Q. Repeat PRK or Photorefractive Keratotomy possible? Hi, welcome this is Dr. Khanna. I’m going to speak to you about a very interesting topic which came up this morning. Somebody who ten years ago had PRK which is photorefractive keratectomy. If you remember, PRK came before Lasik about 20 to 25 years ago. I remember doing my first one in 1997 or so. At that time, we did not have all the advanced lasers that we do now, nor did we have advanced medicines and drops like today, so a lot of the experiences patients had with PRK was very bad. In fact, that’s why we don’t do PRK today and we’ve gone on to Super Lasik, Epi Lasik or Laser Scraper modifications. Today, it’s a much more comfortable journey.
The topic we are coming to is, if you had PRK 10, 15, or 20 years ago and you need a touch up, what’s the best option? The best option would depend on your age. Let’s say you’re in your 40s, the touch up is likely to be less than one or two diopters. In those cases, we would to have to check your cornea with the latest methods of pachymetry and topography mapping to see if, by any chance, Lasik is possible. Ninety percent of the time, PRK might have been done because Lasik was not an option, but there might be 10% of cases that were done because Lasik was unavailable, or the surgeon was not very confident with Lasik at the time.
It’s important to come for a full exam so we can analyze what’s best for you. There are some people who will have corneal weakening or excess refractive numbers, in those cases you would want to see if implantable collamer lens (ICL) might be an option. Let’s say you’re about 55, then before we do a laser touch up, we would first have to discuss other options like presbyopic implants.
Yes, I missed the one age range for 40 to 55, right? That’s interesting because in that group there can be multiple options available and we’ll have to discuss your lifestyle, look at the numbers, and then come up with a better solution. There is no fixed answer for that age group.
As a summary, if you’re less than 40, laser touch up with PRK or rarely with Lasik, might be an option. If you’re above 55, presbyopia implants might be the first option. In 40 to 55, one of these previous two options might work depending on your lifestyle.
If you have any more questions about PRK, Lasik, touch ups or enhancements, feel free to write to us. Thank you and have a wonderful day.