Lasik Vs PRK for Thinner Cornea and Higher Prescription?

Question

My corneal thickness is 520+/- in each eye. Left eye is -6 and right -5. No astigmatism in either eye. Which would you recommend and why? I’m 26 and very active. My thinner cornea, plus the creation of a flap worry me for Lasik. My higher prescription worries me for PRK. Customvue laser will be correcting my vision in either procedure.

Michael K. Tracy, MD · Answer

A corneal thickness of 520  µm is normal and is most likely fine for LASIK with a -6.00 with no astigmatism. 

	 

	The reason that someone who is a candidate for LASIK but would choose PRK instead has to do with types of activity. Individuals who participate in aggressive contact sports sometimes choose to have PRK to eliminate the possibility of flap complications due to contact sports.  If you are at risk for severe eye trauma, PRK is the way to go.  -6.00 should be fine for PRK. 

	 

	However, it sounds like you are a great LASIK candidate.

Arkady Kagan, MD · Answer

We feel that PRK is a much better option for you.  Here is why. Because you are young your prescription may change a bit into your 30’s, having PRK will give you the opportunity to have an enhancement 5, 10 or even 15 years from your initial treatment.  If you had LASIK and need an enhancement 5,10 or 15 years later you must do PRK anyway.

	Secondly, if you are very active and participate in sports, after LASIK there is  always the possibility of dislodging the flap (which has serious visiual consequences).   And last but not least a cornea of 520 in our opinion is a bit too thin to do LASIK, you risk a small chance of corneal ectasia in the future. 

	
	Your “higher prescription”  should not worry you for the PRK procedure because we have done PRK for patients as high as minus 9 with excellent results. One caveat we routinely use Mitomycin for PRK patients to prevent corneal haze again with good outcomes.  

	Good luck, you only have 2 eyes.

Sandy Feldman, MD · Answer

It is important that you feel comfortable with the procedure and the surgeon who performs the procedure.  Either procedure can yield excellent results for your prescription, and with modern technology, including the iLASIK or CustomVue PRK, 98% of patients achieving 20/20 or better vision one year after surgery.  In iLASIK, a thin flap is created with a laser using gas bubbles and the strength is less altered than in older LASIK procedures.  While you think you prescription is high, it actually falls in the moderate category and your cornea, is normal, not that thin.  

	One cannot really determine what is best for you and your eyes without a thorough examination of the shape of your eyes.  Side effects are possible with either procedure but speak with your doctor to determine the best procedure for you!

Emil William Chynn, MD, FACS, MBA · Answer

if you get LASIK your cornea will be kind of thin, you can correct the entire Rx but may not be able to be safely enhanced, so that's out if i were you

	if you get PRK you will have a high chance of scarring plus pain, so forget that one

	you are correct to do CustomVue as you will see better than you do now in glasses or contacts afterwards if that is performed correctly

	your only choice really in my opinion is LASEK or epiLASEK, which are the safest procedures to do in high prescriptions or if your cornea is thin

	hope this helps you make the right decision

Lasik Vs PRK for Thinner Cornea and Higher Prescription?

Answers (4)