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Comment by codysoyland | Hacker News Reader

The thing that always bothered me about LASIK is that the flap never fully heals. I considered doing PRK (an alternative procedure that omits the cutting of the flap), but the healing time can take months. I was screened by an eye surgeon who insisted LASIK is a superior procedure. Has anyone scientifically compared the risk of LASIK vs. PRK?

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I've had PRK, and while the healing time is longer (you have to wait for your eye's epithelium to grow back), the overall risk is less. There is no flap, just a reshaped cornea.

You wear a contact lens for a week to prevent infection. And during the time that you're healing (my case was about 5 days), you get to listen to a lot of audiobooks.

edit: my surgery was 5 years ago and I've had no issues. Still see perfectly today, although with my night vision, I sometimes question if I'm seeing poorly, but I question my wife and she eases my worry by telling me she also cannot see the dark-object-very-far-away-at-night.

I had ICL* surgery instead of LASIK, because the cornea was too thin. It has worked very well so far: I do get halos, but haven't had any other complications. The implants can also be removed or replaced.

* Implantable Contact Lens, from Wikipedia: The procedure is performed under local anesthesia with the patient awake throughout the operation. The flexibility of the ICL enables the lens to be rolled for insertion into the soft silicone tip of the micro incision injector through a very small incision (2.2mm) thus avoiding the need for stitches, and this procedure usually takes less than 30 minutes in the hands of an experienced ophthalmologist. Following the procedure, most people have immediate use of their eyes. The full recovery period is typically 1–2 days with minimal discomfort and most patients are able to go to work the next day. After surgery, the common advice is to avoid driving home and to visit the attending ophthalmologists regularly for several months so as to monitor the implants. ( https://en.wikipedia.org/wiki/Implantable_collamer_lens )

Not scientific but I only had PRK as a choice. And the healing time is a lot more than the LASIK procedure. Although my doctor told me that it "could take a few more days".

Took me a week until I could look at a computer screen with a ridiculously large zoom level and only for a couple of hours total per day. At about 3 weeks, I could look at a computer screen at a lower resolution but no more than 4-5 hours total.

As for risk; from my reading the greatest risk in both are post-op infections which are a concern with any procedure(even sampling blood). The others weren't really something to worry about. With LASIK, there's also a risk of flap detachment. But that could happen even with a healthy flap if the force is big enough.

I got PRK. No long term issues (other than occasional minor dry eye, and maybe a tiny bit of light sensitivity), but yes, the 3 week period after you get it can be very rough. You usually have to take at least one week of work off.

Thanks for mentioning this.

I've only ever had cursory looks at LASIK because my nearsightedness is not quite serious enough to need glasses all the time, but I looked up what you mentioned and found this:

http://www.lasikcomplications.com/flapdislocation.htm

Watching the YouTube video in the link quite literally made me shudder in my chair.

If I ever do get eye surgery I'll probably go for PRK despite the longer healing time.

Your surgeon is lazy. He wants you as a patient for 2 days for his fee, not for two weeks. All my research indicates that PRK is substantially better.

I did a lot of research when I got it last year. PRK is a better procedure, but only marginally so, and I decided it wasn't worth the pain and longer healing time.

If you do a lot of extreme sports, martial arts, race car driving or those sorts of things, PRK may be worth the extra pain and inconvenience though.

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