PRK for Thin Cornea and Dry Eye?

It is typically better to perform PRK rather than LASIK on a patient with a thin cornea. Of course, I don't have your corneal thickness measurements in front of me. Assuming there are no other abnormalities, PRK is a better option as it does not thin the cornea as much as LASIK. You must remember that the long term results of PRK and LASIK are almost identical. It is the short term that is different, with the recovery phase of PRK being somewhat longer than LASIK. When I look at... more

The concern with those with thin corneas is getting too close to the bottom of the cornea which can potentially lead to ectasia which may in some situations require a corneal transplant. There are limits to LASIK and PRK both and it is best to use alternatives such as phakic IOL's instead of taking risks with long term complications.

PRK may be safer for dry eye and thin corneas, but bladeless all laser LASIK may be your wisest choice for accuracy and the most precise vision correction.

Both LASIK and PRK can cause dryness after surgery.  However, many believe including myself that PRK may have less of a drying effect.  This is due to the fact that without a flap in PRK, the ablation is not as deep into the stromal bed of the cornea and may affect less of the corneal nerves.   In patients associated solely with contacts, I think LASIK is OK.    In patients with dryness requiring frequent lubrication or medicated eye drops I will often recommend... more

Both Lasik and PRK can exacerbate the dry eye symptoms for several months after surgery. If the preop exam indicates severe dry eye with corneal changes you may be better off with a refractive lens implant. Certainly starting Restasis preop is indicated.

When patients have thinner corneas that are a normal shape, and a relatively high prescription then PRK may be the best option for vision correction by laser. PRK is photorefractive keratectomy and this is essentially the same type of procedure as LASIK but unlike LASIK it is not done under a protective corneal flap. Instead, the outer skin of the eye is removed either mechanically or with alcohol, and then the laser reshapes the eye cutting through a thin Bowman's membrane and into the... more