LASIK vs. PRK: New vs. Old?

Many people consider LASIK to be the “new” form of laser eye surgery and PRK to be the “old” method of laser vision correction. This is not true. A patient from Thousand Oaks in Ventura County asked me a question last week. This patient, who was not a candidate for LASIK, but was a good candidate for PRK, was worried that PRK was the “old” way of doing laser vision correction eye surgery and LASIK was the “new” way. This is not true. Rather, the newest high technology Customized Wavefront versions of PRK and LASIK are both equally new and equally advanced compared to older, conventional forms of PRK and LASIK.

The difference between LASIK and PRK is that, with LASIK, a very thin flap is created on the surface of the eye — whereas with PRK no flap is made. The LASIK flap can be created either with an automated mechanical microkeratome or a femtosecond laser keratome. The flap, however, has no optical significance if properly created: it is optically neutral and does not, itself, correct the vision at all. After the flap is made, the excimer laser is then used to reshape the cornea to correct the vision. After the optical laser re-shaping is done, the LASIK flap is re-positioned to cover the lasered area, allowing for immediate recovery. It is the quality of the laser re-shaping, not the flap, that will determine the visual outcome. Quite simply, modern Wavefront laser systems outperform older, less sophisticated conventional laser systems whether or not a flap is made.

If no flap is made, as is the case with PRK, the laser re-shaping is performed identically, but the recovery is slower since the surface of the eye is asked to heal without a flap covering it. Once healing is done, however, the visual outcome is, in my experience, the same with LASIK and PRK.

Historically, PRK came before LASIK. When laser vision correction surgery was approved by the FDA in 1995, only PRK was approved. Approximately 2 years later, LASIK gained in popularity as flap technology improved. Because LASIK came after PRK and because recovery was quicker, people thought of LASIK as the “new” method which replaced PRK.

In reality, though, both LASIK and PRK have evolved tremendously since the 1990s — as you would expect. Today, contemporary PRK is just as modern, just as sophisticated, and just as accurate as contemporary LASIK. Both are “new” forms of their predecessor forms of PRK and LASIK. It is the laser re-shaping and surgical technique that has evolved so much over the years. Today, the most modern and advanced versions of Customized Wavefront laser vision correction representsignificant advances over older, conventional laser eye surgery — whether PRK or LASIK!

LASIK vs. PRK: New vs. Old?

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