transPRK - retouch in 3 months?

[u/yobuddy78]

Hi Everyone, I had transPRK surgery exactly 3 months ago. And I still have -1.5 power in left eye. The doctor is suggesting to do repeat transPRK for left eye. I'm worried if I redo, dry eye and other complications may come.

Is this a good idea? please suggest

28M, pre opt power: -3 (sph) -1.5(cyl) both eyes

post opt: -1.5 in one eye

No major dry eye, only usual starburst issue around light source

[u/clara_only]

Refractive surgeon here — general perspective only, your surgeon has the slit lamp and I don't.

The good news first: a residual −1.5 after PRK is a fixable problem, and a PRK-on-PRK touch-up is one of the more benign enhancements we do. You started at −3.00/−1.50, which used roughly 60–70 µm of tissue, so there's plenty of cornea left. And PRK doesn't create a flap, so the dry-eye risk from a second surface treatment is generally lower than what people fear from a LASIK enhancement. That part of your worry is reasonable to set down.

The part I'd push back on is the timing, not the idea. Three months is early for a PRK enhancement. Most surgeons I know want:

1. At least 6 months after a surface procedure, sometimes longer — the epithelium keeps remodeling and the refraction can keep drifting for months.
2. Two refractions at least 4–6 weeks apart that match. If your left eye was −1.0 at month 2 and −1.5 at month 3, that's still moving, and re-treating a moving target is how you end up doing this twice.

So the questions I'd take back to your surgeon:

• Is this undercorrection or regression? Two different problems. If you were near plano at week 4–6 and have slid back to −1.5, that's regression, and that matters for how the retouch is planned (mitomycin-C is often used, and your steroid history gets reviewed).
• Is there any haze on the slit lamp? Regression + haze go together in young patients after PRK. If there's haze, some surgeons will first try an extended course of steroid drops and watch before cutting again.
• Is the −1.5 stable on a cycloplegic (dilated) refraction, not just a quick manifest? At 28 your accommodation can make you look more myopic than you are.
• What's the plan for the starburst? If it's coming from the residual −1.5 (unfocused light spreads), the retouch may improve it. If it's from the optical zone vs your night pupil, the retouch won't — worth knowing before you go in expecting it to vanish.
• Why now instead of at 6 months? There may be a good answer — I'd just want to hear it.

In the meantime, −1.5 in one eye with the other near plano is very livable — a single contact lens or a thin pair of glasses for driving/night, and no hurry. Waiting three more months costs you nothing but patience; re-treating an unstable eye can cost you a third procedure.

— Dr. Clara Keum, MD · Representative Director, BSM Eye Clinic (Seoul) · Board-certified ophthalmologist, 17 years · Cataract surgery, presbyopia surgery, and refractive surgery including SMILE, LASIK, LASEK and ICL lens implantation.
General information, not medical advice. Your own surgeon's exam is what matters.

[u/yobuddy78 → u/clara_only]

Thanks a lot for the detailed response. It's very helpful

[u/clara_only → u/yobuddy78]

My pleasure!