PRK vs LASIK - Pros, Cons, Costs & Who Needs Them (2022)

Thinking about LASIK? Start a conversation with an experienced Patient Counselor to find out if laser eye surgery is right for you. Learn More

PRK vs. LASIK: Which is Right for You?

Photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK) are effective refractive eye surgeries for:

  • Myopia (nearsightedness)
  • Hyperopia (farsightedness)
  • Astigmatism

If you have any of the above conditions, you may be wondering which of the two procedures is suitable for you. Although both achieve the same goal of 20/40 vision or better, PRK and LASIK differ by how they're performed and their recovery timelines.

PRK involves the removal of the corneal epithelium (outer surface of the cornea) to expose the inner corneal tissues for laser treatment. An eye surgeon uses an excimer laser (an ultraviolet laser) to reshape the cornea to better focus light on the retina. This improves near and distance vision. The cornea is the clear front covering of your eye.1

LASIK involves an eye surgeon creating a corneal flap before laser treatment. A flap is a small piece of cornea cut out. It leaves a hinge and is folded back to allow for laser application.

According to research, LASIK has a quicker recovery process than PRK and is associated with less pain and discomfort.

The initial recovery time after PRK is about 1 week to a month, whereas LASIK patients show significant vision improvement within 24 hours after surgery.

A surgeon will recommend PRK if you're not a good candidate for LASIK. For example, one primary requirement for LASIK candidates is a thick cornea, which isn't the case in PRK.

Deciding between the two is difficult without expert advice. An eye doctor can carefully evaluate your general health and eye health to determine candidacy.

Who is a Candidate for Each Procedure?

You'll qualify for PRK if you:

  • Are 18 years or older (most surgeons recommend candidates who are 25 to 40 years because they have more stable eyes)
  • Have good general health
  • Are not pregnant or nursing
  • Have healthy eyes
  • Have a refractive error (myopia, hyperopia, or astigmatism)
  • Have a stable prescription for at least a year
  • Have a thin cornea, making you unqualified for LASIK
  • Want to achieve better vision
  • Want to eliminate dependence on contacts or eyeglasses
  • Understand the risks and benefits of the procedure
  • Have realistic expectations

You'll qualify for LASIK surgery if you:2

  • Are 18 years or older (most surgeons recommend candidates who are 25 to 40 years because they have more stable eyes)
  • Have healthy eyes
  • Have a refractive error (myopia, hyperopia, or astigmatism)
  • Have a stable prescription for at least a year
  • Have a thick cornea
  • Are not pregnant or nursing
  • Want to achieve better vision
  • Understand the procedure
  • Have realistic expectations

Talk to your eye doctor about any medications, previous surgeries, or underlying medical conditions that may interfere with the surgery and healing process.

What to Expect During PRK vs. LASIK

Once your doctor determines your suitability for either LASIK or PRK surgery, they'll schedule your procedure. Like any other surgery, preparation is important. Your doctor will give you pre-op instructions to ensure you're well-prepared.

If you wear glasses or contacts, they’ll advise you to keep them off days or weeks before surgery. This will allow your eyes to stabilize.3 They’ll also discourage wearing facial makeup, especially on the day of surgery.

Your surgeon may prescribe anti-inflammatory and antibiotic eye drops a day before the surgery to keep your eyes free from infection and prevent irritation.

Remember to organize reliable transportation to and from your doctor's office, as your ability to drive may be impaired after surgery.

On the surgery day, your doctor will examine your eyes and take measurements of your cornea to guide the procedure.

LASIK Procedure

During LASIK, you will sit on a reclining chair, and the surgeon will clean and prepare your eyes for surgery. Then, they'll administer a numbing agent to prevent pain and discomfort and sedatives to help you relax during the procedure.

(Video) LASIK or PRK? Which is right for me? Animation.

If you're a LASIK candidate with eye allergies, your surgeon will also administer an anti-allergic agent. This will control the release of histamine, cytokines, and other pro-inflammatory mediators that may affect surgery or the healing process.4

A speculum will keep your eyes open. Then, with a device known as a femtosecond laser, your surgeon will carefully create a flap on the surface of your cornea.5

Traditional LASIK eye surgery uses a blade (microkeratome) to create the thin flap. The newer bladeless versions, such as iLASIK, use a computer-guided laser to map your eye before performing the surgery accurately.

