Which is a Better Option for Correcting Astigmatism, PRK or LASIK?

The key to treating astigmatism is the type of laser.  In our office we use CustomWave Front treatments that can treat even high amounts of astigmatism as part of the correction without any special programming.  Whether the procedure is performed with LASIK or PRK does not matter, the result is identical.  The nice thing about LASIK is that a LASIK enhancement is easier than a PRK enhancement and those with very high corrections whether for nearsightedness, farsightedness or astigmatism are more likely to need fine-tuning of the for best possible vision. 

Astigmatism is a condition in which the front surface of the eye is oval rather than round.  Both LASIK and PRK are terrific procedures to treat astigmatism!  Speak with your eyeMD to determine which procedure is best for you. This may depend upon whether the astigmatism is symmetric or asymmetric, the thickness of the front surface of the eye, and your activities! 

Theoretically both procedures should give a good result since the same laser is used to perform the correction.  In my experience, LASIK gives slightly better results than PRK.  I think that this is because there is less healing after LASIK and therefore less opportunity to regress (get a return of some astigmatism).

I believe the key to a great result when treating astigmatism is not whether PRK or Lasik is done, but the type of corrective laser that is used. Essentially, the terms PRK and Lasik refer to how the eye is prepared for the corrective laser and really have more to do with the speed of healing than the quality of the result. PRK is performed on the very outer surface of the eye and has a slightly slower recovery time when compared to Lasik, which is performed under a corneal flap. The corrective treatment is identical, whether PRK or Lasik is performed. My laser of preference for the best astigmatic results is the Wavelight Allegretto 400 hz laser. I have been using this laser for several years and have treated many complex prescriptions, including complex astigmatism, with amazing results and extremely low retreatment rates. My retreatment rates with the Visx Customvue laser were somewhat higher than the Wavelight, so I use it exclusively now. In the early days of Laser Vision Correction, astigmatism was not always so easy to correct. Modern laser systems have changed all of that and astigmatism correction is now a routine treatment that I perform everyday.