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Treatment options include contact lenses, [7] [8] intrastromal corneal ring segments, custom topography-guided transepithelial PRK combined with corneal collagen cross-linking, [9] or corneal transplant. When cross-linking is performed only after the cornea becomes distorted, vision remains blurry even though the disease is stabilised.
With more recent developments in laser technology, this is less common after 6 months though symptoms can persist beyond a year in some cases. [citation needed] A dilute concentration of the chemotherapeutic agent, Mitomycin-C, can be applied briefly at the completion of surgery to reduce risk of hazing, although with increased risk of sicca. [15]
Some patients need to wear contact lenses or glasses even after treatment. [45] The most common reason for dissatisfaction in LASIK patients is chronic severe dry eye. Independent research indicates 95% of patients experience dry eye in the initial post-operative period. This number has been reported to up to 60% after one month.
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Dry eye also occurs or becomes worse after LASIK and other refractive surgeries, in which the corneal nerves which stimulate tear secretion [4] are cut during the creation of a corneal flap. [4] Dry eye caused by these procedures usually resolves after several months, but it can be permanent. [16]
The difference from LASIK is that the top layer of the epithelium is removed (and a bandage contact lens is used), so no flap is created. Recovery time is longer with PRK than with LASIK, though the outcome (after 3 months) is about the same (very good). More recently, customized ablation has been performed with LASIK, LASEK, and PRK.
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