Once the LASIK flap is created, the surgeon will lift and fold it back to expose the deeper corneal tissue layers. The flap has a hinge to prevent complete detachment.

Using an excimer laser device, the surgeon will then apply special laser beams to the cornea. This device removes tissue and creates a corneal shape that allows light to focus well on the retina.

After the laser treatment, the flap is repositioned. No stitches are necessary. However, you will be provided with eye shields to protect your wound, especially during sleep. The procedure takes about 30 minutes or less for both eyes.

Your doctor will prescribe pain medications, antibiotics, and lubricating eye drops to ease pain and discomfort during recovery. They will also provide detailed post-op care instructions to follow.

PRK Procedure

PRK follows the same evaluation and procedures as LASIK but does not involve flap creation.

After preparing your eyes for surgery, your surgeon will use a speculum (eyelid holder), and an alcohol solution to cut out the thin surface layer of the cornea (corneal epithelium).6 This process exposes the underlying corneal tissues for laser treatment by using the excimer laser device.

After laser treatment, they'll administer anti-inflammatory, antibiotic, and steroid drops to prevent inflammation and infection.

Finally, they'll place a clear contact bandage on the cornea's surface to protect the wound as it heals. You'll also get post-op care instructions to follow for successful recovery.

PRK vs LASIK - Pros, Cons, Costs & Who Needs Them (2)

The PRK procedure takes about 15 to 20 minutes for both eyes.

(Video) PRK (Photorefractive Keratectomy) Laser Eye surgery | Pros, Cons & What to Expect | Dr Rohit Shetty

Attend your first follow-up appointment at least 24 hours after surgery to closely monitor the healing process. Regular follow-up visits are recommended to ensure a successful recovery.

Side Effects and Risks of LASIK vs. PRK

The following are side effects and risks of LASIK surgery:7

  • Dry eyes
  • Eye pain
  • Red eyes
  • Light sensitivity
  • Glares and halos
  • Double vision (diplopia)
  • Undercorrection/overcorrection
  • Astigmatism (uneven corneal shape)
  • Visual regression
  • Flap infections
  • Vision changes/vision loss (rare)

The following are side effects and risks of PRK surgery:

  • Mild pain or discomfort
  • halos and starbursts, especially at night
  • Hazy vision (corneal haze)
  • Possible overcorrection/undercorrection
  • Sensitivity to light
  • Worsening vision (normal during the first phase of healing)

Contact your doctor if you experience sudden vision changes, severe pain, or bleeding.

NVISION Eye Centers offer custom LASIK, affordable pricing plans, and a lifetime guarantee. Learn More

How Much Do LASIK and PRK Cost?

Both PRK and LASIK generally cost between $1,000 and $3,000 per eye. The prices vary by location, pre- and post-op care facilities, and your surgeon's experience. PRK is easier and requires fewer resources to perform. This makes it a bit cheaper compared to LASIK.

Talk to your doctor for accurate pricing information. Some surgeons may offer financing options. Your health savings account (HSA) or flexible spending account (FSA) may also cover some of the costs.

Pros and Cons of LASIK vs. PRK

ProsCons
LASIK SurgeryQuick recovery time (3 days for better vision)Safe and effectiveNo stitches requiredHigh success rateFew follow-up visits requiredHigher risk of dry eyesRisk of poor night visionRisk of flap complicationsUnsuitable for people with increased risk of eye injuries
PRK SurgerySuitable for people with thin corneasLess risk of removing excess corneal tissueNo need for flap creationLess expensive than LASIKLow risk of dry eyesHigh success rateLonger recovery time (1 to 3 months)Higher risk of infectionBlurry visionMild to moderate pain and discomfort for weeksLight sensitivity (photophobia)Requires bandage contact lens

Is PRK or LASIK More Effective?

Both PRK and LASIK are considered safe and effective refractive surgeries. Modern technologies, such as wavefront, have made the procedures safer and more accurate.8

According to outcome studies, over 90% of PRK and LASIK clients experience a notable improvement in their vision quality (20/40 vision or better).

