Glasses and contacts are minimal forms of visual
correction. They are easy. Your contacts are transparent, and
you want blue eyes: you get tinted ones. You want new, more
stylish frames: you order new ones. But deciding to have surgery
takes you to a whole new level. There is no going back once
you have made a surgical change,so before you make this big,
eye-altering decision, you really should know about the different
PRK, LASEK, and LASIK are the three major
surgeries that eye doctors perform. Photorefractive Keratectomy,
keratomileusis, LASEK; and Laser Assisted in-Situ Keratomileusis
or LASIK. The three surgeries use a laser called the excimer,
for refractive cornea surgery. The goal is to reshape the cornea
so that rays of light can focus clearly on the retina, thus
eliminating near-and farsightedness and astigmatism.
In PRK, the cornea is directly sculpted by the excimer laser.
The surgeon completely removes the surface layer of the eye
(the epithelium), which will regenerate
itself within a few days. The laser will then focus on the center of the cornea
and make a small concave indentation to correct nearsightedness. If the patient
is farsighted, the laser will steepen the sides of the cornea. Less than 10
percent of the cornea is touched; the deeper layers of the
eye are left untouched. This
procedure takes about five minutes and is painless.
LASIK is probably the most popular of the three surgeries;
here the surgeon cuts a flap of corneal tissue, with a blade,
leaving it attached to the cornea
a hinge of tissue. The surgeon pulls the flap aside. The laser reshapes the
central part of the cornea for nearsightedness and the outer portion of the
farsightedness. The flap is then replaced. The natural suction of the eye pulls
everything back together. The procedure takes less than 10 minutes and is also
LASEK is the newest procedure; it combines the advantages of
PRK and LASIK and reduces the disadvantages. The flap is
cut in the cornea’s outer
layer of cells instead of through the epithelium and part of the stroma, as
LASEK is different than PRK because the doctor preserves the epithelial layer
as a replaceable flap instead of scraping or lasering it away.
The difference between the surgeries is that the surface layer
of the eye is actually removed in PRK. In LASIK and LASEK,
the surface layer is cut, surgery
is done, and the surface replaced. The range of correction is said to be better
with LASIK. However, the surgery goes deeper into the eye with PRK, where LASEK
has less surface area to heal.
Patients experience 24-48 hours of postoperative pain with
PRK, but only six hours with LASIK. Additionally, PRK can
require postoperative medication for
up to three months, compared to one to two weeks with LASIK.
LASEK, most of the time, does not require pain medication,
though does take five to seven days to regain good vision
with LASEK. PRK takes three to five
of recovery, and LASIK allows you to return to work the next day.
LASIK seems to be the procedure preferred by patients who want
to get the surgery and be back to work the next day, with
the minimal amount of pain. But for
patients who have central scarring of the cornea, larger pupils, or thin corneas,
is the alternative of choice. For patients who have very thin corneas and are
turned down for LASIK, LASEK is a safer way to have laser vision correction.
LASIK, LASEK, and PRK have been very successful. Many people
have said goodbye to glasses and the hassle of contacts.
Though the surgery may not bring 20/20
vision, patients normally do not have to wear any form of prescription afterward.
Before you commit to having the surgery, remember this isn’t disposable
contacts, this is a permanent change. Make sure you understand all the options
and select one that is right for you.