PRK, EPI-LASIK, LASEK (No flap LASIK or Advanced Surface Ablation)
LASIK is a process where the cornea is reshaped by a laser after a flap is created. Think of the cornea as a soft cover book with 500 pages, the cover being the skin of the eye. With Intra-LASIK a laser opens the book 50 pages below the cover creating the flap, and a totally different laser reshapes the body of the “book” starting at page 50. Because the flap remains attached like the binder of a book, it is easily closed and seals itself quickly.
With PRK, Epi-LASIK, and LASEK, the cornea is reshaped by the exact same laser as Intra-LASIK but beginning at page 1 rather than page 50. In order for this to occur, the cover of the book (which regenerates itself quickly) must first be removed. The corneal cover can be removed using a variety of available methods and is always a painless process taking less than 20 seconds. Essentially the vision is being corrected by the same technology but without creating a flap. During the following 3 to 4 days, the skin cover of the cornea regenerates on its own. A non-prescription bandage contact lens (no prescription soft lens) is utilized during this time to facilitate the speed of recovery as well as providing comfort. This contact is removed by our staff between 3 and 4 days after the procedure.
The only difference between PRK, Epi-LASIK and LASEK is the method by which the corneal cover is removed and if it is replaced or simply allowed to regenerate. Dr. Mozayeni has extensive experience with all of these methods and currently prefers PRK, where the cover is removed and regenerates on its own. In our experience, the speed of recovery is fastest using this method.
At Providence Eye & Laser Specialists we consider these three procedures virtually identical to Intra-LASIK because the final results are the same for most people. Comparing our results, 97% of our average patient achieves 20/20 vision or better either with Intra-LASIK or PRK. In fact we our confident that in many cases PRK will provide a better outcome for a particular individual. There is a difference in terms of recovery but about 99% of people that have PRK obtain legal driving vision (20/40) within 72 hours and improve rapidly thereafter to approach 20/20 in 2 to 6 weeks.
PRK is generally recommended to 25% of our patients due to one of the following reasons:
- Corneal thickness is not adequate for creating a flap.
- You have significant problems with eye dryness before the procedure or are at high risk for developing long-term dryness based on your evaluation.
- The skin or cover of your cornea is already fragile or damaged due to age, previous injury, or previous infection.
- There is some unexplained corneal irregularity detected on your mapping.
- You have previous significant scar tissue on the cornea.
- Your occupation is high risk for potential eye injury.
The most important part of determining if no flap LASIK is a better choice for you is our thorough evaluation, advanced Pentacam mapping, and corneal expertise. Because Dr. Mozayeni is a cornea specialist, he is exceptionally capable of detecting subtle corneal abnormalities and therefore recommending the safest procedure for you.
