Brinton Vision – Lasik St. Louis


Advanced PRK in St. Louis

LASEK/LASIK Alternative for Over-40 Vision

Advanced Surface Ablation (ASA), an advanced version of PRK, is a permanent vision correction solution available for about 20 percent of patients who have special considerations, such as thin or irregular corneas, chronic dry eyes, high prescriptions, or who are in the military. For these patients, PRK is the best option for their journey toward visual freedom. (Because ASA is an advanced version of PRK, you will see the terms ASA, PRK and Advanced PRK used interchangeably here.)

There are multiple methods of administering PRK. SmartSurfACE PRK, a version of trans-epithelial PRK (TransPRK), is one technique. If you are a candidate for PRK surgery, your surgeon will discuss options with you and choose the method best suited for your eyes.

Advanced PRK corrects nearsightedness, farsightedness and astigmatism, while providing you with exceptional vision results. It is different from other LASIK alternatives, however, in that PRK recovery is not rapid and the eyes are uncomfortable during healing.

ASA is one form of PRK. Other versions, such as LASEK and e-LASIK (epi-LASIK) are effective, but our doctors prefer ASA because they have observed quicker visual recovery with this surface ablation method compared to LASEK and e-LASIK.

Dr. Brinton and Dr. Tersigni are among the most experienced Advanced PRK surgeons practicing in Missouri, and can help you decide if ASA is right for you following your comprehensive Brinton Vision Ocular Analysis.

What are the benefits of ASA/PRK?

  • The Advanced Surface Ablation (ASA) variation of PRK provides excellent results when it is performed on the best candidates by the best PRK surgeons.
  • ASA is a good option for people with thin corneas who are not good candidates for LASIK.
  • It can enable people to enjoy activities they love, including very physical activities such as boxing or other contact sports, without the inconvenience of glasses and contacts.
  • There is little downtime; most patients are back to what they enjoy doing within days.
  • It is a more affordable option than the recurring costs of glasses and contacts, and there are several financing options available to fit ASA/Advanced PRK into your budget.

Like custom LASIK plus its other modern alternatives, PRK dramatically improves your vision by reshaping the cornea. Instead of using a laser to create a flap in the cornea, Advanced PRK involves the removal of the outer layer of the cornea, called the epithelium, to allow the laser eye surgeon to access the cornea, then reshape it to provide permanent correction of the corneal shape.

ASA is an effective procedural alternative to LASIK. Dr. Brinton has performed hundreds of these procedures across the country. He is one of the most experienced PRK surgeons in Missouri, and his staff is well-trained in ASA.

What is the difference between ASA and SBK/Advanced LASIK?

The main difference between ASA and LASIK is that unlike LASIK, an ASA procedure does not require creation of a flap in the top layer of corneal tissue. Instead, the surgeon loosens and removes the thin layer of protective skin that covers the cornea. Then, an excimer laser, the same laser used in LASIK, is used to reshape your cornea to provide you with better vision.

This is especially helpful for people who are not good candidates for LASIK, including those with thin corneas, or for patients who have had infections or scarring resulting from contact lens wear. It also means, however, that the healing time for ASA is longer than that of LASIK (days rather than hours).

What is the difference between ASA and LASEK, epi-LASIK, or e-LASIK?

ASA is similar to a procedure known as LASEK (sometimes called epi-LASIK or e-LASIK). During LASEK, the epithelial layer, or the clear skin over the eye, is loosened and pushed aside but is replaced at the end of the procedure. Think of it as being much like replacing a skin flap over a blister that has popped.

In contrast to LASEK, during ASA/Advanced PRK, the epithelium is completely removed. Patients wear a special contact lens to protect their cornea while the epithelium grows back. Our doctors have found that his patients heal faster when the epithelial layer is removed.

How do I know if ASA/Advanced PRK is right for me?

