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PRK Instead Of LASIK For Thick Cornea? What Is The Healing Time?

my thickness for both eyes corneas are 470 and 472 and i have a little congenital cataracts, the doctor recommended PKR instead of Lasik. Im a good candidate and she also said since my cornea was so thin they wont be able to do enhancements and my eyes could revert back to what it is now in 5 or 10 years. is this true and do you think it is safe to go ahead with the procedure. also on average about how long is healing. If i have a friday surgery, can i go back to school on monday or tuesday?

Doctor Answers (9)

PRK vs. LASIK

+1

I would not recommend PRK or LASIK in a patient with such thin corneas, ESPECIALLY if you are young enough to still be in school. I would wait until you are 30 years old to consider any laser procedure given your thin corneas.


San Diego Ophthalmologist
5.0 out of 5 stars 1 review

Prk vs Lasik for thin corneas

+1

There are more factors than corneal thickness to consider.  Other factors include age, remaining corneal tissue, prescription and corneal topography (mapping). Most LASIK patients can return to work in 1-2 days.  PRK patients take longer to heal.

Christopher Coad, MD
New York Ophthalmologist

PRK on thin corneas

+1

PRK would be about the only refractive procedure I would consider on a patient with thin corneas like yours.  Having said that, your surgeon needs to be careful your cornea is not abnormal.  Before I considered PRK, I would have a Pentacam scan and have the predictive software programs run to see if you fall into a "normal" category for refractive surgery.  And, the decision will also depend upon the amount of your refractive error.  In the past, before we had the software we have today, I would not consider you a candidate.  Now, patients like you can be PRK candidates.  LASIK is probably out of the question.

Stuart Lewis, MD
Denver Ophthalmologist

Refractive surgery for those with thin corneas.

+1

Most commony those with thinner corneas are encouraged to have PRK instead of LASIK.  If there is more going on such as older age with difficulties with reading or early cataracts, an intraocular procedure may be a better option than working on the cornea.  One option may be to remove the lens of the eye and replace it with a lens implant to compensate for the refractive error.  This is a particularly good idea for someone with any sign of cataracts.

Mark Golden, MD
Chicago Ophthalmologist
5.0 out of 5 stars 3 reviews

PRK vs LASIK

+1

I have been performing both Lasik and PRK for over 18 years and I believe I have done a pretty equal number of each(maybe 30,000 PRK and 50,000 Lasik). It is important to know that the long term results of both PRK and Lasik are the same. PRK entails removing the very outer layer of the cornea, then the laser reshaping of the cornea is done and a bandage contact lens is placed in the eye for about 3-4 days while the surface reheals. Lasik involves lifting up the very outer surface of the cornea, then the exact same laser reshaping takes place, but the surface is put back in position. Explained this way it is obvious that the recovery time is somewhat slower with PRK because more surface healing is involved.

So, why would one choose PRK over Lasik? In 2011, PRK is typically performed on individuals with thinner corneas(<500 microns), because there is more corneal tissue to work with when a flap is not created. A second reason, which is encountered much less today than in the past, is that some of the government service agencies(FBI, etc) used to require PRK instead of Lasik because no flap is involved. I hear far fewer comments about this now that I use a laser to create the corneal flap. In fact, the Navy now endorses Lasik, but only if a laser made flap is involved. The bottom line is to find a surgeon with a good reputation that you can trust, and ask him or her what they would recommend for their brother or sister.....that is a great way to get a straight answer!

Anthony J. Kameen, MD
Baltimore Ophthalmologist

PRK vs LASIK

+1

1.  We do not know your level of myopia.  If you have a low amount of myopia - you can have PRK and later on return for an enhancement.  However - if you are very, very near-sighted - then it is possible  the doctor could be right and you would be treated only once.  There is no way to answer this part of your question without more information

2. Patients with thin corneas who are otherwise normal CAN have LASIK.  All of the peer-reviewed articles on LASIK in thin corneas have demonstrated that LASIK can be done safely and effectively.  However, the topography has to be completely normal.  Feel free to google my articles on LASIK and thin corneas

3. There have been no conclusive studies that have proven that any form of surface ablation:  PRK, LASEK, or Epi-LASIK, provides superior visual results, faster visual recovery, or less risk.  Dr. Chynn's comments are unfortunately incorrect.  I have worked with 2 Epi-LASIK companies and performed LASEK for many years.  The fact is - all surface ablation procedures provide the same visual results - and thankfully the results are quite good - equal to LASIK at 3 months.

Best regards

Bill Trattler, MD

William Trattler, MD
Miami Ophthalmologist

Prk lasik lasek for thin corneas

+1

you should NOT get LASIK or any other incisional sugery like IntraLase if you have thin cornea.  the ONLY safe procedure for you would be a SURFACE ABLATION.  i don't know why any surgeon in 2011 would perform a PRK.  i did my last PRK in 1999.  the modern form of surface ablation is LASEK or epiLASEK which are ADVANCED surface ablations.  this means they are more advanced than the old way of lasering the surface, which is PRK.  PRK is very painful, the recovery takes a long time, and carries the risk of inflammation and scarring.  LASEK and epiLASEK are not painful, the recovery is quick, and the risk of scarring is minimal.  if you look at my other postings you will see that the math of residual corneal thickness prohibits LASIK.  for example, at 470, a flap would be 120 min, leaving you with a bed of 350.  which is the minimum i allow after LASEK, so you would not  be able to get lasered (no tissue to laser).  you have to indicate what your Rx is, btw, so we can calculate residual stromal thickness.  if you're let's say -5, i would have to take off 50 microns for standard, 70 for CustomVue WaveFront.  so 470 - 70 = 400, which is above the 350 minimum i use as my safe lower limit (LASIK surgeons use 250.  don't do a refractive lens exchange for 470 microns unless your Rx is -10 or worse--the risks are worse

Emil Chynn, MD
New York Ophthalmologist
4.5 out of 5 stars 10 reviews

PRK for Thin Cornea

+1

PRK, known as photorefractive keratectomy, is a laser vision correction procedure which is used to treat nearsightedness, farsightedness and astigmatism.  Laser vision correction thins the cornea more which is why an enhancement may not be possible.  Other procedures are available to reduce your prescription such as refractive lens replacement and/or implantable collamer lens.  The best procedure for your eyes should be determined.  PRK is more uncomfortable than LASIK and does have slower healing.  If you have a Friday surgery, you can probably return to work on a Tuesday. 

I would recommend that you seek care of a doctor who performs all procedures to determine what is best for your eyes. Become educated about the procedures thoroughly and get all of your questions answered before the procedure.

Sandy Feldman, MD
San Diego Ophthalmologist
4.5 out of 5 stars 2 reviews

PRK Instead Of LASIK For Thick Cornea? What Is The Healing Time?

+1

Hello,

Generally, with a thinner cornea, PRK would be recommended over LASIK.  The healing and recovery time is a little longer compared to LASIK.  You may feel some discomfort in the eyes for a few days and your vision may take a few days to be sharp.  As far as enhancements that all depends on your prescription.  If you have a high prescription your chances of being a candidate for an enhancement would be lower.  However, with the current technology available now the likelihood of needing an enhancement is low.  I hope this helps!  Good luck with your procedure.

Robert T. Lin, MD
City Of Industry Ophthalmologist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.