About 70% of PRK and 90% of LASIK clients achieve 20/20 vision.9 The outcomes are permanent.

Summary

Photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK) are surgical procedures for treating myopia, hyperopia, and astigmatism.

They're based on the same principle, but the procedures and recovery times differ significantly. LASIK involves the creation of a corneal flap before laser treatment, whereas PRK only removes the thin layer of the cornea. PRK is a great alternative for LASIK in people with a thin cornea.

(Video) Is laser eye surgery riskier than people think?

Although PRK has a longer recovery time than LASIK, both are considered safe and effective at correcting refractive errors.

In this article

FAQs

Who is not a good candidate for PRK? ›

Patients considering PRK must be at least 18 years old. Your vision should also be stable for at least one year before undergoing this procedure. Additionally, candidates should: Not currently be taking steroids or certain medications such as Cordarone®, Accutane®, or Imitrex®

Why do people choose LASIK over PRK? ›

If you're active, you might prefer LASIK because you'll have clear vision faster. But if you're into contact sports, PRK might be best because LASIK requires the doctor to cut a flap on your cornea, and it could get knocked loose. PRK may be a better choice for people with thin corneas and dry eyes.

Is PRK surgery better than LASIK? ›

Ultimately, neither LASIK nor PRK is better or worse than the other. Both are relatively low-risk procedures when performed on suitable candidates, and both are capable of producing exceptional results. Modern technology has made both procedures safer and more dependable than ever before.

Which lasts longer PRK or LASIK? ›

Both techniques are equally effective in permanently correcting your vision. The main difference is the recovery time. LASIK takes a few days or less to see clearly while PRK takes about a month. The final results won't differ between the two if the procedure is done properly by a licensed, experienced surgeon.

What is the age limit for PRK surgery? ›

LASIK/PRK and Age

In actuality, the only age requirement for the laser vision correction procedure is that patients be at least 18 years of age. This is because an individual's vision may continue to change and not fully stabilize until after age 18. Adults of all ages undergo LASIK/PRK each year.

What is the success rate of PRK surgery? ›

According to the FDA, the overall success of PRK is around 95%, which means that the high majority of patients who go through PRK experience a notable improvement in the quality of their vision.

Does PRK last forever? ›

How Long Does PRK Last? PRK is considered to be permanent. However, it cannot prevent eyes from aging, nor the optical conditions that can develop as a result. If you have PRK surgery at 40 years of age or older, you can expect these changes to occur.

Who is not suitable for LASIK surgery? ›

Because vision can change dramatically during the adolescent years, LASIK is not recommended for anyone under the age of 18. Those who are pregnant or nursing. Hormone fluctuations during pregnancy and nursing can cause changes to a woman's vision and corrective prescription.

How long does it take to get 20/20 vision after PRK? ›

PRK can accurately correct nearsightedness. Approximately 90% of PRK patients have 20/20 vision without glasses or contact lenses one year after the surgery.

How long is recovery from PRK surgery? ›

Sometimes it takes a few weeks to be able to see clearly. But you will probably be able to return to work or your normal routine in about 5 days. It is common to be sensitive to light or to see starbursts or halos for 1 to 3 weeks. Most people will see well in a few weeks.

Is PRK eye surgery worth it? ›

The results from PRK are just as good as the results from LASIK are. Over 95% of patients achieve 20/20 vision or better. The recovery period is longer after having PRK, but it's worth it for excellent vision!

What is the fastest way to recover from PRK? ›

12 tips for a smooth recovery from LASIK and PRK:
  1. Ask someone to help you settle in at home after your surgery. ...
  2. Wear something comfortable on surgery day so you can go straight to bed when you get home. ...
  3. Organize your post-op meals before surgery. ...
  4. Eat a filling meal before your surgery.
3 Dec 2020

How many times can you have PRK? ›

Answer: PRK enhancement and presbyopia

You can only take away a certain amount before you interfere with the structural strength of the cornea. In addition, We don't usually do more than one enhancement as there should be few reasons to ever have to do a third enhancement. PRK/Lasik do not currently treat presbyopia.

What are the long term effects of PRK? ›

Under- or over-correction, regression, decentration, haze, corneal ectasia and dry eye are among the most common long-term complications.