Brinton Vision is the only refractive surgery center of its kind in St. Louis. We provide LASIK plus all of its six modern variations: ASA, Kamra InlayRLE, Visian ICL, and SMILE. To determine which procedure is best for your unique eyes and vision needs, we perform a comprehensive Brinton Vision Ocular Analysis (BVOA), which is one of the most thorough, modern examinations available in the world. Your BVOA will arm our doctors with the information they need to determine if you are a candidate for vision correction, and if so, which procedure is the best fit for you.

What to Expect on PRK Procedure Day

In our St. Louis laser eye surgery center, Advanced PRK takes 15 minutes to complete, and the visual freedom our patients obtain can last a lifetime.

On the day of the procedure, plan to be at Brinton Vision for about two hours. You will need someone to drive you home, as your vision will likely be blurry immediately following the procedure.

Just as if you were going to an eye examination, you don’t need to wear special clothes or change your attire while you’re here. The only thing we’ll add to your outfit is a small, blue cap which you’ll wear during the procedure.

Prior to beginning, we will repeat some of the same tests that were conducted during your Brinton Vision Ocular Analysis so our surgeons have the most accurate information possible about your vision.

When you’re ready for the procedure, numbing eye drops will be administered so that you are comfortable during your PRK. In a quick 15-minute procedure, the cornea will be precisely and permanently reshaped to improve your vision once healing is complete.

After the procedure, you will receive easy-to-follow instructions and a written hand-out on how to use your eye drops. Our highly trained surgical technicians will answer any questions you may have and provide you with your surgeon’s personal phone number should you have concerns once you return home.

With PRK, you may need a couple of days of recovery time, as you can expect your eyes to feel irritated and uncomfortable. Within a week or so, you will notice what is often a dramatic improvement to your vision. In the meantime, we’ll follow you through your recovery and be there every step of the way.

Is PRK permanent?

The changes made to the cornea during ASA are permanent. However, there is a natural aging process called presbyopia that causes changes in the lens, located in the back of the eye. These changes, often referred to as “over 40 vision,” happen to every one of us, including those who have had ASA. These changes will likely alter your up-close vision so that you may one day require reading glasses. ASA does not hinder treatment for over 40 vision or cataracts, and does not cause or hinder treatment of eye diseases such as macular degeneration or glaucoma.



Once I get a BVOA, how long are my results valid?

Your Brinton Vision Ocular Analysis results are valid for three months. That means that, if you do plan to have LASIK or any other procedure, you will need to schedule it within that timeframe. If you plan to wait longer, the BVOA will be repeated prior to surgery. This is because eye conditions can change. We will not perform surgery on someone without taking the steps needed to ensure accurate results.

Am I too old or too young for LASIK or any other procedure?

Brinton Vision is a unique practice in that we specialize in LASIK plus all of its modern forms. With that range of tools, we can correct vision in patients ages 18 to 108 years old. We are also different in that we provide a tailored solution for your vision correction needs, rather than just offering one or two blanket treatments to everyone who comes in the door. During your Brinton Vision Ocular Analysis, you will learn what the best option is for you and your individual vision goals.

Do you have financing plans available for laser eye surgery?

Yes. We accept all traditional forms of payment, including cash, credit cards, and checks. We also accept funding from FSAs and HSAs, and we work with financing companies to provide a range of payment plans based on approved credit. The two most popular plans our patients opt for are a convenient and affordable 60-month plan with no pre-payment penalty, and a 24-month, zero down, no interest plan. Once we know you are a candidate for a particular procedure, we will work with you to find the best plan for your budget and individual situation.

Will you correct both eyes at the same time?

Most of the time we will correct both eyes at the same sitting, but there are a few exceptions. Refractive Lens Exchange (RLE) and Implantable Collamer Lenses (ICLs), sometimes called implantable contact lenses, are sometimes done one eye at a time if  your surgeon deems it necessary. Your eye surgeon will discuss this with you and answer any questions you may have at your Brinton Vision Ocular Analysis (BVOA).

Will you use anesthesia?

Numbing eye drops are the only type of anesthesia (to use the term loosely) that you will need. You will likely be surprised at just how pain-free your procedure is! If you find you are uncomfortably nervous or anxious, let your surgeon or one of our team members know ahead of time.