-op; the left was totally different, I had moderate pain 1 hour after the surgery for 3 days. I was off work 4 days for each(2 days were weekend). I a few months I'll see where I am, and if the left is still a little blurry, consider re-op, but for now I am very satisfied.

Who is you doctor you are considering? Definetly talk to him/her if you have doubts about Lasik. Let me know if you have any other questions.

Chris

There is no simple answer to which procedure you should have. PRK and LASEK are basically one in the same and involve lasering the surface of the cornea after the epithelium (skin) of the cornea has been removed or moved to the side. They both involve 3-4 days of healing during which time the discomfort can vary from nothing to moderately severe pain. Most patients describe it as an annoying rubbing sensation (like a dirty contact). There is a small (less than 2%) chance of corneal haze although that number is less these days with Vitamin C and other modulators of healing. It is very effective for lower prescriptions (<6 diopters) but can work well in those patients who are higher. LASIK, on the other hand involves lasering the middle of the cornea after a flap has been created. There in lies the small but definite risks of striae, poor flap construction, epithelial ingrowth, etc. LaSIK also helas quicker and with less discomfort. I tell patients they are really trading in one set of risks for another set (haze vs flap) and the healing speed/discomfort. I also thell them that 4-6 months down the road, results are excellent and similar with both procedures.

Hope this helps.

Patrick Chin, MD
Westwood, NJ