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Seeing options

by Lindsey Rowland, staff writer

Surgical correction for vision problems is safe and successful.

Remember last time you went to the eye doctor? Your choices were glasses or contact lenses, soft or hard, blue or brown. Today you go to the eye doctor and your choices include all of these and PRK, LASEK, or LASIK, all surgical options. Glasses and contacts correct symptoms; these choices are permanent corrections of the problem underlying the symptoms. The benefit is that not only can you correct your vision problem, but you may never have to deal with contacts or glasses again.


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 surgeries.

PRK, LASEK, and LASIK are the three major surgeries that eye doctors perform. Photorefractive Keratectomy, PRK; epithelial 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 by 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 cornea for 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 painless.

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 in LASIK. 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 days 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, PRK 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.


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