What is the minimum corneal thickness for PRK? ›

Although the minimum CCT that is appropriate for refractive procedures has been considered to be 500 µm (5), previous studies did not prove that refractive procedures on thinner corneas should be contraindicated.

Is 50 too old for LASIK eye surgery? ›

The good news is that no one is too mature for laser vision correction. You may be able to schedule LASIK after 50 years old. You should know that not everyone is a candidate for LASIK.

Who is a good candidate for PRK? ›

Ideal candidates for PRK are people who experience refractive errors (myopia, hyperopia, astigmatism) and would like to achieve great vision without the reliance on corrective lenses. They should be in good health overall and understand the risks and benefits of PRK.

Can you get PRK after 40? ›

LASIK/PRK and Age: What You Need to Know

Currently, there is no upper age limit for LASIK or PRK. According to the American Academy of Ophthalmology (AAO), more adults over the age of 50 are undergoing LASIK, and Dr. Vu herself has safely performed laser vision correction on hundreds of older adults.

Can your eyesight get worse after PRK? ›

In the first day or so after PRK, vision in the treated eye may be good. As the top surface layer heals, your vision may actually get slightly worse. This is expected and due to the slightly “bumpy“ nature of the new epithelium under the bandage soft contact lens.

Can PRK cause nerve damage? ›

Conclusion: PRK damages the corneal nerves but they are partially regenerated by three months after surgery in rabbits. Nerve loss after PRK extended peripheral to the excimer laser ablated zone, indicating that there was retrograde degeneration of nerves after PRK.

Does PRK affect night vision? ›

In addition to sensitivity to bright lights, patients will notice a diminished quality in their night vision as one of the side effects of PRK. This typically means problems with contrast, and a general difficulty seeing certain objects in the dark. This will last for a few weeks.

Can you watch TV after PRK? ›

Avoid Eyestrain After PRK

In the first 24 hours after PRK, it's important that patients avoid any activities that may result in eyestrain. This includes reading, using the computer, watching TV or movies, and so forth. By resting your eyes for the first day, you will improve your overall healing experience.

How painful is PRK recovery? ›

Post-PRK discomfort

Most patients should expect to feel some discomfort or mild pain for up to 3 days following their PRK laser vision surgery. In most cases, this can be effectively managed using regular doses of over the counter pain relief.

Can PRK cause blindness? ›

As with other eye surgeries, there are serious problems associated with PRK, including worse vision than before the surgery due to errors and blindness.

Why is laser eye surgery not recommended? ›

It is important to know that if you have dry eyes, LASIK surgery may make the condition worse. Large pupils. If your pupils are large, especially in dim light, LASIK may not be appropriate. Surgery may result in debilitating symptoms such as glare, halos, starbursts and ghost images.

When should you not get laser eye surgery? ›

Which conditions make you unsuitable for laser eye surgery?
  • Corneal dystrophy.
  • Eye herpes.
  • Glaucoma.
  • Blindness in one eye.
  • Partial sightedness in one eye.
  • Macular degeneration.
  • Rheumatoid arthritis.
  • Lupus.
9 Dec 2021

What is the safest eye surgery? ›

Laser vision correction (LVC) is considered the safest eye correction surgery to obtain a “specs-free” life for patients with myopia (nearsightedness), hyperopia (farsightedness), and astigmatism (blurring of vision due to improper shape of the eye).

When can I use phone after PRK? ›

Since your eyes are still healing, they will be especially sensitive in the first 24 hours after the LASIK procedure. Because of this, it's recommended to wait at least 24 hours before using your phone, computer, tablet or watching TV.

How long after PRK can I rub my eyes? ›

You should not rub your eyes for 2 months after LASIK and PRK. You do not want to displace the corneal flap in LASIK or loosen the corneal epithelium in PRK. It should be safe to rub the eyes 1 month after PCRI/AK and SMILE.

How long until vision stabilizes after PRK? ›

The first few weeks after your procedure will see you experiencing significant fluctuations in your vision. Your eyesight will then continue to improve until your vision becomes stable. This may take anywhere from a few weeks to a maximum of six months. Until your vision becomes stable you will.

