Is it better for someone to have PRK for a LASIK enhancement if they developed dry eyes from the original LASIK surgery?

Question

I had LASIK monovision surgery in 2004 when I was 49 years old. I am now 60, and my dominant eye (right) no longer sees distance well, and my left eye no longer sees up close well, but it can see distance clearly. I also developed dry eyes from the LASIK surgery too. I would like to have an enhancement done on both eyes, but I am afraid if I have LASIK again, my dry eyes will get even worse. Would it be better for me to have PRK for my enhancement?

Mazin Yaldo, MD · Answer

Yes, PRK as a primary treatment or as a pretreatment (especially 10 years later) would carry a lower risk of postoperative dry eye than LASIK, and would be a good choice to consider.Ignoring the risk of dryness, many surgeons would still opt to perform a PRK 10 years after LASIK since the flap is extremely well healed at this point, and lifting it could be difficult (and, could be associated with an elevated risk of epithelial ingrowth). Additionally, treatments to improve the near vision are usually very wide (large diameter) optical zone treatments, and may not completely "fit" under a flap, especially an older flap that may have been made smaller than current flaps are. All these add up to very good reasons to consider PRK.Note that even with the above, it is certainly possible to do a LASIK retreatment 10 years out, and results are typically excellent. Patients should discuss the particulars of their case with their surgeon and together decide on the best route to proceed.

Brian Davis, MD · Answer

Many surgeons including myself recommend PRK enhancement if it has been 3 years or longer since the original Lasik. This is because redoing lasik has an increased risk of something called epithelial ingrowth. This is where the tissue on the surface of the cornea grows abnormally underneath the flap and can cause problems including vision loss. PRK generally causes less drying than Lasik but it does cause some so your dryness is likely to worsen for a period of time.Best of Luck

Is it better for someone to have PRK for a LASIK enhancement if they developed dry eyes from the original LASIK surgery?

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Is it better for someone to have PRK for a LASIK enhancement if they developed dry eyes from the original LASIK surgery?

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