My LASIK surgeon told me that he might switch to PRK mid-surgery due to scarring, but he wouldn't know until starting. Is this safe? By Kristina Oneill on December 19, 2013


My LASIK surgeon told me that he might switch to PRK mid-surgery due to scarring, but he wouldn't know until starting. Is this safe?

I have a very old, shallow scar on one of my corneas. My LASIK eye surgeon said the scar was outside of my range of vision, so it did not prohibit me from being able to have LASIK.  During today's pre-operative eye exam, the LASIK surgeon’s Optometrist told me that the scar might mean that the surgeon may switch me to PRK mid-surgery, but there's a very good chance that the Intralase laser will break through my corneal scar, and they'll continue with LASIK. Is this the normal protocol for someone with a corneal scar?


LASIK requires making a corneal flap.  Although all laser LASIK can be performed in small superficial scars, and long standing scars, the type you describe may make it a better option to consider PRK.  


The PRK procedure is more of a surface treatment, rather than under a flap so the laser will essentially, ignore your scar and not stir it up.  It is sometimes difficult to make a LASIK flap through a corneal scar.  Scarring of the cornea can interfere with the creation of the LASIK flap so it is important for your LASIK surgeon to determine what is the safest and most effective for you to achieve your best corrected vision.  PRK is not a lesser procedure by any means.  The biggest difference between LASIK and PRK for the patient is a more prolonged healing process.  The visiual outcome once healing is complete is the same with LASIK and PRK.  Not everyone with a corneal scar is necessarily disqualified for having the LASIK procedure.  The location of your scar and its depth will determine whether or not LASIK should be performed.

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