LASIK vs. PRK eye surgery

This is not directly cycling related but I value this community’s opinion.

I am planning on getting LASIK or PRK eye corrective surgery. In fact I have booked both LasicMD (LASIK) and PacificLaser Center (PRK) for late February.

Both clinics are in Vancouver BC

I will be canceling one appointment (I just haven’t decided which one yet)

I was wondering if anybody has any experience with either of these procedures. I am especially interested in the opinions of anybody in the industry, Drs, or optometrists.

  • My understanding is the final result will be the same. Meaning, my eyesight will be improved equally from each procedure.
  • The cost is the same for each procedure
  • LASIK has a much quicker recovery time. PRK requires me to take a week off work (this will be big extra cost)
  • PRK is less invasive. It doesn’t require a flap of tissue to be cut off.
  • There is a possibility that the LASIK may have to be redone in the future (for free)

Thanks in advance :blush:

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I’m a physician, though not an opthalmologist, so I might as well be a carpenter, train conductor, IT specialist or lawyer - we’d all be equally qualified to render an opinion! Regardless, I looked into this as well. I was all in for LASIK until I found out I’m not a candidate because my corneas are too thin. There may be more risk for the need for another surgery down the road with LASIK, but it’s a very small risk, and all things being considered, I’d jump at the chance for LASIK. And the PRK is more difficult enough (due to the required time off work, being essentially functionally blind for at least a day, that I have not as yet gone through with it. And I went through the whole process to get evaluated 4 years ago.
I’m approaching 50 and I’ve noticed with my normal age related mid life vision change, my vision is getting to the point that I really need prescription lenses for cycling, at least for cross and mtb. Road is a little easier to deal with. For what it’s worth, I hope that helps.

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Not quite the case. In PRK, the epithelium is removed, just not replaced afterwards as in Lasik (a.k.a. “flap and zap”). Hence the longer recovery time since the epithelium has to grow back. PRK does allow more of the corneal depth to be used, since the removal is thinner than in Lasik.

Both procedures may require a touch-up, although it is less likely with PRK.

Age is an important issue to keep in mind; as you get closer to 60-65, the potential of cataract goes up; new treatment options for cataracts are attractive as alternatives to corneal surgery (Lasik or other), and thinning the cornea beforehand may limit some of these options.

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Thanks for the reply.

What does this mean exactly for a patent?

Does it provide a better range of vision?

No, it alllows more correction for a given eye, or less corneal depth usage for a given correction. In other words, someone who may not be able to get corrected though Lasik because of insufficient corneal depth may get there with PRK.

In both procedures, you are removing corneal tissue to corrrect the optics.

Keep also in mind that neither procedures can address presbyopia, unless doing differential treatment (i.e. one eye for far vision, one for near) which does not work for everyone.

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Have you considered getting an IOL insert between the cornea and the lens?

An IOL is basically a cataract surgery. One option I was alluding to is to get a “good eye cataract surgery”, which involves replacing the cristalline (the lens) even though it is not yet affected by cataracts.

Thats one option, but the second option is an IOL between the lens and the cornea. Ask me how I know? I have had a bunch of eye issues and have an IOL from cataract surgery. I am aware however of places inserting an IOL to piggyback on your natural lens without having cataracts.

You do not need cataract surgery to have an IOL implanted. However, if you have cataract surgery, the natural lens is replaced by an IOL.

I stand corrected, you are right. Those are phakic IOLs. Not sure how that interplays with a future cataract surgery, would have to ask my resident expert (my wife).

The phakic is removable. Cataract surgery would just remove the natural lens and replace it with an IOL. I would assume the doc would just replace both with the new IOL, as they will likely need to remove the phakic for access and suck the existing natural lens prior to capsular bag IOL insertion.

But I am not a doc, so take my advice with a grain of salt and ask your real doc lmao

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I’ll ask ze wife - nothing like shop talk over pre-dinner drinks.

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For what it’s worth… I’m 41. Had LASIK four years ago. Zero degradation thus far. Dry eyes is the only issue post op, but gets better over time. Not sure where your going in BC, but if money isn’t an issue I highly recommend Gordon Weiss-Schanzlin in La Jolla, Ca. Good luck.

