Asking for a friend who is considering PRK. She is out of state, in ID. Pros/cons other than going blind, TIA

Had it done in 2005. Still 20/20. Great decision!

The recovery is longer than lasik, but it's the better route. Make sure she does the drops and follows the post surgery directions.

Pros - still 20/20 15 years later.
Cons - longer recovery then lasik.

I actually think Lasik is probably better. I tend to see better Lasik outcomes, and Navy pilots are starting to do more Lasik than prk since Lasik got approved. For a while it was only prk.

But I'd ask ophthalmologists and optometrists what they'd get if it was them, as well as what's best for her. She may be a better candidate for one than the other.

I had PRK in 2006, still 20/20 today. As previous poster mentioned, recovery time is a bit longer than LASIK. The procedure itself was short and painless. I didn't really have the option to choose one or the other; my cornea was too thin for LASIK. I highly recommend getting it done, one of the best decisions I have ever made.

This discussion is interesting:

https://texags.com/forums/16/topics/3089714

Just something to remember - You will still begin to have problems with close-up vision beginning sometime around age 40-45. It is inevitable for essentially everyone and is not related to your cornea (the outer part of the eye that is worked on during LASIK or PRK). It's still great to not have to deal with glasses or contacts for distance vision, but don't think that having the surgery means you won't eventually need "readers" or monovision with contacts.

Something else to keep in mind - Your ability to produce tears can be permanently diminished after LASIK/PRK. This is a minor annoyance when you are relatively young, but I can imagine that it becomes much more of a problem when you are in your 70's and 80's when your ability to produce tears naturally diminishes further. I had PRK and my eyes are bone dry in the mornings, so I have to use those sort of expensive Refresh Plus drops when I wake up every morning. This is probably going to be a lot worse as I age.

For your eyes, it seems like it's pretty much all down hill after your 30's. In your 40's, your close-up vision goes. In your 50's, your middle distance vision starts to go. In your 60's, 70's, and 80's, you get to start dealing with cataracts, diminished ability to see at night, and macular degeneration. Enjoy your 30's!

bigtruckguy3500 said:

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I actually think Lasik is probably better. I tend to see better Lasik outcomes, and Navy pilots are starting to do more Lasik than prk since Lasik got approved. For a while it was only prk.

But I'd ask ophthalmologists and optometrists what they'd get if it was them, as well as what's best for her. She may be a better candidate for one than the other.

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I agree,

when I got my operation done last year the surgeon basically said that they kept PRK around only for those that didn't qual for LASIK. The issues with the flap coming undone are basically ironed out and I don't really see a reason to do PRK these days if you qual for LASIK and the prices are the same.

I had it done in 1989. I'd been wearing glasses since 4th grade, then contacts for 7 years, and hated it the whole time, always intending to get it done when I could afford it.
30 plus years later and no regrets. Best money I ever spent, hands down.
I'm approaching 60 now and my left eye is still near 20/20, but right eye vision sucks. I am left eye dominant, so no big deal, but it sucks for shooting, since I am right handed.
I've tried glasses and contacts and really dislike them, and but vision is just not sharp anymore, so I guess the honeymoon will soon be over.

Quote:

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ust something to remember - You will still begin to have problems with close-up vision beginning sometime around age 40-45. It is inevitable for essentially everyone and is not related to your cornea

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What is the cause or catalyst -- why is this so if nearly inevitable? Its something that interferes with writing work and close analysis of pictures for sure.

titan said:

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Quote:

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ust something to remember - You will still begin to have problems with close-up vision beginning sometime around age 40-45. It is inevitable for essentially everyone and is not related to your cornea

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What is the cause or catalyst -- why is this so if nearly inevitable? Its something that interferes with writing work and close analysis of pictures for sure.

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Your lens continues to grow and become stiffer through life. So eventually the body's ability to change the shape of the lens to focus on near objects diminishes.

I believe it is technically "fixable" by getting an intraocular lens (an artificial lens that replaces your natural lens), which is typically done for people with cataracts. A newer option is something called an intracorneal lens (something I'm not terribly familiar with). I think they make both bifocal/progressive focus type lenses, as well as put one distant vision lens in one eye and one near vision lens in the other, to help eliminate the need for glasses.

My Lasik lasted about 10 years but now I am back in glasses. Your vision changes over time, especially your near vision.

It was a glorious 10 years though!

jejdag said:

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I had it done in 1989. I'd been wearing glasses since 4th grade, then contacts for 7 years, and hated it the whole time, always intending to get it done when I could afford it.
30 plus years later and no regrets. Best money I ever spent, hands down.
I'm approaching 60 now and my left eye is still near 20/20, but right eye vision sucks. I am left eye dominant, so no big deal, but it sucks for shooting, since I am right handed.
I've tried glasses and contacts and really dislike them, and but vision is just not sharp anymore, so I guess the honeymoon will soon be over.

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Can they touch up LASIK or PRK in right eye?

I had SMILE done a while back. https://www.laservue.com/smile-laser-eye-surgery/

Essentially they cut a contact lense shaped part of your middle cornea with a laser then cut a small slit to pull the material out. So instead of a 270 degree cut you have a 60 degree cut. It's supposed to disrupt less corneal nerves (causing dry eye) and keep more corneal structural strength compared to LASIK.

It's the most recent FDA approved procedure just in the past 2-3 years, but common overseas. It seems to me that it's a midpoint between PRK and LASIK. I had my heart set on PRK but the eye specialist said that my correction (about -7.5) can be riskier with PRK so I picked SMILE.

