Trans PRK Aspheric Treatment for Vision Correction –

Advanced Surface Ablation Procedure

The term refers to latest version of Surface Ablation. After the initial PRK was elbowed out by Lasik, the procedure of choice for two decades was Lasik. However, the last few years has seen a reversal of trend with a fresh interest in surface procedures.

Reasons behind Resurgence of Surface Ablation Procedures:

Several reasons led to the resurgence of surface procedures albeit with significant additions/ improvements to the initial procedure –

1. Lasik is not a suitable option in all those with thin, irregular or unstable corneas. In such cases, surface procedure is only laser vision correction possible.
2. Because of inherent tissue saving in surface procedures, all higher prescriptions are benefitted by undergoing these procedures. Many patients who were earlier declared unfit for Lasik due to their thin corneas or higher numbers, can safely undergo vision correction by surface procedures.
3. Though rare, but a definite possibility of flap complications, makes it a safer option than Lasik.
4. As no flap is created in surface procedures and the healing is accomplished by epithelial regrowth over the treated corneal bed, the bio-mechanical integrity of the cornea is maintained.
5. Surface procedure is a safer option for patients who engage in contact sports, particularly boxing or mixed martial arts, where there is a risk of blunt trauma to the eye as there is then no concern for risk of flap dislocation.
6. it may be a safer option for patients who have had prior eye surgery such as LASIK or RK, among others.

Differences in procedures between Lasik and Trans PRK (Surface Procedure):

1. In surface procedures the first step of Lasik where a corneal flap is lifted by using microkeratome or femtosecond laser is skipped or modified. The corneal bed for laser application is prepared by removing only the epithelium.
2. The patient feels more pain in the post-operative period of Surface Procedures than after Lasik. The usual period of discomfort after Lasik is 3-4 hours, but after Surface Procedures it is 2- 3days.
3. The Surface Procedures need longer times for visual recovery. Visual recovery is 1-2 days for Lasik, whereas it takes 4- 5 days for Surface Procedures.
4. Surface Procedures needs 1-2 additional post-op visits more than the Lasik.

Indications for Trans PRK:

PRK or Advanced Surface Ablation is a very effective alternative to LASIK that may considered when:

• you have corneas that are too thin for LASIK, large pupils, and/or dry eyes
• you are at least 18 years of age
• you have had a stable eyeglass or contact lens prescription for two years
• you wish to reduce your dependence on eyeglasses and contact lenses
• you have other factors that might make PRK preferred over LASIK
• safer option for patients who engage in contact sports, particularly boxing or mixed martial arts, where there is a risk of blunt trauma to the eye as there is then no concern for risk of flap dislocation.
• safer option for patients who have had prior eye surgery such as LASIK or RK, among others.

THE PROCEDURE: Trans-PRK ‘No – Touch’ Laser Treatment:

The newer advanced surface ablation procedures are performed in several ways, each with a slight variation as to how the corneal bed is prepared for the ablation by excimer laser. In all the variants the epithelium which forms the top most layer of the cornea is removed by different means which leads to difference in healing and recovery.

This is the latest and the most advanced form of surface ablation procedure available today. The Trans-PRK also known as ‘No-Touch’ surface treatment is the most advanced version of surface treatments. Here the epithelium is neither removed by scraping nor by microkeratome but by controlled and very precise ablation by the laser. The ‘No-Touch’ surface treatment from SCHWIND is the only surface treatment where the eye doesn’t require contact with an instrument. Furthermore, the epithelium is removed more precisely and more easily than ever before. The precise pattern of epithelial removal ensures rapid regrowth of epithelium to produce much rapid healing and visual recovery than seen in any of the earlier surface procedures. Healing is also aided by the fact that the area of epithelium removed is much less than that with alcohol based manual scraping or with microkeratome. Moreover, due to very precise removal of epithelium the chances of developing any haze in the post-operative period is also minimized.

TO LEARN MORE, GO TO ‘Understanding Laser Vision Correction Page’

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