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I’m 41 also, had LASIK done about 5 years ago, 2020 vision, quick recovery. My wife drove me in the next morning for a checkup, I drove home afterwards. They should give you heaps of free eye drops to use. When you go back to get a checkup, ask for more, they give out the small bottles which are great for work. Best thing I have ever done for myself period. Previously were contacts, left eye was -3.8, right eye was - 3.5.

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I am an eye surgeon, trained in laser vision correction myself, and I had femto-LASIK. When I was training in London in 2012, my boss did it for me on a Saturday and I was operating again myself on the Monday. It was one of the best decisions I have ever made. What a brilliant operation; made a huge difference to my lifestyle, especially for running and cycling.

I presume you’ve had your surgery by now. Did you choose LASIK or PRK? How is it going?

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Yes, I had LASIK in early March. It all went well I am very happy with it so far.

The only problem is I have very dry eyes when I first wake up in the morning. I hope that will go away eventually. Can anyone share some first hand information on how long that will continue?

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For me, I had the same dry eye when waking up, and it lasted at the same severity until about 2 months after LASIK. From there it got progressively better over the next 6 weeks or so, and now I never use eye drops (had procedure last July). This seems to be same as some of my family and friends who have had the procedure.

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Im way late to the party here, but I figured I’d offer my .02.

I considered both when I made my decision, and for background, I am a career infantry Soldier in the Army, 25 years of jumping from airplanes as part of my job, and no small part of my decision making, The army accepts either surgery, and I was a candidate for both.

I had my surgery 10 years ago, and I went with LASIK primarily because I was deploying to Afghanistan on short notice, and PRK would have meant I couldn’t go for 6 months. (I know right?)

As others have said, it was without a doubt the best decision I’ve made for myself personally. I didnt hate wearing glasses at all, in fact the only time it bothered me was cycling, and military duty. Sweat is a son of a gun when you’re trying to see the trail, or down your sights.

At ten years since completion, I’m beginning to have some issues with up close vision to the point that I am wearing readers for reading, though for the record I am 47 years old. I am going back to the clinic to have the evaluate the possibility of a touch up, though I expect to wear readers going forward anyway.

My vision was corrected to beyond 20/20 and I still test at 20/10 left 20/15 right. I often joke with the optometrist when they ask the smallest line I can read on the exam and I read the manufacturers data at the bottom of the chart.

Long term effects, I still have dry eyes. I dont think I would say it was ever SEVERE, but I have an amazon subscription for drop vials that comes once a month, and I use them daily. I have had two eye injuries from foreign objects since the surgery, shrapnel and dirt was blown into my right eye in theatre (despite my APEL eyepro) which gave me a week of looking like popeye afterwards. No ill effects there at all, another time I had aviation fuel enter my left eye while performing Jumpmaster duty and that was a more long term injury, which several visits to a specialist. I was given a few kinds of eye drops, and ultimately recovered 100% from it as well. The concern there was clouding of my cornea as I understand it, but vigorous treatment and luck I suppose prevented any real issues.

So today ten years and several injuries later I can still read the fine print on signs from football fields away and I’m quite happy.

If you are a candidate, I strongly recommend it, it was indeed the smartest decision I ever made for my quality of life.

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I had the PRK done about 12 years ago, I think at the time it was called epilasik, but same idea: no flap, epithelium had to grow back.
Short version is that it was a pain in the ass to wait for vision to come back (it was a few weeks until it was good), and 12 years down the road it’s pretty much worn off.

I got corneal ring implants about 20 years ago. My eyes have changed enough since then that I need to get them updated. It’s not offered in the US, so I’ll have to figure out how I manage that.

I can’t provide any technical feedback, but I do have a real world example. Around 5 years ago, I got LASIK and my wife got PRK, within a week of each other. Wife got PRK because of dry eye issues and something else I can’t recall, so the doctor recommended PRK instead. We both used the same doctor.

We both had good results, BUT my wife’s recovery was very slow in terms of her vision coming back, and she was super sensitive to light for a few days after the procedure. As in sitting in the living room, blinds closed, wearing sunglasses. And in the meantime, she was worried about how good her results would turn out.

With LASIK, I had light sensitivity for a day, but my vision was instantaneously improved. I knew right away and didn’t have to wait and worry about whether my eyesight had been pooched by the procedure.

If you’re a LASIK candidate, I would definitely go that route.

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