PRK /LASEK

Nowadays PRK and its advancement, LASEK, is only applied for certain groups of patients, such as shortsighted patients with thin corneas who are not suitable for LASIK. Both procedures have disadvantages compared to LASIK, which will be discussed in the following. PRK is the abbreviation of Photo-refractive Keratectomy. In this procedure the uppermost layer of tissue is first dissolved, and thereafter removed ("ablated") from the surface of the cornea (the corneal epithelium) with the excimer laser, in order to reshape it. The difference to LASIK is that no corneal lamella, the so-called "flap", is prepared.

 


Hereafter, the entire corneal layer is removed, and the laser treatment takes place. Shortsightedness up to -6.0 dioptres, longsightedness up to +3.0 dioptres, and astigmatism up to -3.0 dioptres can be corrected. The subsequent somewhat larger corneal wound can lead to considerable discomfort, and maybe even pain. A moderate to severe scarring can occur, which must be treated with cortisone eye drops for a longer period of time. Furthermore, the improved vision may take days or even weeks to adjust itself. One of the advantages with the LASIK treatment is that the wound inside the cornea is protected by the flap, which causes the wound to be far less painful. Additionally, the flap ensures that no scarring will occur, and enables the vision to adjust very quickly. Until a PRK wound has healed, it is common that the patient must wear a soft contact lens to relieve the pain.


The further developed form of PRK is the LASEK (LASer Epithelial Keratomileusis). In this surgical procedure, the upper corneal layer is not removed but the surgeon prepares it in a way that enables it to be moved aside. After the laser treatment, the surgeon will distribute it over the corneal wound as a protective layer. This means that no complete corneal flap is prepared like in LASIK, but just a thin epithelial layer is put aside to cover up the wound.


The advantages of LASEK compared to PRK is first and foremost the reduced pain, and the faster eyesight recovery. Other than that, the risk of scarring is far greater with the PRK and LASEK, than with the LASIK. Especially because of the risk of scarring, the above mentioned refractive limits should never be crossed.

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