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Panicha Por Vongthoytong

Mr. Able Cadias
English 10 / 10:01
May 14, 2017

The Difference and Similarities of PRK and LASIK for Myopia Surgery

PRK and LASIK are laser vision correction surgeries for myopia, but their methods

and outcomes are different. The purpose of this research is to identify the differences and

similarities between PRK and LASIK for Myopia Surgery. The importance of this research

report is to provide information for myopia patients who attended to correct their eye vision.

This research report uses eight sources. First, PRK Laser Eye Surgery: What Is PRK And

How Does It Differ From LASIK? by Brian, which compares and contrasts between PRK

and LASIK. Second, the article entitled Photorefractive Keratectomy (PRK) Eye Surgery

explains what PRK is, and how does it perform. Next in order, from David Huang his article

entitled LASIK for Myopia and Astigmatism: Safety and Efficacy points out specific

LASIK procedures and outcomes. Fourth, an article called Comprehensive Ophthalmology,

Anterior Segment Surgery, and Diseases of Vitreous and Retina demonstrates LASIK

procedure and provides information before patients correct their eye vision. Additionally, the

article entitled PRK vs. LASIK Eye Surgery identifies the similarities and differences

between PRK and LASIK. The next source is PRK vs. LASIK. Why is PRK right for you

where the site reveals how patients could prepare themselves for the surgery and whether the

patients are suitable for using PRK to correct your vision or not. Seventh, the article called

LASIK Eye Surgery illustrates the Potential Side Effects, advantages and disadvantages,

and preparation of LASIK Eye Surgery. The last source is The Pros and Cons of LASIK

Surgery which identifies pros and cons of LASIK Surgery.

Photorefractive Keratectomy (PRK)

Photorefractive keratectomy or PRK is a laser vision correction surgeries that use a

cool ultraviolet, called excimer laser to reshape the cornea in order that the light could
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properly focus onto the retina for clear vision (Brian, 2016). However, recovering from PRK

takes a bit longer than LASIK procedures. Before the surgery, patients will stay in the

treatment room for ten minutes. Anesthesia and anti-inflammatory drops are then applied to

the patient's eye to prevent infectious contamination that could happen during the surgery

(PRK vs. LASIK Eye Surgery, 2016). After anesthesia and anti-inflammatory have been

dropped, 5 to 10% of the epithelium thickness is removed by an excimer laser to correct

patient's vision. Once the surgery is completed, a temporary contact lens is placed on patient's

eye to reduce discomfort. If the contact lens fell off, patients shouldnt try to replace it by

themselves. There are some cases that patients tried to replace the contact lens back, they end

up to get their eye blurred and really fuzzy PRK vs. LASIK Eye Surgery, 2016). In PRK, no

flap is created but the epithelium is removed instead. The epithelium will automatically grow

back by itself within few days after the surgery. Seven days later, the temporary contact lens

is removed. Patients might need to wear glasses after the temporary contact lens is removed

(Kozarsky, 2015). Patients will feel more comfort and they will get better soon within a few

months.

PRK is a better choice for myopia patients with thin cornea or whose with high levels

of myopia because the flap is not created which requires patients to contain both deeper

stromal tissue and epithelium. It's free of corneal flap complication risks, reduced risk of

compromised corneal thickness and is much less likely to cause dry eye. PRK has a higher

risk of haziness, infection, and discomfort after resulting from the surgery. Myopia patients

who recovered from LASIK have improved their vision within less than a month but who's

with PRK takes one to three months (Kozarsky, 2015). There are some cases who experience

a complication after the surgery. A 26-year-old female had -2 myopia without astigmatism,

severed corneal haze after resulting from PRK procedures. Her vision got worse after the
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surgery, she felt like she was wearing 3D glasses all time which made her life harder (Reilly,

2014).

Laser-Assisted in situ Keratomileusis (LASIK)

Laser-Assisted in situ Keratomileusis or LASIK is a laser vision correction surgery

that is commonly used to correct vision for myopia patients (LASIK Procedure - A Complete

Guide, 2016). It isnt suited for everyone. As a patient, it is important to understand the

procedures to be a good candidate (Abbott, 2008). Patients mustn't have high levels of

myopia, pupils mustn't be too large, and cornea must be thick enough. It takes about 10 to 15

minutes to complete the surgery. Patients will stay in the treatment room for one to two hours

before the surgery. Like PRK procedures, anesthesia and anti-inflammatory drops are applied

to the patient's eye. Patients eyelids are open by using an eyelid holder called speculum to

keep their eye open and prevent patients from blinking (McDonald, 2008). A thin flap is then

created in the cornea by an instrument called a microkeratome or a femtosecond laser

(Durrie, 2008). An excimer laser is then placed above patients eye. The patient will see a

point of light called fixation light or target light while the use of excimer laser is directed at

the eye to correct vision. After reshaping the cornea, the flap is placed back (Krouner, 2016).

Lasik has many advantages including less pain than PRK procedure, no stitches are

required, patients dont need to wear glasses anymore, and they will feel better by the day

after the surgery. Patients will feel discomfort for the first one or two days. They might see

the halo, have dry eye, and fluctuating vision. Lasik patients are more likely to have dry eye

(Brian, 2016). The doctor will give eye drops to prevent patients from dry eye and infection.

