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Refractive Surgery

Refractive Surgery is defined as "various procedures that alter the shape of the cornea and thus how it bends light, in order to change the eye's refractive error. Can reduce or eliminate the need for spectacle or contact lens correction". At the O'Donnell Eye Institute, we perform Lasik and PRK to correct myopia (nearsightedness) and astigmatism. Usually, it is a personal choice which procedure you have done, however, there are certain conditions which makes one more preferable and safer than the other. Dr. Santos is our refractive surgeon and he will review your exam measurements and discuss which procedure is best for your eyes.

Both Lasik and PRK use the same EXCIMER laser to resculpt the corneal stroma tissue. The difference between the two is how the stromal tissue is reached. With PRK (which was the first refractive surgery technique using the laser), either your surgeon or sometimes the laser is used to remove the superficial layer of tissue (epithelium) of the cornea. This is like creating a large scratch on the surface of the eye which has to heal after surgery. Comfort is achieved by wearing a bandage contact lens for several days. With Lasik, a microkeratome is used to create a flap of corneal tissue that is of a certain depth and size but is still attached in one area. This allows the surgeon to flip this tissue over and expose the stroma for surgery and then repositioned back in its original postion after surgey.

Each procedure carries its own risk and complications. Several of these can be vision threatening. With PRK the greatest risk is getting an infection while the eye is healing. This could leave a scar and impare vision. Also, patients who have PRK usually don't see sharply for several days. With LASIK, the greatest risk is in creating the flap of tissue. As mentioned, the flap has to be of a certain size and thickness and the "hinge" has to be of a certain size. If any of these are not correct, it could affect your surgery outcomes. Also, there have been reports of inflammation occurring in the interface between the flap of tissue and the treated area. This needs to be caught early and prompt treatment started in order to prevent vision loss.

This is just a brief discussion on Lasik and PRK. If you wish to inquire about LASIK or learn more about your options, please contact us and ask to speak with our Laser Vision Coordinator to set up an evaluation.