PRK and EPI-Lasik
Eye Surgery in New York City, Manhattan, and Long Island, New York
Collectively known as surface ablation procedures, PRK and EPI-LASIK are for patients who are not LASIK candidates. Corneas that are thin, steep, flat, or irregular in shape may not respond to LASIK in an ideal way. Surface ablation techniques may also be a better treatment for those with moderately dry eye because fewer corneal nerves are impacted when compared to LASIK. The range of correction with PRK and EPI-LASIK is similar to standard LASIK. Since less corneal tissue is removed with PRK and EPI-LASIK, thinner corneas can be treated. Like LASIK, PRK and EPI-LASIK are permanent.
A significant advantage of EPI-LASIK and PRK over Lasik is the elimination of risks associated with creating a corneal flap; however, a significant disadvantage of surface ablation technology is the slower visual recovery. With LASIK, typical visual recovery is about 90% in a day whereas with EPI-LASIK and PRK typical visual recovery takes about a week. Please note that vision continues to improve for many weeks after the procedure with any form of laser vision correction.
About the procedure
PRK has the longest track record in the field of laser vision correction with more than 15 years of results worldwide. It differs from LASIK in that the thin skin layer (epithelium) of the is manually removed in sections prior to applying the customized wavefront correction. EPI-LASIK is a variation of PRK whereby the epithelium is removed as a continuous sheet using a mechanical instrument called an epi-keratome. Unlike LASIK, there are no sharp instruments involved.
There may be more rapid healing and less discomfort when the epithelium is removed as a continuous sheet rather than in sections.
In any case, after the skin layer is removed, the customized wavefront correction is applied to the eye followed by the placement of a specialized transparent bandage to promote healing. After several days the epithelium is regenerated by the body. There is research to indicate that when using customized wavefront corrections, PRK and EPI-LASIK may actually provide superior results to LASIK.
Anesthetic eye drops are used to numb the eye while an eyelid holder maintains the eye in an open position. A mild relaxant medication is also given for patient comfort. Please note there are absolutely no injections. Sophisticated tracking devices (developed by NASA) on the laser follow the natural eye movements during the very brief (about 1 minute) customized resurfacing.
The total surgical time is often about 5 minutes per eye. After a brief rest, patients leave the office wearing sunglasses. Because vision is initially blurry, it is required that the patient be accompanied home. There is discomfort for a few days after the procedure, most notably tearing, light sensitivity, and a sensation that there is something in the eye. Pain-relieving eye drops and over-the-counter oral pain relievers alleviate much of the discomfort. We ask that you rest as much as possible during that time.
Side Effects
More than 99% of patients obtain vision within 2 lines of 20/20 and can perform exceedingly well in most or all activities. There are side effects associated with PRK and EPI-LASIK. Most side effects are temporary but some can be chronic. The most common side effects are dry eye, nighttime glare, and the need for a fine-tuning procedure.
The goal of is to eliminate or reduce any dependence on corrective lenses, but the result is not guaranteed. We are thrilled to report that satisfaction rates at Kelly Laser Center are very high.
Dr. Kelly and staff will discuss more details with you during the consultation to allow you to make an informed decision about whether to proceed. Be sure to have all questions answered to your satisfaction regarding the examination and consent forms.
If you have been told that you are a non-candidate for LASIK, please Kelly Laser Center today to schedule a thorough eye exam. We will determine if you are eligible for PRK or EPI-LASIK or Implant Vision Correction at Kelly Laser Center’s New York and Long Island offices.
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