Why don't LASIK doctors suggest PRK for thin corneas?

Question

I forgot about PRK. I went to 3 LASIK doctors (2nd and 3rd opinions) and was told that my corneas were too thin. Neither suggested PRK. Is there a problem with suggesting PRK for patients who can't get LASIK?

Richard Strecker, MD · Answer

PRK is actually a great solution for thin corneas. Ideally, you want to have 300 microns of residual cornea remaining after you have the laser procedure. That is the key factor as to whether you are a laser vision candidate be it PRK or LASIK.

Joseph Dello Russo, MD · Answer

Dr. Dello Russo responds:   I don't understand the question as it Is proposed.   Usually when a surgeon says that corneas are too thin, they mean too thin for LASIK. Then they would often recommend PRK, assuming the eyes qualify.   If you have been told by three laser surgeons that you are not a candidate for PRK then you are not a candidate for another reason,.    Your prescription may be too high to be fitted into a thin cornea. If this is your situation then there is another non-Laser surgery called phakic IOL, or the implantable contact lens.   If you are not being evaluated by an experienced surgeon you may not be offered procedures other than PRK.

Richard A. Norden, MD (in memoriam) · Answer

A number of possibilities exist here. The first is that the combination of your thin cornea and the size of your prescription may mean too much tissue removal so that you're turned down for both LASIK and PRK.Many LASIK specialists feel that a cornea thinner than 500 microns should not have any procedure and turn down patients for both procedures without any evidence that LASIK shouldn't be performed on these patients.I and a co-author, two years ago, have presented a series of several hundred patients that have undergone LASIK successfully with corneas thinner than 500 microns with some patients having over twelve years of successful follow-up.My recommendation is to find a LASIK surgeon with this experience and, assuming there are no other contraindications, have LASIK performed.Richard A Norden MD

Why don't LASIK doctors suggest PRK for thin corneas?

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