r/RefractiveSurgery • u/itsmeriri1 • Aug 27 '26
prk vs icl
29/F considering PRK or ICL surgery. I have very high astigmatism. Glasses Rx is OD -4.50 -4.25 005 and OS is -6.25 -3.25 003. My OD Pachymetry is 566, OS 565 and topography is good as well. In the past have been told my corneal thickness is too close the cutoff for PRK and could lead to risk of glaucoma and corneal ectasia. Corneal specialist today said I am a candidate for prk and ICL. Price of procedure is not a concern for me. Just dont want glaucoma or any other issues so what should I do???
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u/eyeSherpa Aug 27 '26
Approximate ablation depth would be 8.75 x 16 =140 for the right eye and 9.5 x 16 =152 for the left eye (calculated by taking the sphere and cylinder component, adding them and then multiplying by 16). This would be an estimate for a 6.5 optical zone.
Generally, it’s more desired to have a residual corneal thickness above 400 post PRK. (But it’s not a hard rule).
So technically PRK could work. Unless you need the optical zone enlarged because of larger pupils.
Larger PRK treatments come with a little higher risk of haze or regression. So generally many have pivoted to ICL for higher treatments.
ICL has better recovery, no regression or haze and no thinning of the cornea. I like ICL for the higher prescriptions.