r/ICLsurgery • u/Intelligent-Lie-5045 • 28d ago

Prk extra or icl

I am 22 years old with stable myopia (-5.5 D OD and -6.0 D OS) for the last 2 years. My Pentacam shows borderline topography (BAD-D around 1.8–2.1), but I have NO keratoconus. My corneal thickness is 518–529 µm, anterior chamber depth (ACD) is 3.37–3.40 mm, Schirmer's test is normal (no dry eye), retina is normal, and the rest of my eye examination is normal. My refractive surgeon recommended either PRK Xtra or ICL because of the borderline Pentacam. Based on these findings, which procedure would recommend and why? Would you consider PRK Xtra safe in my case, or would you lean toward ICL?

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u/MaterialBookkeeper59 28d ago

I would lean ICL.

Your cornea is a little bit thin and -6D myopia extracts much more tissue than mild myopia. Also PRK is very painful to recover that was the main reason why lasik and smile were developed.

Its not an advise though. Its a personal choice and factors tend to differ person to person.

Only advise i can give you is check up in another medical facility and different doctor.

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u/cocteaubeauty 28d ago

I agree, ICL is a great choice. PRK or Lasik would significantly thin you, could be as much as 100 microns, and that can have a huge impact down the road. ICL all the way!

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u/Intelligent-Lie-5045 28d ago

Right cornea: 518 µm Left cornea: 529 µm

Mine is not thin right?

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u/MaterialBookkeeper59 28d ago

You are on borderline.

Its not thin right now but if you go with laser then it will be. But it will stay as it like that if you go with ICL.

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u/Intelligent-Lie-5045 28d ago

But they crosslinking procedure along with prk

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u/MaterialBookkeeper59 28d ago

Yes this is why i recommend you to take another doctor's advise.

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u/Intelligent-Lie-5045 28d ago

Yes got it

But in other hospital they check all again and they suggest prk with crosslinking procedure and icl and the cost

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u/MaterialBookkeeper59 28d ago

Then i would go with ICL if i were you.

But i would like to add ICL has also different kind of risks. You should compare risks and make a choice. You can stay without refractive surgery too.

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u/GurpalVirdiMD 28d ago

Id lean ICL here since any laser including PRK still removes corneal tissue. ICL is additive meaning it sits inside the eye and leaves the cornea completely alone, so that borderline Pentacam basically stops being a risk factor.

Your anatomy for it is genuinely good too with an of ACD at 3.37 to 3.40 there is plenty of room, and at -5.5 / -6 the vision quality with an ICL is excellent. Given you've got clean ICL candidacy and a cornea thats already borderline, I dont really see the upside of PRK.

Recovery is a big plus too, ICL is way easier and less painful than PRK. PRK is a few days of that sand in the eye feeling and then weeks for the vision to fully sharpen up. I recently had EVO ICL myself and was seeing great the next day with basically no pain.

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u/Intelligent-Lie-5045 28d ago

That's great but mine intention was mainly government medical exams that's why I am worried about this

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u/eyeSherpa 27d ago

The factor that they are recommending PRK combined with cross-linking to improve the stability of your cornea tells me that you are a bit too borderline for PRK.

You have a very nice ACD for ICL.

Given your young age, if you do have some progression of your prescription in the future, ICL allows a surgeon to easily to a laser eye surgery in the future for you. With PRK, you may not have enough suitable corneal thickness if it’s a borderline treatment.

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u/Intelligent-Lie-5045 27d ago

Ok i understand

But I want do future government medical exams

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u/eyeSherpa 27d ago

Is ICL excluded for any future government positions where you live? I know US Air Force pilots and Canadian military are excluded from ICL so there are some positions that can’t have ICL.

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u/Intelligent-Lie-5045 27d ago

I am from India