How do you sleep after PRK surgery? ›

After Surgery
  1. Remain quiet the evening of surgery.
  2. A 2 to 3-hour nap is highly recommended immediately after the procedure. If unable to sleep, eyes should be kept closed for 4 hours to improve comfort and help initiate the healing process. You can increase activity as your comfort and vision allows.
21 Jan 2019

Why is PRK recovery so long? ›

Another one of the key differences between LASIK and PRK is it takes longer to recover after PRK. You're definitely not looking at spending months in bed after having the procedure, but because your surgeon removes the epithelium, it takes some time to regenerate.

Can you fly after PRK surgery? ›

Domestic Travel – Wait One to Two Weeks

Depending on your mode of travel, you will be ready to travel one to two weeks after your PRK surgery.

Can PRK cause glaucoma? ›

Following refractive surgery, a number of glaucoma-related problems can arise: After PRK, watch for steroid-induced glaucoma. The biggest glaucoma-related issue in the post-operative period is associated with the use of steroids, primarily following PRK.

How much cornea is removed in PRK? ›

The corneal flap is typically about 160 microns thick. For every one diopter of prescription power, 12 to 14 microns of corneal tissue are removed.

Does PRK fix astigmatism? ›

Your eye doctor can tell you which treatment options are right for you. Two laser surgeries that can treat astigmatism are LASIK (laser-assisted in situ keratomileusis) and PRK (photorefractive keratectomy).

How blurry is vision after PRK? ›

Your vision will be blurry for several days following the procedure, but your eyesight should improve as the days and weeks pass. Most patients experience optimal visual acuity between 1 – 3 months after having PRK laser eye surgery.

What can you not eat after Lasik surgery? ›

That's why the team of King LASIK has put together the following list of foods to limit in your diet.
  • Fatty Meats. A diet high in processed meats that are high in saturated fat, including red meat and sausage, often lends itself to high cholesterol. ...
  • Junk Food. ...
  • Sugar. ...
  • Fried Foods. ...
  • Foods for Good Eye Health.

Why do I have to wear sunglasses after PRK? ›

Experts at the National Eye Institute say that after your PRK (photorefractive keratectomy), you need to stabilize your vision. An essential component in achieving visual stability is to protect your eyes while you heal. Eye experts recommend wearing quality sunglasses while recovering from your PRK surgery.

Does vitamin C help with PRK? ›

Vitamin C 500mg twice daily: This dosage of vitamin C is what Dr. Mandel has found to be the most effective to aid in healing after PRK. Again, this is recommended for the first 6 months during the time that the collagen in the cornea is changing and polishing.

What is ghosting after PRK? ›

Ghosting vision or double vision, also more properly known as diplopia, is a condition that occurs when your eyes that normally work together start to see two slightly different images. Double vision occurs when these two different images cause you to see them transposed next to each other.

What are disadvantages of PRK? ›

Disadvantages of PRK

Complications of PRK may include scarring, infection, cloudiness of the cornea, and a “halo effect” around lights. There is a risk of over or under correction of your vision—this is often remedied with glasses, contacts, or additional surgery. In rare cases, vision may become worse after PRK.

What causes haze after PRK? ›

In most eyes, transient early mild haze following PRK is caused by corneal fibroblasts, not myofibroblasts. In rabbits, haze can be associated with fibroblasts in normal riboflavin-UV cross-linking and with RK or AK incisions.

Can PRK cause retinal detachment? ›

Introduction: Refractive surgery by LASIK or photorefractive keratectomy (PRK) generaly aims at a myopic population that has a high probability of developing rhegmatogenous retinal detachment (RD).

How can I thicken my cornea naturally? ›

If you wear glasses or contact lenses, or even if you have had LASIK, there are always ways to strengthen your cornea and eyes.
...
7 Tips To Strengthen Your Cornea And Eyes
  1. Eat Colourful Veggies. ...
  2. Look For Leafy Green Veggies. ...
  3. Keep an Eye Out for Brightly Colored Fruit. ...
  4. Take Breaks. ...
  5. Don't Forget To Blink.
25 Apr 2017

Does epithelium grow back after PRK? ›

The epithelial layer removed during PRK surgery will regenerate; however, this occurs over a period of weeks. In some patients, the regrowth of the epithelium could take up to three months.

