14 doctors weighed in:

Lasik or lasek or prk I am a good candidate for laser eye surgery, but I have been getting different answers regarding which surgery is best and safest. I hear many rumors, but where are the statistics?

14 doctors weighed in
Dr. William Goldstein
Ophthalmology
4 doctors agree

In brief: Both

Both surgeries are extremely effective, lasik has a slightly longer track record.
You need a consult with a surgeon who performs both surgeries. Lasik has a faster recovery, and as long as you don't have thin corneas or dry eyes, will work well for you. Statistically speaking, outcomes are almost identical. Balance the risks and benefits, avoid the hype, and you will find the right procedure for you. Don't let any surgeon tell you that there is only one procedure out there that is 'the' answer for all patients. You have to avoid advice that is biased or one-sided to decide what works best, make a decision based on logic and statistics. In other words, don't listen to rumors, seek facts! good luck in your search.

In brief: Both

Both surgeries are extremely effective, lasik has a slightly longer track record.
You need a consult with a surgeon who performs both surgeries. Lasik has a faster recovery, and as long as you don't have thin corneas or dry eyes, will work well for you. Statistically speaking, outcomes are almost identical. Balance the risks and benefits, avoid the hype, and you will find the right procedure for you. Don't let any surgeon tell you that there is only one procedure out there that is 'the' answer for all patients. You have to avoid advice that is biased or one-sided to decide what works best, make a decision based on logic and statistics. In other words, don't listen to rumors, seek facts! good luck in your search.
Dr. William Goldstein
Dr. William Goldstein
Thank
Dr. Mark Golden
Ophthalmology
3 doctors agree

In brief: LASEK

Lasek and prk are both forms of surface ablation.
Numerous studies have shown that standard prk with removal of the epithelium is less painful and heals more quickly than lasek where the epithelium is placed back on. Lasik involves making a flap and its advantage is much faster healing. Unless not a good candidate for lasik, it would be strange to want a procedure that is more painful and takes much longer to heal. If prk surface ablation is your only choice for a variety of reasons, it works well and gives the same vision as lasik over the long run.

In brief: LASEK

Lasek and prk are both forms of surface ablation.
Numerous studies have shown that standard prk with removal of the epithelium is less painful and heals more quickly than lasek where the epithelium is placed back on. Lasik involves making a flap and its advantage is much faster healing. Unless not a good candidate for lasik, it would be strange to want a procedure that is more painful and takes much longer to heal. If prk surface ablation is your only choice for a variety of reasons, it works well and gives the same vision as lasik over the long run.
Dr. Mark Golden
Dr. Mark Golden
Thank
Dr. John Kim
Ophthalmology
3 doctors agree

In brief: I

I agree with dr. Goldstein.
They are not the same. In lasik, a thin flap is made on your cornea either with a high speed blade or with a laser. Then the flap is lifted to expose the cornea that will be reshaped with a laser. In lasek (also called epi-lasik), the epithelium (skin of the cornea) is temporarily removed to expose the cornea for laser. They both have positive and negative aspects. The main difference is the pain you will feel after the surgery when the anesthesia wears off. There is minimum pain with lasik, patients often describe it as a scratch sensation for three hours. With lasek, there is lot more pain. I had lasek and it was painful for almost a week. The reason i had lasek was the issue with flaps. Creating the flap will cause your cornea to be significantly thinner. If your cornea is too thin, it can lead to other more serious problems. Also understand that reshaping of your cornea actually remove more corneal tissue. Higher the prescription, more corneal will be removed. For this reason, some patients do not qualify for lasik but can be a candidate for lasek. All patients will develop dry eyes after surgery with either lasik or lasek! this is because the nerves to the cornea that control your blinking is either cut and burned (lasik) or burned (lasek). So patients will blink at a lower rate leading to dry eyes. For this reason, they must all use plenty of artificial tears after the surgery until the nerves grow back in three to six months.

