My 2017 TransPRK/Lasek Experience — Part One: Why I chose TransPRK over Lasik

In this three part series I talk through my recent TransPRK Laser treatment for the benefit of others. In Part One I cover my reasons for opting out of Lasik, whilst Part Two and Three look at my recovery and tips for anyone thinking about treatment.

Thinking about getting your eyes lasered?

In 2007 I tried on a friends glasses in absolute shock. I was seeing in 4K High Definition before it became all the rage. It was at an indoor cricket net session and all of a sudden I could see EVERYTHING. I tried them on when batting and realised I could see the seam on the ball. I scheduled an eye test the next day, and spent the next 10 years wearing glasses (prescription -1.75). I acknowledge glasses are not that bad , though when you need them to play sport, read clocks, or watch movies, they can be a real inconvenience. Many opt for contacts, however I (and Vision Express!) could never get them in. In fact any touching of the eye makes me queasy and uneasy. I opted for laser surgery on the recommendation of two friends who had been recently treated. I decided on TransPRK over Lasik, despite the latter being the most popular choice of treatment for many patients and clinics. This post aims to provide an useful and unbiased read for anyone thinking about the process, given many similar blogs are either dated or Lasik focused.

The difference between Lasik and Lasek/TransPRK

There are two main types of laser treatment for standard refractive correction — Lasik and Lasek/TransPrk.

During Lasik, the surgeon creates a thin flap in your eye that is lifted to reveal the raw surface of the cornea. The cornea is then reshaped with the laser, before the flap is replaced. Patients are often able to see clearly immediately and return to work the next day with minimal discomfort. Over 90% of patients select this treatment given the quick recovery and results.

Lasek/TransPRK are known as the surface treatments — there is no flap creation however the thin layer of skin on top of the cornea (the epithelium) is removed to allow for the cornea to be reshaped. As the skin is removed, there is an extra healing process for the eye to go through compared with Lasik where the flap is replaced and secured through osmotic pressure. This extra recovery is more challenging for the patient and extends the healing time (at least one week off work), so why would I want to put myself through the extra hassle?

Note: TransPRK is a form of “no-touch Lasek” — the SCHWIND AMARIS laser allows for precise removal of the epithelium whereas traditional Lasek uses an alcohol solution for removal

6 Reasons Why I chose TransPrk over Lasik

  1. Lasik has a faster and pretty much painless recovery but you will always have the flap in your eye, and always have a risk of it being dislodged. This is important if you do contact sports or any physical sport in general. There is no flap in Lasek/TransPRK so no worry of this.
  2. There is still debate in the medical community whether the flap ever fully heals. It is difficult to know who to trust here as Optical Express insist otherwise, though everyone agrees it is held in place by osmotic pressures
  3. I tend to rub my eyes a lot so having a flap is extra burden and worry
  4. I have dry eyes which can be made worse by the flap creation in Lasik
  5. Less tissue is taken from the eye in Lasek/TransPRK allowing for re-treatment should better surgeries come along in the future or touch up work be required
  6. Lasek/TransPRK is easier for the surgeon to perform on patients who are queasy with eye touching or struggle to keep their eyes open. In fact new TransPRK is now done in one movement with the laser removing the skin more precisely than previous Lasek (which used alcohol), and reshaping the cornea together.

Bonus Reason: My cousin is a trained optometrist and recommended Lasek/TransPRK (and also my surgeon having heard great things whilst at Moorfields). It is always good to have a trusting family member on hand but especially to have someone who actually understood the procedure relatively well!

Lasek/TransPRK is a better option if you participate in contact sports

There is no doubt that Lasek/TransPRK has a tougher and more variable recovery than Lasik. The epithelium of the eye first needs to regenerate, whereas in Lasik the flap is lifted and replaced. It can be 1–2 weeks of major recovery, with an adjustment period up to months as your vision improves consistently. With that said, you are treating your eyes and want to make the correct decision for you. If you play sports, have dry eye, or don’t like things near your eyes, then you need to suck it up and embrace the recovery. It is a lifetime of results vs 1–2 weeks of discomfort, and a less invasive surgery.

Choosing a surgeon — Optical Express or Moorfields?

Naturally you want to have the very best surgeon performing your treatment, though cost is always a consideration. I initially had consultations with three surgeons from Moorfields, and the free Optical Express appointment. My first alarm bell came when all three Moorfields professionals recommended Lasek, whilst Optical Express insisted I should have Lasik. They applied a lot of pressure to have the treatment in the next two weeks and not worry about my concerns above. As I resisted I was even offered discount, essentially reducing the price half that of Moorfields. I was told they use the same lasers (true) and have had a 99% success rate.

Still calling me for that Lasik treatment

I eventually chose Moorfields as I decided that I wanted the very best doing my treatment, and someone that was not worried about pushing sales. I also figured if I had any complications, I would rather have the private consultant managing my issues than Optical Express. The surgeon I chose was Romesh Angunawela (info below) as he showed the most patient care, took time to answer my concerns, and understood my queasiness for the eyes. The other two surgeons are world class in the field and a great choice for anyone. I felt I needed someone sympathetic to my eye queasiness. I viewed recommending Lasek/TransPRK as an integrity move — though they understood it would require more follow up care, all Moorfields consultants gave the best advice for my eyes even though I was eligble for Lasik.

As humans it is very difficult to make a decision when it involves a tougher path, even if you know it is the right one. I hope that this post helps shed some light on why some might want to choose a surface treatment over Lasik.

In Part Two I discuss the surgery and in Part Three the recovery. This will provide a useful read for anyone thinking further about a surface treatment over Lasik.

Please feel free to comment below or reach out with any questions.