Laser eye surgery is a great option for vision correction, and most patients experience a dramatic improvement in quality of life by eliminating the need for glasses or contact lenses. Laser eye surgery precisely reshapes the cornea, providing clear vision without the assistance of glasses or contact lenses.
- Associated with little pain
- Vision is corrected almost immediately
- Adjustments can be made quite readily if required
- Recovery is quick
- Freedom from all the hassles of glasses
- Myopia (Short-sightedness)
- Hypermetropia (Long sightedness)
One of the more common questions that patients have at SafeSight cataract and Eye Laser Centre is about the differences between LASIK and PRK. Our doctors routinely perform both procedures with excellent results and understand that what each patient really wants to know is which procedure would be the best for them.
So, we will discuss the two procedures so when you visit SafeSight for your consultation, you’ll have a great background of understanding to help the discussion with our doctors about what is best for you!
How are LASIK and PRK similar?
Most eye care professionals agree that LASIK and PRK are both considered safe and effective Laser Vision Correction procedures provided of course that the patient is a good candidate. Both procedures use an excimer laser to correct vision and because they have a similar method of achieving improved vision without glasses or contacts, the final visual result for patients tends to be very similar.
In the majority of cases, patients achieve 20/20 vision, whether the correction is done with the PRK procedure vs the LASIK procedure.
LASIK and PRK have similar results because they both reshape the cornea. The cornea is the structure in the front of the eye responsible for most of the eye’s focusing ability (it’s the part of the eye where a contact lens is placed).
A basic understanding of the cornea is helpful to understand more about how LASIK and PRK work. First, the cornea has five layers. The main layer, called the stroma, is the middle layer of the cornea, comprises 90% of its thickness, and is made of collagen tissue fibres arranged in a way that makes the cornea translucent and have a high refractive index – both important characteristics of a focusing lens. The outermost layer of the cornea is a layer of translucent epithelium tissue (skin) to protect the cornea from the environment.
Just like skin on other parts of the body, the cornea’s epithelial layer grows back if it is damaged or removed, however the collagen tissue that makes up the stroma does not. In LASIK and PRK procedures, the excimer laser sculpts the stroma layer, resulting in a permanent change to the shape of the cornea. When the shape of the cornea is changed properly, the result is that the light that enters the patient’s eye is focused more properly for improved vision without glasses or contact lenses.
How is LASIK and PRK different?
While LASIK and PRK have comparable results, they are performed differently. That gives each procedure its own set of advantages and disadvantages. In certain cases, a patient may be only a candidate for LASIK or only a candidate for PRK. In other situations, the patient can be a candidate for both and may choose the procedure they prefer.
The difference is the way that the LVC Surgeon accesses the cornea to reshape it with the excimer laser. The epithelium (skin) tissue that covers the cornea must be removed or temporarily moved out of the way before the excimer laser can sculpt the cornea. The method that removes the tissue is called PRK, and the method that temporarily moves it out of the way is called LASIK.
LASIK Procedure Explained
With LASIK, the surgeon fashions a LASIK “flap” or “cap” using a specialized surgical instrument (blade/ femto-laser) to temporarily move the epithelial layer together with the anterior stromal layer, out of the way. The LASIK flap contains the epithelial layer and a thin portion of the anterior stromal layer and remains attached to the rest of the cornea. The surgeon lifts the flap and folds it out of the way to expose a lower layer of the cornea to be sculpted with the excimer laser. After the reshaping is complete, the surgeon positions the flap in its original position and the healing process begins.
During flap creation, the patient experiences pressure on the eye (numbed with anesthetizing eye drops) and dim or dull vision for about 45 seconds. This is usually the most uncomfortable part of the 10 minute-per-eye LASIK procedure.
When the procedure is complete, the patient can see. For most patients it looks as though they have their eyes open under water – it is a rather foggy view of the world, but typically dramatically better than the blurry world the patient had before. Visual recovery is generally very rapid, and most patients experience little to no discomfort during the initial healing time. Most patients have 20/20 or better vision without glasses or contacts by the morning after their procedure.
PRK Procedure Explained
With the PRK procedure, there is no flap created. Instead, the surgeon gently removes the epithelial tissue layer of the cornea, and then applies the excimer laser to the exposed cornea for the reshaping step. So there are no cuts into the cornea. When the reshaping is complete, a contact lens bandage (a contact lens with essentially no prescription power) is placed over the cornea to allow the skin to grow back underneath.