In brief: I

I agree with dr. Goldstein.
They are not the same. In lasik, a thin flap is made on your cornea either with a high speed blade or with a laser. Then the flap is lifted to expose the cornea that will be reshaped with a laser. In lasek (also called epi-lasik), the epithelium (skin of the cornea) is temporarily removed to expose the cornea for laser. They both have positive and negative aspects. The main difference is the pain you will feel after the surgery when the anesthesia wears off. There is minimum pain with lasik, patients often describe it as a scratch sensation for three hours. With lasek, there is lot more pain. I had lasek and it was painful for almost a week. The reason i had lasek was the issue with flaps. Creating the flap will cause your cornea to be significantly thinner. If your cornea is too thin, it can lead to other more serious problems. Also understand that reshaping of your cornea actually remove more corneal tissue. Higher the prescription, more corneal will be removed. For this reason, some patients do not qualify for lasik but can be a candidate for lasek. All patients will develop dry eyes after surgery with either lasik or lasek! this is because the nerves to the cornea that control your blinking is either cut and burned (lasik) or burned (lasek). So patients will blink at a lower rate leading to dry eyes. For this reason, they must all use plenty of artificial tears after the surgery until the nerves grow back in three to six months.
Dr. John Kim
Dr. John Kim
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Dr. Val Zudans
Ophthalmology
2 doctors agree

In brief: LASIK LASEK PRK femt

Prk is preferred for thin corneas and dry eyes.
As a surgeon, i know that most reported surgical complications from laser vision correction are flap related / dry eye. I tell patients that prk is more painful with slower recovery, but my preference -no flap / less dry eye. The final visual results are equal. In the end the informed patient makes the decision. Over 40 > risk epi defect w lasik.

In brief: LASIK LASEK PRK femt

Prk is preferred for thin corneas and dry eyes.
As a surgeon, i know that most reported surgical complications from laser vision correction are flap related / dry eye. I tell patients that prk is more painful with slower recovery, but my preference -no flap / less dry eye. The final visual results are equal. In the end the informed patient makes the decision. Over 40 > risk epi defect w lasik.
Dr. Val Zudans
Dr. Val Zudans
Thank
Dr. Jeffrey Whitman
Ophthalmology
2 doctors agree

In brief: Safety

Safety is good for all, but if your eyes are good candidates for lasik--that will give you the quickest vision recovery.

In brief: Safety

Safety is good for all, but if your eyes are good candidates for lasik--that will give you the quickest vision recovery.
Dr. Jeffrey Whitman
Dr. Jeffrey Whitman
Thank
Dr. Emil Chynn
Ophthalmology - LASIK Surgery
1 doctor agrees

In brief: I

I should have answered this question more clearly, so this is an addendum to my first reply statistically, approximately 90% of all lasik complications involve the flap in some way.
Either cutting the flap, or afterwards having some type of problem related to the flap. All you have to do is a google search of images, and type in "lasik complications" and you will see that the vast majority of complications involve the flap in some way (eg, flap wrinkles, incomplete flap, dlk or inflammation under the flap, epithelial ingrowth under the flap, etc) therefore, by not cutting a lasik or intralase flap to begin with, you are eliminating 90% of all possible complications--meaning that, statistically, a no-flap procedure (such as lasek or prk) must be 10x safer than an incisional one the only downside to advanced surface ablations is that it takes a couple of more days to heal, and there is some very minor discomfort during those days. I had lasik myself (i was the 1st lasik surgeon in nyc to have lasik himself, way back in 1999 when there were no good alternative procedures), and can tell you that there is no pain at all, and you recover in 1-2 days. With asas, there is some minor discomfort and your surface heals, and it takes 3-4 days, which is double the time i should have also been more precise in my survey of 100 eye surgeons across the country who drove and flew in for the "updates in ophthalmology" course given at cape cod, organized by a harvard and tufts-affiliated surgeon of the 100 eye surgeons in the audience, i made them vote on which type of procedure they were now primarily performing. 90% said that they were primarily performing incisional procedures, ie lasiks and intralase, which was the expected answer i then asked the following question: "if you were forced to yourself undergo a refractive procedure now, either to get rid of your glasses or contacts for distance or reading (many of them were in their 50s so in reading glasses), knowing what you do about possible complications, even if rare, which type of procedure would you have yourself?" the answer to this question was both surprising and stunning, and even a bit disconcerting 90% of them voted the opposite direction--ie, they said if it were their own eyes, they would have a nonincisional procedure (lasek or epilasek, or if non-advanced, a prk) when i asked them to explain this contradiction, they said things like; "we know it's marginally safer to have a non-incisional surgery, but cannot convince the patients that a recovery that is twice as long (4 vs 2 days) is worth saving this low risk" so it is true that the vast majority of eye surgeons in the us today are still doing incisional procedures, and it is also true that they will have excellent results without a major flap complication over 99% of the time, however, to get that success rate as close as possible to 100%, you really have to get a non-incisional procedure thanks and hope this helps.

