Can PRK Be Done After LASIK?
Doctor Answers 4
PRK or ASA after LASIK
the old way of enhancing a LASIK was to relift the old flap and relaser, or cut a new flap
both methods are fraught with problems, like epithelial ingrowth, or cutting into the old flap
i was the 1st surgeon in NYC to routinely enhance LASIKs by performing a LASEK on top of the old flap
and now this is becoming standard of care across the US
the reason is you eliminate the risk of epithelial ingrowth or flap wrinkles, which is significant
you also don't go deeper into the cornea, so don't weaken it further and cause KC or keratoconus
but please don't call an ASA or LASEK a PRK, or you'll think it hurts, takes a long time to recover, and carries a significant chance of haze or scarring. you really need an ASA or LASEK, and you also should have MMC, or your may very well scar. we use MMC, vit C, branded PredForte, oral steroids, and UV protection after our ASA enhancements of prior LASIKs, which is really necessary to avoid scarring
When is PRK performed after LASIK?
PRK is often performed if one needs an enhancement years after the original LASIK procedure. If one has a LASIK enhancement, the original flap is lifted and the edge is not precise. There is a risk of cell growth under the flap which may require additional surgeries. To avoid this, many surgeons prefer to perform PRK if someone needs an enhancement years after LASIK. PRK may also be indicated is if your residual cornea underneath the flap is not thick enough. This could predispose you to a progressive condition of the eye, known as ectasia.
PRK commonly performed over LASIK
PRK is commonly performed as an enhancement procedure after LASIK and should provide you with a good result. Be patient since the final results take a bit longer than LASIK.
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PRK may be a better option for enhancing a LASIK result
PRK is a safe way of enhancing a LASIK result. We have found that the risk of complications from lifting a LASIK flap goes up dramatically after a few years and prefer to perform the safer PRK enhancement. PRK uses the same laser as LASIK but there is no flap. Another reason to perform PRK enhancement after LASIK is when there is a concern as to whether there is enough cornea for a safe LASIK enhancement.