Thin corneas aren’t a dealbreaker for vision correction. They just mean laser-assisted in situ keratomileusis (LASIK) isn’t the right procedure. Photorefractive keratectomy (PRK) treats the same vision problems LASIK does, and it’s safer for eyes that don’t have the tissue thickness needed for flap creation.
If your vision is blurry and you don’t think you’re eligible for LASIK, Stephen Khachikian, MD, performs PRK surgery, too, and it can truly transform your eyesight. Here’s what sets this laser eye surgery apart and why thinner corneas need a different approach.
LASIK and PRK are two types of laser eye surgery. Both use an excimer laser to reshape the cornea, but they access the tissue through separate methods.
During LASIK, Dr. Khachikian creates a thin flap in your cornea’s outer layer, lifts it to reshape the tissue underneath, and repositions it. The flap speeds up recovery because it acts like a natural bandage.
PRK skips the flap entirely. Dr. Khachikian removes the epithelial layer — the thin sheet of cells covering your cornea — before reshaping the underlying tissue. Without a flap, there’s no risk of flap complications, which makes PRK safer for corneas that don’t have enough thickness to support LASIK.
The epithelial cells grow back naturally over the week following surgery. Recovery with PRK takes a little longer than LASIK because the eye needs time to regenerate that protective outer layer.
PRK corrects three common refractive errors:
According to the American Academy of Ophthalmology, about 90% of PRK patients achieve 20/40 vision or better after surgery. Many people reach 20/20 or sharper.
Presbyopia falls into a different category. This age-related condition stiffens your eye’s natural lens, making reading and close-up work harder after age 40. Because PRK reshapes the cornea rather than replacing the lens, reading glasses might still be necessary for small print even after surgery.
Dr. Khachikian has two options for addressing presbyopia during PRK. Monovision PRK optimizes one eye for distance and the other for near vision, which can reduce dependence on reading glasses for daily activities. In some cases, he may recommend a corneal implant like KAMRA® to correct presbyopia at the same time as PRK surgery.
Dr. Khachikian numbs the eyes with anesthetic drops before starting. There’s typically no pain, though it’s normal to feel some pressure during the procedure.
Once your eyes are numb, he removes the epithelial layer from your cornea. Vision dims or blurs temporarily without this outer covering in place. The computer-controlled excimer laser then reshapes your cornea, removing microscopic amounts of tissue with extreme precision. The laser work takes less than a minute per eye.
Dr. Khachikian places a bandage contact lens over your cornea at the end of your procedure. This protective lens stays in place for about a week while the epithelial cells regenerate. Someone else will need to drive you home because your vision will be too blurry to get behind the wheel safely.
Your vision should improve gradually. Some patients notice clearer vision within days, while others take a few weeks to see their full results.
Thin corneas are the most common reason to choose PRK, but contact sports and jobs with high trauma risk also push people toward this option because there’s no flap that could get dislodged if an impact occurs.
Military personnel and law enforcement officers often prefer PRK for this reason. Boxing, rugby, or martial arts participants benefit from the flap-free approach that eliminates a potential weak point in the eye’s structure.
Dr. Khachikian evaluates several factors during consultations:
The comprehensive testing reveals which procedure gives the safest results for particular eyes.
Not qualifying for LASIK doesn’t mean being stuck with glasses and contacts. PRK can help you see brilliantly. Call Stephen Khachikian, MD, in Rapid City, South Dakota, at 605-203-4256 or schedule an appointment online today.