In brief: I

I should have answered this question more clearly, so this is an addendum to my first reply statistically, approximately 90% of all lasik complications involve the flap in some way.
Either cutting the flap, or afterwards having some type of problem related to the flap. All you have to do is a google search of images, and type in "lasik complications" and you will see that the vast majority of complications involve the flap in some way (eg, flap wrinkles, incomplete flap, dlk or inflammation under the flap, epithelial ingrowth under the flap, etc) therefore, by not cutting a lasik or intralase flap to begin with, you are eliminating 90% of all possible complications--meaning that, statistically, a no-flap procedure (such as lasek or prk) must be 10x safer than an incisional one the only downside to advanced surface ablations is that it takes a couple of more days to heal, and there is some very minor discomfort during those days. I had lasik myself (i was the 1st lasik surgeon in nyc to have lasik himself, way back in 1999 when there were no good alternative procedures), and can tell you that there is no pain at all, and you recover in 1-2 days. With asas, there is some minor discomfort and your surface heals, and it takes 3-4 days, which is double the time i should have also been more precise in my survey of 100 eye surgeons across the country who drove and flew in for the "updates in ophthalmology" course given at cape cod, organized by a harvard and tufts-affiliated surgeon of the 100 eye surgeons in the audience, i made them vote on which type of procedure they were now primarily performing. 90% said that they were primarily performing incisional procedures, ie lasiks and intralase, which was the expected answer i then asked the following question: "if you were forced to yourself undergo a refractive procedure now, either to get rid of your glasses or contacts for distance or reading (many of them were in their 50s so in reading glasses), knowing what you do about possible complications, even if rare, which type of procedure would you have yourself?" the answer to this question was both surprising and stunning, and even a bit disconcerting 90% of them voted the opposite direction--ie, they said if it were their own eyes, they would have a nonincisional procedure (lasek or epilasek, or if non-advanced, a prk) when i asked them to explain this contradiction, they said things like; "we know it's marginally safer to have a non-incisional surgery, but cannot convince the patients that a recovery that is twice as long (4 vs 2 days) is worth saving this low risk" so it is true that the vast majority of eye surgeons in the us today are still doing incisional procedures, and it is also true that they will have excellent results without a major flap complication over 99% of the time, however, to get that success rate as close as possible to 100%, you really have to get a non-incisional procedure thanks and hope this helps.
Dr. Emil Chynn
Dr. Emil Chynn
Thank
Dr. Jay Bradley
Ophthalmology - LASIK Surgery

In brief: Laser eye surgery

If you are good candidate for all three types of laser eye surgery, each option is equally safe for vision correction.
Each procedure has its own specific risks but all three are incredibly safe in appropriate candidates.

In brief: Laser eye surgery

If you are good candidate for all three types of laser eye surgery, each option is equally safe for vision correction.
Each procedure has its own specific risks but all three are incredibly safe in appropriate candidates.
Dr. Jay Bradley
Dr. Jay Bradley
Thank
Dr. Emil Chynn
Ophthalmology - LASIK Surgery

In brief: IntraLase

Intralase is safer than lasik because it's safer to cut your eye with a laser than a metal blade lasek is safer than intralase as there is no cutting at all the only downside is the healing takes a few days longer i gave a talk at harvard w 100 eye surgeons in the audience last year made them vote on which procedure they would have themselves if forced to get one 95 chose lasek/epilasek and only 5 chose lasik/intralase that should tell you something hope this helps!

In brief: IntraLase

Intralase is safer than lasik because it's safer to cut your eye with a laser than a metal blade lasek is safer than intralase as there is no cutting at all the only downside is the healing takes a few days longer i gave a talk at harvard w 100 eye surgeons in the audience last year made them vote on which procedure they would have themselves if forced to get one 95 chose lasek/epilasek and only 5 chose lasik/intralase that should tell you something hope this helps!
Dr. Emil Chynn
Dr. Emil Chynn
Thank
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