According to the Dr it's another month or two for me to fully recover and my vision to stabilize but I would give it a 8/10 right now. I don't have to put in contacts anymore, but my vision is not as good as I could get with contacts.

lazuras_dc said:

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jejdag said:

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I had it done in 1989. I'd been wearing glasses since 4th grade, then contacts for 7 years, and hated it the whole time, always intending to get it done when I could afford it.
30 plus years later and no regrets. Best money I ever spent, hands down.
I'm approaching 60 now and my left eye is still near 20/20, but right eye vision sucks. I am left eye dominant, so no big deal, but it sucks for shooting, since I am right handed.
I've tried glasses and contacts and really dislike them, and but vision is just not sharp anymore, so I guess the honeymoon will soon be over.

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Can they touch up LASIK or PRK in right eye?

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Because mine was done with blade instead of laser, I think the concern is with scar tissue, so no one I've talked to has given me any hope for it.

titan said:

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Quote:

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ust something to remember - You will still begin to have problems with close-up vision beginning sometime around age 40-45. It is inevitable for essentially everyone and is not related to your cornea

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What is the cause or catalyst -- why is this so if nearly inevitable? Its something that interferes with writing work and close analysis of pictures for sure.

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Two things focus light/images for your eyes - your cornea and your lens (see diagram above). First is the cornea. It is more or less a fixed shape (at least day-to-day). If it is not shaped correctly, it will focus light incorrectly and your vision will be blurry. This is what's going on with basically everyone that needs glasses or contacts to see things far away. PRK/LASIK reshapes the cornea to focus light correctly.

The second thing is the lens. It is not a fixed shape. It has muscles connected to it that cause it to change shape depending on what you are focusing on. If you hold a book far away from your face and then zoom it in toward your face, your lens is changing shape to accomodate for this distance. As you hit your 40-45 age range, though, it starts to lose its flexibility and subsequently its ability to accomodate for close-up things. You can choose to wear reading glasses, bifocals, or wear one contact lens that corrects the up-close vision in one eye while you keep distance vision in the other eye (of course, then you can't see anything far away in the one eye and anything close up in the other eye - this is called monovision and can also be accomplished with LASIK. A lot of people can't get used to two eyes seeing different things, though). There are some multifocal contacts that some people are able to get used to.

If you have cataracts, you can have your lens removed and replaced with an artificial lens. It can't change shape, though, so you would still need reading glasses, bifocals, etc. There are some relatively new lenses that are multifocal and/or accomodating, but they have their own set of problems that can be hard to adjust to. If they can ever get this fully figured out, it will be a game-changer for opthalmology.

Seven Costanza said:

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titan said:

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Quote:

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ust something to remember - You will still begin to have problems with close-up vision beginning sometime around age 40-45. It is inevitable for essentially everyone and is not related to your cornea

---

What is the cause or catalyst -- why is this so if nearly inevitable? Its something that interferes with writing work and close analysis of pictures for sure.

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Two things focus light/images for your eyes - your cornea and your lens (see diagram above). First is the cornea. It is more or less a fixed shape (at least day-to-day). If it is not shaped correctly, it will focus light incorrectly and your vision will be blurry. This is what's going on with basically everyone that needs glasses or contacts to see things far away. PRK/LASIK reshapes the cornea to focus light correctly.

The second thing is the lens. It is not a fixed shape. It has muscles connected to it that cause it to change shape depending on what you are focusing on. If you hold a book far away from your face and then zoom it in toward your face, your lens is changing shape to accomodate for this distance. As you hit your 40-45 age range, though, it starts to lose its flexibility and subsequently its ability to accomodate for close-up things. You can choose to wear reading glasses, bifocals, or wear one contact lens that corrects the up-close vision in one eye while you keep distance vision in the other eye (of course, then you can't see anything far away in the one eye and anything close up in the other eye - this is called monovision and can also be accomplished with LASIK. A lot of people can't get used to two eyes seeing different things, though). There are some multifocal contacts that some people are able to get used to.

If you have cataracts, you can have your lens removed and replaced with an artificial lens. It can't change shape, though, so you would still need reading glasses, bifocals, etc. There are some relatively new lenses that are multifocal and/or accomodating, but they have their own set of problems that can be hard to adjust to. If they can ever get this fully figured out, it will be a game-changer for opthalmology.

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Seven Costanza, Bigtruckguy3500,

Thanks very much for this feedback in your two posts. This is very informative and explains just what is going on very well. I have a suspicion then, that the ability to focus close-up may last longer if you do it to excess-- only now is giving some issues. Maybe the lens is "petrifying" in the more close-up mode than the usual further away. It also explains why it may be misleading to think that LASIK "fails" over time. If LASIK was working with the cornea, and the gradual loss of focus is due to issues with the lens flexibility and muscles--those are entirely different things. One was "fixed" (the wrong shape cornea) but the other is wearing out or petrifying.

Had PRK done 3 years ago...only regret is not getting it done 10 years ago. Recovery was about 3 days but it's been 20/20 ever since

Seven Costanza said:

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There are some relatively new lenses that are multifocal and/or accomodating, but they have their own set of problems that can be hard to adjust to. If they can ever get this fully figured out, it will be a game-changer for opthalmology.

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As someone in their early 40s and wearing glasses since they were 4 yrs old due to farsightedness, this is about the only hope for me. I've never been a candidate for LASIK or PRK, so maybe the technology and my eyesight will converge in my 50s for lens replacement. At that point I may not care anymore though.