With Dr. Branko Ivošević about PRK and LASIK laser dioptre reduction techniques

Laser removal of diopters – LASIK or PRK?

In most cases, laser removal of diopters is performed using two techniques: LASIK and PRK , which we also use in our eye center to correct patients’ diopters. Both methods are equally successful with the end result of clear vision without the use of glasses or contact lenses. But which one is best for you? Which would Dr. Branka Ivošević recommend? Read below.

How is PRK performed in practice, and how is the LASIK method performed?

Both methods are almost completely painless. A small device is placed on the eyelids to prevent blinking during the intervention.

• LASIK: A small instrument ( microkeratome ) is placed in the form of a ring that exerts slight pressure on the eye to create a cover (flap). The laser then removes the dioptre in a few seconds using UV rays, completely insensible to the patient. After that, the flap is returned to its place, antibiotic drops are applied and the same procedure is repeated on the other eye if it is necessary to remove the diopter of both eyes. It only takes about ten minutes to remove the dioptres of both eyes by laser.
• PRK: Unlike LASIK, a microkeratome is not used, but a gentle brush that removes the superficial layer of the cornea (epithelium). Then the laser removes the diopter using UV rays. Finally, in addition to antibiotic drops, a soft therapeutic lens is placed until the epithelium heals. This method also takes ten minutes.

Which technique do you prefer?

Patients often ask me that. There are compelling reasons why I prefer the PRK technique. My seventeen-year practice has shown me that for the LASIK blade, which really gives a wow effect in the form of a quick recovery, it still cuts the cornea and makes the eye more resistant compared to the PRK technique, where the cornea is not cut and the eye remains much more resistant to any injuries. You never know whether an eye injury will occur during various sports activities or during the performance of various professional activities. In that case, patients whose dioptres were removed using the PRK technique have a much better prognosis, because then the eye behaves like any healthy eye that has not undergone previous surgical intervention. Another great benefit of this technique is that patients who may develop glaucoma at some point in their lives have a much better prognosis, that is, glaucoma will be treated much better and vision will be preserved for longer. Therefore, as a surgeon, I am aware that my decision can sometimes be very fatal for patients, and my personal opinion is that I think long-term about the health of our patients’ eyes.

Which method do you use in practice?

After the examination, the ophthalmologist is obliged to assess which technique the patient is a better candidate for. In a long series of years, performing patient examinations and preparations for laser diopter removal, I have noticed, especially in the last 5-6 years, that young patients come to us who increasingly have pronounced dry eye syndrome. One of the mandatory parts of the examination for this operation is the measurement of the tear film. As dry eye syndrome has become a frequent occurrence, it is another factor that has led me in the direction of making PRK my dominant technique. It can be performed precisely on patients who have dry eye and does not disturb their tear film nearly as much as the LASIK technique does. Another additional benefit of the PRK technique is that it can be performed in patients who have a very thin cornea, and if retreatment is needed (re-removal of the restored smaller part of the diopter over time) it is technically much easier to do because the cornea is thicker after this technique and it is possible to remove almost every “returned diopter”.

What does recovery look like with these two techniques?

Postoperative recovery varies. With the LASIK technique, it is somewhat shorter and the symptoms are very mild. Unlike LASIK, patients after PRK experience some post-operative symptoms such as scratching, burning and tearing and these symptoms last 2 to 3 days after surgery. As far as vision is concerned, the same improvement in vision is obtained with both LASIK and PRK techniques, but the recovery of vision with PRK technique is slightly longer. If you were to ask me personally which technique I would use to remove my diopter, it would always be the PRK technique.

We hope that we have answered your questions and at least somewhat dispelled some of your fears. We are always at your disposal for all questions and concerns. Write to us at marketing@kucazdravlja.rs or contact us through our social networks.