Like other surgeries, the complication could occur. The most complication occurs during the

flap is created, which will affect to patients vision (Wachler, 2016). A 58-year-old man

presented with red eye and felt pain after resulting from LASIK 6 years. The examination
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revealed that his cornea was submitted for histopathologic (Gohari, 2007). Another case, a

32-year-old man who resulted from LASIK in January 2006, felt pain and slowly lost his

vision after four years later. His doctor identified that he presented infection from

Pseudomonas aeruginosa during the surgery (Ferrer, 2011). Based on these two cases, the

complication could occur even a few years passed. Infection could mostly occur by

opportunistic organisms or bacteria during creating a flap. It is important to choose a doctor

whos had many experiences performing the surgery (Abad, 2011).

The Similarities of PRK and LASIK

PRK and LASIK are types of laser vision correction surgeries. Laser vision

correction surgery is also called refractive surgery, refers to the procedures that used a laser

to correct vision problems by reshaping the cornea in order that the light could travel

through easier (Thompson, 2017). For myopia patients, the laser is used to flatten the

cornea. Patients might have some potential complication after resulting from the laser

vision correction surgery for example chronic dry eye, infection and delayed healing, worse

vision, excess corneal haze, regression, Halo effect, and blindness. After resulting from

LASIK or PRK procedures, patients might have dry eye (Adler, 2016). The heat of laser

decreases the ability of tears production which causes to dry eye (Weber, 2016). Infections

and delayed healing are incurred by the infectious contamination of ocular flora during the

surgery. Patients with infection normally have eye pain and slowly lost their vision.

Furthermore, an infection could lead patients to require corneal transportation which is hard

to treat. Most potential complication cases require regression. Myopia patients have more

chances to require regression because their center part of the cornea is thinned and

weakened (Yong Ming, 2015). Excessive corneal haze and Halo effect typically occurred

after resulting from the surgery, this could affect with night driving. After a few weeks,

excessive corneal haze or Halo effect will no longer occur. If this symptom still occurs after
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four months, patients should go to see a doctor.

However, chances of experiencing serious complication are minimal. The Eye

Surgery Education Council (ESEC) stated that less than 1% of myopia patients experience

serious problems from correcting vision from PRK and LASIK procedures. Before patients

correct their vision, they should ensure that their eye must be healthy, have sufficient

thickness, vision stay stable at least a year, and be over the age of eighteen (Brian, 2016).

After the surgery, patients should be able to know how to take care of themselves in order

to avoid or decrease chances of experiencing serious complication for example: follow the

eye drop doses as the doctor instructed, dont rub or touch the eye, avoid applying makeup

and using computer, wear protective eye wears while sleeping, wear sunglass while going

outdoor, and rest the eye (How to Protect Your Eyes After Laser Eye Surgery, 2005).

Conclusion

This research report aimed to find similarities and differences of PRK and LASIK.

The two laser vision correction surgeries are used to correct vision for myopia patient using

an excimer laser to reshape the cornea. The difference is that in LASIK procedure, a thin

flap is created before using an excimer laser. However, resulting from both surgeries could

lead patients to the side effects. The symptoms could occur the day after or a few years

later. Patients should ensure that they clearly understand the procedures and know which

procedure is suited for them before the surgery. The researcher recommends having further

research on how the LASIK and PRK could affect patients after the surgery, and find ways

to reduce the side effects.

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References

Brian S. (n.d.). PRK Laser Eye Surgery: What Is PRK And How Does It Differ From
LASIK?. Retrieved March 22, 2017, from
http://www.allaboutvision.com/visionsurgery/prk.htm

Clevel Clinic. (n.d.). Photorefractive Keratectomy (PRK) Eye Surgery. Retrieved March 22,
2017, from http://my.clevelandclinic.org/health/articles/photorefractive-keratectomy-
prk-eye-surgery

Comprehensive Ophthalmology, Anterior Segment Surgery, and Diseases of Vitreous and

Retina. (2013). Retrieved March 23, 2017,
http://www.kazieyecare.com/Services/LASIK.aspx

David H., Brand H. (January 20, 2015). LASIK for Myopia and Astigmatism: Safety and
Efficacy. Retrieved March 24, 2017, from http://eyewiki.aao.org/LASIK_for_
Myopia_and_Astigmatism%3A_Safety_and_Efficacy

Healthcare Marketing Services. (March 1, 2014). PRK vs. LASIK. Why is PRK right for you.
Retrieved March 22, 2017, form http://www.lasik.com/articles/lasik-prk-difference/

Infection After LASIK. (2007). Retrieved March 23, 2017, from http://www.lasikcomplica
tions.com/infection.htm

Laser Eye Surgery Risks and complications. (n.d.) Retrieved April 24, 2017, from
http://www.medic8.com/laser-eye-surgery/complications.htm
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LASIK Eye Surgery. (n.d.). Retrieved March 22, 2017, from http://www.webmd.com/eye-
health/lasik-laser-eye-surgery#1

LASIK Procedure - A Complete Guide. (July 21, 2016) Retrieved May 7, 2017, from

http://www.lasik.com/articles/lasik-procedure-a-complete-guide/

PRK vs. LASIK Eye Surgery. (n.d.). Retrieved March 23, 2017, from https://www.qualsight
.com/prk-corrective-procedure