Category Archives: Intra-LASIK

LASIK (flap) versus Surface PRK (no flap)

By | Calgary, Dry eye, Epi-lasik, Epilasik, Intra-LASIK, Laser Eye Surgery, Laser vision correction, LASIK, Ophthalmologist, Ophthalmology, Opthamologist, Photorefractive, PRK, Refractive Surgery, Surgeon, VISX | No Comments

STAR S4According to some reports over 28 million laser vision correction surgeries have been performed worldwide since the excimer laser was developed in the 1980s.  Both PRK surface laser and LASIK surgeries use the excimer laser to reshape the corneal surface.  The main difference between the two types of laser vision correction methods is the creation of a corneal flap with LASIK and treatment on the surface of the cornea after removing the thin layer of epithelial cells with PRK.  eyelabeled

 

Advances in both the excimer laser and in flap creation technology have resulted in a variety of names for laser vision correction surgeries.  Flap surgeries include LASIK and IntraLase and no flap treatments include PRK, LASEK, and Epi-LASIK.  With LASIK a small oscillating blade in a device called a microkeratome is used to cut the LASIK flap.  With IntraLase the femtosecond laser is used to create a corneal flap.  Originally called “flap and zap”, with LASIK and Intralase the flap is lifted and the excimer laser reshaping is done on the underlying corneal tissue.  With no flap treatments the excimer laser energy is applied directly to the surface of the cornea.

PRK surface laser vision correction gained in popularity from it’s introduction in the 1980s over the next decade.  LASIK was introduced in the 1990’s  and became the most popular laser vision correction by the early 2000’s due to faster recovery.  Within the past several years there has been a shift back towards surface treatments due to the improvements in post operative management and in excimer laser technology.  It has also been determined that for some people PRK surface treatments may be a better choice.  The reasons that PRK may be recommended include:

1. Risk of flap shift or trauma with job or sports activities.

2. Thin corneas that may be a risk for ectasia (unstable cornea with progressive thinning) with LASIK flap.

3. Very steep or very flat corneal curvatures that may increase LASIK flap complication risk.

4. Previous injury or eye or eyelid surgeries that may raise the risk of LASIK flap complications.

5. Moderate dry eye might be worsened by the deeper disruption of corneal nerves with LASIK flaps.

Both LASIK and PRK have be demonstrated to produce equally good results over 6 months or more.  In the short term of days to weeks LASIK patients will recover vision more quickly.  So taking a short term perspective it makes sense that people may choose a LASIK flap laser vision correction method.

Taking a long term approach there are advantages to forgeting the LASIK flap and choosing a no flap PRK surface treatment.  Advantages of a no flap PRK approach include:

1. no LASIK flap = no flap complictions such as incomplete flaps, buttonholed flaps, partial flaps

2. no LASIK flap eliminates the risk for flap dislocation in the future

3. no LASIK flap means there can not be complications like epithelial ingrowth, diffuse lamellar keratitis, interface debris, flap wrinkles,  or other LASIK flap related complications.

4. Less risk of a weak and unstable cornea called corneal ectasia due to the LASIK flap disrupting the cornea more deeply than surface PRK.

5. Possibly less risk of severe dry eye with surface PRK.

To make the choice that is right for you, first find out if you qualify for laser vision correction and then learn the pros and cons of the treatments available to you.  If you have questions about laser vision correction or wish to book a complimentary evaluation with Dr. Anderson Penno, contact Western Laser Eye Associates.

 

5 Steps to Successful LASIK, PRK, Epi-LASIK or Intra-LASIK vision correction

By | Epi-lasik, Epilasik, Intra-LASIK, LASIK, PRK | No Comments

Step 1:  Do your research.

The more you know about the different procedures available the better you can understand which choice might be right for your eyes.  Look for information from trusted websites such as http://www.geteyesmart.org/eyesmart/  or http://www.mayoclinic.com/health/lasik-surgery/MY00375 .

Dr. Anderson Penno’s book Laser Vision Correction:  What You Need to Know has information about who can safely have laser vision correction, what types of procedures are available, and how to choose a surgeon or surgery center.  This book is available at http://www.amazon.ca/Laser-Vision-Correction-Anderson-Penno/dp/143926497X and in Kindle edition at http://www.amazon.com/Laser-Vision-Correction-What-ebook/dp/B003F77DV4.

Having the right expectations will make you happier with the results.

Step 2:  Have a laser vision correction evaluation.

An evaluation, also sometimes called an assessment, is a complete eye check that includes specialized testing in order to find out if laser vision correction is a safe option for you.  During this eye check a qualified eye care provider will usually give information about what options are available at that surgery center and tell you if you qualify for LASIK, PRK, Epi-LASIK or Intra-LASIK.

Sometimes serious eye conditions are detected during this evaluation and additional testing may be recommended.  This evaluation also includes a medical history since there are some medical conditions like rheumatoid arthritis that may disqualify you from laser vision correction.

Step 3: Get a second opinion.

It can be a good idea to have a laser vision correction assessment at more than one center.  This can give you more information about the types of surgeries available and also allows you to compare the style of care to see if it is a good fit.  Some centers may be lower cost but may not offer as much face to face time with the surgeon.  Other centers may have a higher cost but other features that are important to you such as specific technology or more individualized care.

Step 4: Talk to your friends and family.

It can help to talk you people you know who have had LASIK, PRK, or another type of laser vision correction.  Keep in mind that each person may have variations in healing and that the recovery times may be different between different procedures.  Ask them about their experience.  Was the staff courteous?  Were their questions answered?  Were they comfortable with the surgeon?

If you have a trusted optometrist or other health care provider like a family doctor, talk to them too.

Step 5: Take some time to consider your options.

Rushing to make a decision because your wedding is coming up or you want to squeeze in surgery before your vacation may not be a good idea.  You need to understand the healing process and book enough time to recover.  For some procedures you need to book more time off than others.  It is uncommon to have a complication but it is better to allow for the possibility of needing more time off ahead of time rather than having to cancel or change your plans if your vision recovery is slower than expected.

If you are a good candidate for LASIK, Epi-LASIK, PRK, or Intra-LASIK these steps will help you make the choice that is right for you and understand what laser vision correction can do for you.

For more information or to book a complimentary assessment, contact Western Laser Eye Associates.