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Alternatives to LASIK - PRK and the ICL

Beyond LASIK Surgery in San Diego - Alternative Technologies

LASIK and all laser IntraLASIK surgery has helped millions of people to see clearly with decreased dependence on glasses and contact lenses. Although LASIK is the preferred procedure for the majority of people, it is not for some. Dr. Pham offers more options than LASIK at the San Diego LASIK Institute. The options below are for people who may not qualify for LASIK or all laser LASIK.

Photorefractive Keratectomy (PRK)

  • What is PRK?
  • How does PRK work?
  • Does PRK hurt? What is the recovery period for PRK?
  • What are the advantages and disadvantages of PRK?
  • Is PRK right for me? Why would Dr. Pham recommend PRK?

Implantable Contact Lens (ICL)

  • What is the ICL?
  • How does the ICL surgery work?
  • What are the advantages and disadvantages of the ICL surgery?
  • Does the ICL surgery hurt? What is the recovery period for ICL eye surgery?
  • The ICL as an alternative to LASIK surgery.



Photorefractive Keratectomy (PRK)

What is PRK?

PRK is not for everyone but for the right patient it may be a good alternative to LASIK. Photorefractive keratectomy or PRK was the first FDA approval for laser vision correction surgery in the United States. It is an important alternative to LASIK surgery. Some patients that may not qualify for LASIK may be eligible for PRK. PRK is able to save more corneal tissue because there is no flap made. Thus, PRK may be an alternative for people who have thinner corneas, slightly irregular corneas, corneal scars, and other disqualifications from LASIK.

How does PRK work?

For any laser vision correction procedure to work, your LASIK surgeon will need to be able to treat the middle layers of your cornea. When Dr. Pham performs LASIK surgery, he treats the middle of your cornea by making a flap. In PRK, the laser surgeon removes the superficial layer of the cornea to treat the middle of your cornea. This layer is removed manually or with an Amoils brush. This superficial layer (corneal epithelium) grows very quickly and naturally replenishes throughout your life. Think of this layer as the top layer of your skin which continually regrows. The ability of these cells to replenish quickly is one of the reasons PRK works. During the time of PRK, Dr. Pham may use a medication to help prevent scarring.

Does PRK hurt? What is the recovery for PRK like?

Since Dr. Pham needs to manually remove the superficial layer of your cornea there can be associated discomfort and delay of vision recovery until this layer is healed. Everyone heals at a different rate and the discomfort that people may experience is varied. Most patients report mild discomfort during recovery while others may feel postoperative pain. The visual recovery also varies. Some patients heal very quickly while others may take longer. Dr. Pham may help you heal more quickly with bandage contact lenses, eye drops, and medications. Dr. Pham does everything in his power possible to make the recovery from PRK as fast possible.

What are the advantages and disadvantages of PRK?

There are several advantages that make PRK an alternative to LASIK. The long term results of PRK are comparable to those of LASIK patients. This is particularly true for myopic corrections of less than - 5.00 diopters. There is no flap that is created with PRK. Thus, flap complications are not relevant.

PRK like any surgery has its risks but they are generally small. There may be some mild haze after surgery that often resolves on its own. Dr. Pham may use a medication to prevent haze during your laser vision correction surgery. Infection and poor healing are a concern but this is infrequent. Some patients take longer to heal than others. Thus, Dr. Pham will often counsel you that the healing is much slower than in LASIK eye surgery.

An important advantage of PRK is that more tissue is available for laser ablation. Patients with thinner corneas or irregular corneas may consider PRK as an alternative. Less dry eye is also associated with PRK. PRK is a great alternative to LASIK for the right patient.

Is PRK right for me? Why would Dr. Pham recommend PRK?

As always, no website can give you all the information needed to make an informed decision. Dr. Pham would love to have the opportunity to evaluate you for laser vision correction. Most of the time all laser LASIK is a great option. Occasionally he would recommend PRK. He may recommend PRK if your cornea is thinner or if your cornea is slightly irregular. Overall, PRK is a great alternative to LASIK. Its main disadvantage is the slower healing process. Please feel free to come in to Dr. Pham about your laser vision correction options at the San Diego Institute.


Implantable Contact Lens (ICL)

The San Diego LASIK Institute has stopped doing the ICL and may refer you to another surgeon if it is another treatment option for you. 

What is the ICL?

The implantable contact lens or ICL is made by a company called Staar Surgical. The ICL has a much greater range to treat severe myopia than LASIK surgery. It is a thin and highly advanced contact lens that Dr. Pham inserts in your eye. The ICL is a good alternative to people with the most challenging and extreme prescriptions. It is also a good alternative for people with significant corneal disease. Dr. Pham is one of only a handful of eye surgeons in the San Diego area who has implanted the ICL.


How does the ICL surgery work?

The ICL is a made of a high grade material that makes it relatively inert and safe to put in the eye. By implanting a contact lens, the eye surgeon is able to treat your myopia. Prior to surgery, Dr. Pham may perform two small laser procedures. These procedures are not related to LASIK. Rather, they allow the lens to be inserted into the eye without an increase in the eye's pressure. The ICL surgery is done under sterile conditions in an operating room. Anesthesia is given to keep you comfortable. Dr. Pham makes a micro incision in your cornea and inserts the lens. The typical procedure can takes Dr. Pham approximately 10-15 minutes.


What are the advantages and disadvantages of the ICL surgery?

The disadvantage to the ICL surgery is that it is an intraocular surgery with its associated risks. The risks are similar to cataract surgery and there is a low risk of infection, increased eye pressure, or cataract formation. However, with the major advancements of intraocular surgery these risks are relatively low. The ICL has been used outside of the United States for many years.

The advantage of the ICL is that it is often a good and often the only alternative for some patients that do not qualify for LASIK. Patients with extreme levels of myopia or very thin corneas may not qualify for LASIK. They may qualify for the ICL. Patients with severe dry eyes or cornea disease may make poor LASIK candidates but good ICL candidates.

  • This is a picture of the ICL once implanted in the eye.
  • One of the things that Dr. Pham finds amazing is that it is hard to even see the ICL once it is implanted.
  • It is quite possible for a eye care professional to not even know you had the surgery.

Does the ICL surgery hurt? What is the recovery period for ICL eye surgery?

Anesthesia is given during the procedure. There may be mild discomfort or pain during the immediate recovery period. The recovery for ICL surgery is very similar to that of cataract surgery. Dr. Pham recommends you keep the eye clean, use medicated drops, and avoid strenuous activities for at least 2 weeks.

Is the ICL right for me?

Dr. Pham will recommend the ICL if he believes you are not a good candidate for LASIK surgery in San Diego. No webpage can give you all the information to make this decision. Dr. Pham would be happy to discuss this with you in a free LASIK consultation. For people who have not qualified for LASIK surgery, the ICL may be the right technology for them.

Step 8 - Updates in LASIK

San Diego LASIK Surgery

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