possible reason I was told to leave hard contacts out for only 72 hours.
Nevertheless, I have had no side effects but I have been approved to have a PRK in Oct. The reason for this vrs Lasik is flap risk with previous RK scarring and thin corneas.
The cornea thickness R .48 and left .52.
Vision right eye -3.25 left -2.25

My question is I would prefer lasik, is it possible? And can one expect good results from
PRK after having the RK so many years ago.

In my opinion only a surface ablation technique could be appropriate, and you may want to reconsider even that.

You cannot have IntraLASIK or Epi-LASIK after RK, so those are automatically excluded.

Many patients who had RK years ago are experiencing a hyperopic (farsighted) shift due to the instability of the cornea after RK incisions. For this reason you would not want to have LASIK, which would weaken the cornea more than a surface ablation technique like PRK or LASEK.

Demonstrated stability of your corneas is very important when considering additional surgery after RK. If you corneas are fluctuating now, you don’t want to thin them more and possibly make them more unstable.

If you are at or over age 40, you may want to consider keeping some of that myopia (nearsighted) vision. Your near vision will be limited due to presbyopia, but being myopic can limit the loss of near vision due to presbyopia. You may want to read http://www.usaeyes.org/faq/subjects/monovision.htm

Glenn Hagele
http://www.USAEyes.org

I am not a doctor.

All contact lenses have the possibility of distorting your corneas. The reason to keep your contact lenses out is to allow your corneas to take on their normal shape prior to laser surgery. Typically, hard contact lenses or gas permeable contact lenses cause more corneal changes than soft contact lenses. As a result, it is usually necessary to keep hard contact lenses or gas permeable contact lenses out for a longer time (typically a few weeks) prior to your work-up compared with soft contact lenses (typically 5-7 days).

While it is possible to have LASIK over old RK incisions, many physicians feel that PRK is safer. The problem with LASIK over RK is that you can get a "pizza pie" effect as the old RK incisions may not allow for a perfect flap (instead you can end of with holes in the flap in the area of the old RK incision). Because no flap is created with PRK, this problem can't happen. Having thinner corneas is another good reason to chose PRK over LASIK. I would agree with your surgeon that PRK is preferable.

I hope this information is helpful.

Michael H. Goldstein, MD