PRK/Epi-LASIK Frequently Asked Questions
Q. What is the difference between PRK/Epi-LASIK and LASIK?
A. LASIK involves cutting of a corneal flap. Surface procedures (PRK/Epi-LASIK, LASEK) are not called LASIK, as they involve no cutting of the cornea with either a scalpel blade or a laser. In 2011 a study was published showing that the LASIK flap never fully heals; therefore, people who have had LASIK have to be concerned forever that a blow to the eye might cause dislocation of the flap. If this happens and it is not fixed in the first hour, the patient is likely to require a corneal transplant to restore good vision. For this reason, Dr. Gold no longer performs LASIK.
Q. Is there any difference in the possible complications between PRK/Epi-LASIK and regular LASIK?
A. Yes, essentially all of LASIK's complications are flap-related. In Surface treatment, there is no flap cut, and therefore less potential for complications.
Q. How Long is the PRK/Epi-LASIK Recovery Time?
A. Your eyes start healing after the first hour of your nap. The regenerating cells usually reach the center in 3-5 days. During those days you may experience intermittent burning and tearing and the feeling that there is something in your eye. Complete regrowth of these cells takes about 6 months, but as soon as the surface is sealed your bandage contact lenses are removed by Dr. Gold and your activities return to normal.
Q. How Soon After PRK/Epi-LASIK Can I Resume Normal Activities?
A. It is common to be able to resume normal activities as soon as you wake from your two hour nap. Everyone reacts differently and so common sense should be used. Usually patients can drive the next day if your vision seems reasonably safe for driving when you look outside. For about the first week, when you shower you should have the water come from behind, instead of directly into your face. Most of our patients can return to work the next day, especially if you work in a clean environment without dust. Eye makeup should be avoided for about one week to help prevent eye infections from contamination. Exercise can be resumed the same day as your procedure as long as you take precautions against sweat getting into your eyes. Swimming with your face in the water should be avoided for at least a week.
Q. What is the difference in dryness between PRK/Epi-LASIK and regular LASIK?
A. In LASIK, the cutting of the flap involves cutting of about 70% of the corneal nerves; these nerves are involved in a feed-back loop to the part of the brain that sends the message to the tear glands about how much tears to produce. In the PRK/Epi-Lasik treatment, there is no cutting of the nerves.
Q. Does PRK/Epi-LASIK Make My Night Vision Worse?
A. In fact, for most patients the prevalence of night vision problems is reduced. In a survey done by the FDA in 2014 about 40% of Laser Vision Correction patients complained of night vision problems before surgery and when the same group responded to the same questions after surgery that percentage dropped to about 25%.
Q. What types of patients usually have PRK/Epi-LASIK?
A. People involved in hazardous activities that might dislodge a LASIK flap such as contact sports, police and fire fighters, martial arts and anyone else who recognizes the inherent safety advantages of not having a flap.
Q. Is PRK/Epi-LASIK painful?
A. No, there is no cutting involved. PRK/Epi-LASIK only involves the surface of the eye. During the first days after PRK/Epi-LASIK there may be some ocular irritation, burning and tearing, but these can usually be controlled with eyedrops and cold packs.
Q. Why would I choose PRK/Epi-LASIK over regular LASIK?
A. All risks are lower with PRK/Epi-Lasik: Quality of vision is potentially better, the eyes are less dry, there is less weakening of the cornea, and there is no possibility of a dislodged flap.
Q. Will the procedure hurt?
A. I explain to all of my patients that their eyes will be numbed with incredibly potent anesthetic drops. The anesthetic drops give the eye about 20 to 30 minutes of numbness during which time any one of a number of ocular surgical procedures can be accomplished. PRK takes between three and four minutes per eye in the hands of a skilled and confident Ophthalmologist.
Q. Will there be post-operative pain?
A. Pain during the post-op period is extremely rare and I educate my patients that if they experience pain they need to call me any time 24/7 to report it. In those rare cases, I will always have them come to the office immediately to determine the cause and solve the problem.
Q. What happens if I move?
A. I will be talking the patient through the entire procedure telling them what will happen next. The eye cannot move during the first phase of the procedure: cutting the flap in LASIK or removing the epithelium in PRK/Epi-LASIK, because I am physically in control of the eye. If movement occurs during the laser portion of the procedure, the laser tracking system detects as little as 0.5 mm movement and shuts off. Then when I settle patient back down, the laser resumes where it left off.
Q. What if I blink?
A. The eyelids are gently held open with a small retainer that does not hurt, but will eliminate blinking.
Q. How important is the choice of a doctor?
A. It is critical to choose a surgeon who has done thousands of procedures so he/she is beyond the “learning curve”. Dr. Gold has performed over 12,000 Laser Vision Correction procedures. It is highly important to have your surgery performed by the same person who does your work-up and will also do your postoperative care.
Q. What about glare and haloes after surgery?
A. I anticipate some glare and haloes after every Laser Vision Correction procedure, but with modern technology and Custom treatment, it is only very rarely disabling in terms of driving and working and then only for a very short period of time.
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