Speaker :
Oh, did you need to look at this? The thing too?
Dr. King:
I don’t think so, I didn’t look at it, but I don’t care. Stop massaging the table.
Dr. King:
Well, hi there. Welcome to Days of Our Eyes. I’m Dr. King. And I’m Dr. Cha. And today we’re gonna talk about alternatives to LASIK. In our last episode, we talked about LASIK refractive surgery, but not everybody qualifies. And what can you do? What are your options if you don’t qualify? Well, a, a couple laser options are SMILE and PRK. Don’t know what those are. Stick around. We’ll tell you.
So now what happens if you’re not a candidate for traditional LASIK? Let’s talk about that. So if your cornea is pretty thin, we can do an alternative procedure called PRK that we just remove the top layer. We actually just remove it. Then we can do the same laser type patterns to reshape the cornea. Then we’ll put a bandage contact lens on there to allow the corneal epithelium to regrow. That means you’re gonna be blurrier longer. So the vision recovery is slower. So we don’t usually do this two eyes at a time. We’ll do it one eye at a time and allow some recovery time, but we’re not disturbing that deeper stromal bed. So the cornea can stay healthier. So PRK is a advantageous for those with thin corneas.
There’s also something called corneal dystrophies. Some people have a dystrophy called epithelial basement membrane dystrophy. That’s where you get these little lines growing through the epithelium, the top layer. Well guess what? When we do PRK, we remove that. When it grows back, it grows back smooth. So not only have we treated your vision, we’ve actually treated that corneal dystrophy as well. So PRK can be advantageous for some folks with other stuff going on too. You get a, you get better bang for the buck. Let’s put it this way, speaking of Buck, PRK is about the same price as LASIK because they use the same lasers. The, the only difference is we’re not making that flap. We’re preserving that corneal thickness by removing lesser top layer and able to get down and do the treatment. So it definitely has its place in our armamentarium. Armamentarium, that word again, that’s our $64 word here at Alliance Vision Institute. They didn’t actually believe me that armamentarium was a word.
Speaker :
Spell it.
Dr. King:
A R M A M. Wait, I know how to spell this one.
Speaker:
Background Video
Dr. King:
Armamentarium. A R M A M E N T A R I U M. Armamentarium.
Speaker:
Dang. Good. Spelling bee.
Dr. King:
I’m going to the nationals in D.C.
Speaker :
Okay. So what prescriptions does PRK Correct?
Dr. King:
The optimal range is similar to LASIK, the around -1 to -9
Dr. Cha:
And also the hyperopic side.
Dr. King:
Oh Yes. I’m sorry, don’t be mad at me hyperopes, , all you farsighted folks out there. I’m not forgetting you.
Dr. Cha:
Up to around 5 to 6. +5, +6 in and around there.
Dr. King:
Really?
Dr. Cha:
I believe so
Dr. King:
Wow.
Dr. Cha:
And they’re always pushing, you know, how much we’re able to, you know, treat healthily as well.
Dr. King:
That’s true. We at our practice, try to have the latest lasers because they have the broadest range. That’s what you want. So, you know, when you’re considering any sort of refractive surgery, always check out how many do they do, do they have the latest lasers, that kind of stuff. Because the newer lasers do have a broader range. Sometimes we have to pedal fast to keep up with the changes. Yeah. The healing process is probably the greatest disadvantage to PRK. We have to be realistic. You’re not seeing right away. Because we’ve removed the top layer. So the first day it’s pretty darn uncomfortable. Long term. It’s wonderful results. The results are as good or better than LASIK as far as your final outcome. But it’s gonna take you a good month to get there. The first few days are pretty blurry and scratchy. After that, then you started getting more comfortable and the vision starts to clear, but it’ll fluctuate the first few weeks. That’s why PRK isn’t more popular. It’s not the the results, it’s the recovery time. Yeah.
Dr. Cha:
Whether our patients get LASIK, whether they get PRK, they’re very happy with the results.
Dr. King:
Yes. With the final outcome, you’re gonna like it.
Dr. Cha:
You know, we, we know we talked about it on previous videos on that cornea. The, from part of that eye’s, one of the fastest growing tissues in the entire body but also is the most sensitive parts of the entire body. People have something less than like a millimeter in size stuck in their eye and they feel it and you know, they go crazy to go to the emergency room for it.
Dr. King:
Yeah. It’ll feel like a boulder and it’s, you know tiny.
Speaker:
So are you awake or are you put under for this procedure?
Dr. Cha:
You, you’re relaxed. We usually say, you know, it’s, it’s our eyes. Again, it’s the most sensitive area. So people are quite squeamish, quite sensitive and protective of their eyes. And so they’re literally going under the laser to
Dr. King:
Yeah the laser. We don’t use knives. Yeah. Laser.
Dr. Cha:
Yeah. No knives. I mean we do hold your eyelids open, you know, it’s a new experience for a patient, but like we mentioned before, we don’t want you completely unconscious. ’cause you know, there’s the bells phenomena, bells reflex where your eyes roll to the back of your head. Yep. We need you to look,
Dr. King:
You should be able to look at that light. So you’re not unconscious, but you are relaxed. We do give you something for some anxiety and you’re monitored with that. Yeah. Yeah. So
Dr. Cha:
I would, I would take it if it was offered for me
Dr. King:
You take that a little too easy. . It is your eyes. We know that. And you know, I’ve said this in previous episodes that, you know, we’re very protective of our vision with people’s greatest fear of losing any sense it’s the vision. So, you know, we try to take that into account when we’re, when we’re performing these procedures.
Dr. Cha:
And we kind of touched upon it on our kinda overview of refractive surgeries. Instead of like LASIK and PRK where we’re having direct access to a large area of the cornea that front part of the eye, SMILE has the benefit of not having even that much area exposed. We use its own special laser that makes a lenticule, we use this vocabulary word.
Dr. King:
Yes lenticule is another fancy word we use
Dr. Cha:
Yeah. Pretty much. We’re literally taking a lens out of that very thin front tissue of the eye, the cornea. It’s more so a laser that can focus, focus his energy within the inner layers of the cornea. And then it makes a small opening, a small incision with the laser for the surgeon to kind of go in and remove that tissue out. One advantage is it’s, is an even faster recovery than LASIK. LASIK already has a pretty fast recovery. But SMILE even that much faster.
Dr. King:
Whenever we disturb the corneal epithelium, whether we scrape it or we make a flap and stuff, the eye tends to get a little drier, especially the first month. So anybody who has dry eye, it can become worse and that’s tougher to recover from and SMILE, we’re not disturbing the surface of the eye much at all. Except for that small incision. So we induce less dryness, faster visual recovery. It’s a little more limited in the amounts it can correct. But if you think of the concept, it’s the least invasive of anything that we do in that we have that laser and it basically creates the shape of a lens within the layers of the cornea. And then they can just go in and just slide that lens out, which lets the top layer kind of reshape and there we are, we’re correct.
So we’ve talked about, you know, we, we’ve talked about LASIK in previous episodes. We’ve talked about PRK, which is LASIK without the flap. And we’ve talked about SMILE, which is removing a lens from within the cornea to where three different ways to work on that cornea. And that covers a lot of folks. Within the limits of what a laser can treat. And we hope that you found that informative and we hope that you like what we said. If you do subscribe and if you have any questions, enter ’em in the box. And we’ll try and get back to you. In the meantime, I’m Dr. King,
Dr. Cha:
I’m Dr. Cha.
Dr. King:
Stay tuned next time and we’ll talk about what happens if laser isn’t the option for you.