Removing the epithelial layer is rather quick, easy, and complications free, taking less than 30 seconds. Surgeons vary in their technique but regardless of the technique used, the patient may experience a small amount of pressure on the eye and dim vision when the surgeon gets in the way of their vision. The reshaping step is next, and usually takes less than 30 seconds as well.
When the reshaping is complete, the patient receives the contact lens bandage and a few eye drops. After the procedure is completed, the patient can see fairly well, typically dramatically better than before the procedure without glasses on. That vision is short-lived however, as vision tends to get slightly worse before it improves as the eye heals after PRK. In the first week expect 80% of your final vision. In the second week 95%, normally enough for you to get back to work. Week three to four that’s when you get 100% of your vision.
Healing and subsequent visual recovery after PRK takes longer because the epithelial tissue must heal and become as regular and smooth as it was before removal. Full visual recovery typically takes about thirty days and has three general stages: initial healing, bandage contact lens removal, and full healing.
The patient wears the contact lens bandage for about 4-5 days as the epithelial tissue undergoes the initial healing phase where it seals the surface from where it was removed. During this time, the patient’s vision is typically blurry and there is usually a relatively high amount of discomfort and light sensitivity. SafeSight doctors will prescribe a few medicines that significantly help with the discomfort, but it usually lasts about 3 to 4 days, improving slightly day after day. Most patients are not comfortable driving a car during this time, so planning with work and life is important for PRK recovery.
When the epithelial tissue has sealed, the doctor removes the contact lens at a follow up appointment about 4 to 5 days after the procedure. When the contact lens is removed, the patient is typically through the worst part of the recovery after PRK. Each patient is different, but vision improves markedly with the removal of the contact lens and the patient’s vision tends to be rather functional at this point.
In the recovery phase, the patient experiences a gradual improvement in vision day after day. Patients continue to use medicated drops over this time and have a few more follow up visits so our doctors can monitor the healing of the eyes. At the follow up visits, the doctor will adjust the dosage of the medicated drop to control the healing of the epithelial tissue and ensure that it heals properly. Since the epithelial tissue of the cornea regenerates itself every thirty days naturally, it is typically around the 30-day mark after PRK when the patient has achieved the majority of their final visual result.
Pros and Cons of LASIK and PRK
As you have likely gathered so far, the advantages of LASIK over PRK include a significantly faster visual recovery and, comparatively, little-to-no discomfort during the healing phase. These advantages are directly tied to the LASIK flap that allows the epithelium to be temporarily moved out of the way and replaced, so the patient essentially has their own tissue back as a natural bandage over the treated area. Most patients have very busy lives and appreciate the ability to able to get back to life much sooner, so LASIK tends to be the more popular procedure of the two.
While LASIK’s advantages are the result of the LASIK flap, PRK’s advantages are the result of not having a flap. In spite of the longer, more challenging visual recovery after PRK, for certain patients, PRK is the patient’s preference, and in other cases PRK is the better procedure from a medical perspective to treat their vision.
Which procedure is best for you?
The most important and first step of getting rid of your glasses and contacts is to visit Practice in Morningside, Sandton for a consultation to have our Laser specialist doctors evaluate your eyes to see if you are a candidate for one or both procedures. You may be a candidate for only one or the other, and if that is the case, our doctors will carefully explain their recommendation. Most people are candidates to have their vision corrected are able to choose which procedure they would prefer, and most people’s choice, including most LVC Surgeons, is PRK.
So with this overview of LASIK and PRK now in your mind to help your consultation with our doctor, give us a call on 011 346 5025 or contact us thru the website chat, and we will help find a time for you to come visit us.
The current cost of Laser Vision correction treatment is R25 000 for two eyes, all inclusive.
This price applies to all laser refractive surgery operations, regardless of which type of Laser Vision correction procedure we think is best for you.
So we do not charge you for any additional costs.
The above price includes the following:
- Laser Vision Correction procedure,
- Facility fee (we use our in-house laser suite)
- FREE follow-up appointments for 1 months,
- Post procedure scans,
- FREE enhancements if required for life, conditions apply.
You may pay the balance on the day with your card or you may do an EFT prior to your procedure date.
Unfortunately medical aid health insurance does not cover the cost.