PRK or ICL? By Kristina Oneill on June 30, 2013



My corneal thickness is 460.  My right eye is -12.00 and my left eye is -11.00.  Can I have PRK or should I have the ICL procedure?


As with any procedure you must look at the risks and the benefits of each based on your individual measurements.  Both are safe, effective and accurate procedures, but the ICL procedure is more involved and is usually reserved for patients with high prescriptions and/or those who are not good candidates for either LASIK or PRK.    A -10.00 and above prescription is a very high amount of nearsightedness. Certainly this is the type of prescription that an ICL is used for frequently.  On the other hand, many studies show that PRK is very accurate and quite stable over many years.  Stability may even exceed that of LASIK.  It is a fantastic procedure when done properly and the healing isn't nearly as bad as some may tell you. 


The ICL procedure is an intra ocular procedure.  This means it is not on the surface of the eye but rather is performed within the eye.  The ICL procedure is a more involved procedure than LASIK or PRK that requires making a surgical incision and entering the eye, then gently gliding a permanent plastic contact lens type lens into position in front of the human lens.

The ICL procedure often provides better vision for patients with higher prescriptions and you are back to normal activities after a few days. 


With PRK, the higher the prescription the more corneal tissue needs to be removed for vision correction. This means that a thicker cornea is needed as a precondition for doing this procedure.  PRK is a safe and effective way to correct the refractive error.  PRK aftercare and visual recovery is something for patient to consider.  Since this procedure is performed on the very outer layer of the cornea, the patient needs to heal the surface.  During this period, the patient will wear a bandage contact lens to remain comfortable while healing for the first few days. The vision will improve steadily and gradually.

If a patient’s corneas are thinner than average as yours are, and their prescription is very high, I would suggest the ICL procedure as that is more suitable for this type of situation.  Corneal thickness is very important.   You say that your thickness is 460 microns and this is approximately 20 percent thinner than average.  A lot of this depends on the particulars of your eye exam and your surgeon's recommendation. The skill and care of your surgical team and surgeon are very important.   Choose that carefully and you will do great!  Make sure that you have a full understanding of why your doctor is making the ICL or PRK procedure recommendation. 

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