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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Suggest the best refractive surgery for myopia

Answered by
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Dr. Dadapeer K

Ophthalmologist

Practicing since :2003

Answered : 5709 Questions

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Posted on Mon, 21 Apr 2014 in Vision and Eye Disorders
Question: Hello, I am 26 years old holding eye power -2 for both eyes & is stable for past 1 year. I want to go for refractive surgery & has consulted few hospitals for the same, As per the ORB scan my cornea thickness is around 460 hence I am suggested to go for Epi-LASIK (surface) instead of Flap LASIK. However the opinion differs with each counselor and the kind of surgery they offer. Please suggest what would be the best for me as I am confused with several options & their terminology as stated below: 1. LASEK 2. EPI LASIK 3. Wavefront LASIK 4. Custom LASIK 5. Transepithelial PRK 6. PRK Please let me know if some of the above names are just synonyms to each other.
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Answered by Dr. Dadapeer K 44 minutes later
Brief Answer: You are fit for LASEK, or Epi-LASIK or Trans PRK Detailed Answer: Hello Welcome to Health care magic Iam Dr. DADAPEER K an ophthalmologist and I answer health problems related to eye. It seems from the history that you are having refractive error, myopia of -2 dioptres. Since the refractive power is stable for 1 year and age is more than 21 years, you are fit and eligible to undergo refractive surgery. But since the corneal thickness as indicated by orbscan is 460, performing LASIK is not a good option as LASIK involves making a corneal flap and applying excimer laser to corneal stroma, thus LASIK makes the cornea weak and normally performing LASIK in corneas below 500 microns is not allowed as this will make the cornea weak. Hence the recent modified refractive laser surgery should be considered as told by your counsellors. LASEK and Epi-LASEK are almost similar and they can be done in people with thin corneas like yourself. In LASEK the corneal epithelium is folded and excimer laser is applied, thus cornea is not weakened here. The corneal epithelium is replaced at the end of surgery. In EPI-LASEK the corneal epithelium is raised by a keratome like a flap and replaced at the end of surgery. Wavefront LASIK and Custom LASIK, both are similar are called as Zyoptix and is modified version of LASIK. Here customized laser is used and it corrects normal aberrations present in cornea other than refractive error, thus is superior to LASIK. But this is not suitable for you as this also involves making a corneal flap and it also weakens cornea. PRK called as Photorefractive keratectomy is one of the oldest refractive laser surgery and it is almost similar to LASEK. The difference is in LASEK the epithelium is replaced at the end of surgery but in PRK it is not replaced. Trans epithelial PRK is modification of the old PRK and here the corneal epithelium is removed by laser thus reducing the pain and discomfort in the post operative period. Hence you can undergo either LASEK, or Epi-LASIK or Trans epithelial PRK and all of them are almost similar and you can undergo any one of them. Hope I have answered your question and the information is helpful to you. Thank you
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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