Do corneas thin with age? ›

Thinning of the cornea at a rate of 3–7 μm per decade has been observed in older age in some ethnic groups. A study in 1998 with 1,242 participants aged 10–87 years showed that CCT decreased by 5–6 μm for each decade of life.

Can everyone get PRK? ›

The general requirements for PRK are: You're at least 18 years old. You don't take any steroids. You don't have any existing conditions like glaucoma or cataracts.

Is PRK good for astigmatism? ›

Your eye doctor can tell you which treatment options are right for you. Two laser surgeries that can treat astigmatism are LASIK (laser-assisted in situ keratomileusis) and PRK (photorefractive keratectomy).

How long does it take to get 20/20 vision after PRK? ›

PRK can accurately correct nearsightedness. Approximately 90% of PRK patients have 20/20 vision without glasses or contact lenses one year after the surgery.

What if you're not a candidate for LASIK? ›

Photorefractive Keratectomy or PRK is an excellent vision solution for people who don't qualify for LASIK. It's designed for patients with excessively thin corneas because we don't have to create a flap during the eye surgery procedure. We simply remove a circle of surface epithelium.

Who is a good candidate for PRK? ›

Ideal candidates for PRK are people who experience refractive errors (myopia, hyperopia, astigmatism) and would like to achieve great vision without the reliance on corrective lenses. They should be in good health overall and understand the risks and benefits of PRK.

How painful is PRK after surgery? ›

Your eye will hurt, burn, or itch for 3 or 4 days after surgery. Your vision may be blurry, your eyes may water, your nose may run, or you may feel like there is something in your eye. But it is important not to rub your eye. Rubbing your eye could damage it.

Can you fly after PRK surgery? ›

Domestic Travel – Wait One to Two Weeks

Depending on your mode of travel, you will be ready to travel one to two weeks after your PRK surgery.

When can you watch TV after PRK? ›

In the first 24 hours after PRK, it's important that patients avoid any activities that may result in eyestrain. This includes reading, using the computer, watching TV or movies, and so forth. By resting your eyes for the first day, you will improve your overall healing experience.

How long after PRK is vision blurry? ›

The first few weeks after your procedure will see you experiencing significant fluctuations in your vision. Your eyesight will then continue to improve until your vision becomes stable. This may take anywhere from a few weeks to a maximum of six months.

How much cornea is removed in PRK? ›

The corneal flap is typically about 160 microns thick. For every one diopter of prescription power, 12 to 14 microns of corneal tissue are removed.

Can I wear my glasses after PRK? ›

PRK recovery

Full recovery after PRK takes about a month. With PRK surgery, we prescribe medicated eye drops that help keep your eye moist during the healing process. You may also be given pain medications to keep you comfortable. Most patients after PRK eye surgery don't need glasses as they achieve 20/20 vision.

What is the fastest way to recover from PRK? ›

12 tips for a smooth recovery from LASIK and PRK:
  1. Ask someone to help you settle in at home after your surgery. ...
  2. Wear something comfortable on surgery day so you can go straight to bed when you get home. ...
  3. Organize your post-op meals before surgery. ...
  4. Eat a filling meal before your surgery.
3 Dec 2020

What is ghosting after PRK? ›

Ghosting vision or double vision, also more properly known as diplopia, is a condition that occurs when your eyes that normally work together start to see two slightly different images. Double vision occurs when these two different images cause you to see them transposed next to each other.

What is considered a high prescription for LASIK? ›

Typically, eye doctors will set their limits to +6 for farsightedness, -12 for nearsightedness, and 6 diopters for astigmatism. However, not all laser strengths are the same, so there's some wiggle room.

Can people with astigmatism get LASIK? ›

There's a common, dated misconception that astigmatism rules out LASIK as an option, but in reality, people with mild to moderate astigmatism can be candidates for the procedure. Of course, you have to be a candidate for LASIK in general in order to be a candidate for LASIK treatment of your astigmatism.

How long does it take to fully recover from LASIK surgery? ›

While most people who get laser in-situ keratomileusis (LASIK) eye surgery notice an immediate improvement in their vision, or at least do by the next day or so, it takes the eye about three to six months to fully recover and heal.

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