Updated on 

May 24, 2022

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

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.

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

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.

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.

diagram showing four steps in photorefractive keratectomy (PRK) surgery

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

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.

Questions about LASIK? Call NVISION to speak with an experienced Patient Counselor who can answer all your questions and set up a free consultation. No commitment required.

LASIK Surgeon Using Laser

Side Effects and Risks of LASIK vs. PRK

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

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.

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.

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

Pros and Cons of LASIK vs. PRK 

Pros Cons
LASIK Surgery Quick recovery time (3 days for better vision)Safe and effectiveNo stitches requiredHigh success rateFew follow-up visits required Higher risk of dry eyesRisk of poor night visionRisk of flap complicationsUnsuitable for people with increased risk of eye injuries
PRK Surgery Suitable for people with thin corneasLess risk of removing excess corneal tissueNo need for flap creationLess expensive than LASIKLow risk of dry eyesHigh success rate Longer 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.

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

Still not sure about LASIK? Talk with an experienced Patient Counselor at NVISION to find out if it's right for you.

Surgeon performing LASIK Procedure
9 Cited Research Articles
  1. Corneal Modifications,” The American Optometric Association (AOA)
  2. LASIK Candidate,” Harvard Medical School.
  3. What should I expect before, during, and after surgery?,” United States Food and Drug Administration (U.S. FDA) 11 Jul. 2018.
  4. Abelson M., “The Best Corneal Surface for LASIK,” Review of Ophthalmology, 22 Jan. 2004.
  5. Aristeidou  A. et al., “The evolution of corneal and refractive surgery with the femtosecond laser,” National Center for Biotechnology Information (NCBI), 14 Jul. 2015
  6. Somani S. et al., “Photorefractive Keratectomy,” National Center for Biotechnology Information (NCBI), 02 Nov. 2021.
  7. LASIK eye surgery,” Mayo Foundation for Medical Education and Research (MFMER), 29 Sep. 2021.
  8. Steinert R., “Understanding Wavefront Technology,”  American Academy of Ophthalmology (AAO), 11 Nov. 2013.
  9. What Is the LASIK Success Rate?,” Refractive Surgery Council (RSC), 23 Oct. 2021
Melody Huang is an optometrist and freelance health writer. Through her writing, Dr. Huang enjoys educating patients on how to lead healthier and happier lives. She also has an interest in Eastern medicine practices and learning about integrative medicine. When she’s not working, Dr. Huang loves reviewing new skin care products, trying interesting food recipes, or hanging with her adopted cats.
Vincent Ayaga is a medical researcher and experienced content writer with a bachelor's degree in Medical Microbiology. His areas of special interest include disease investigation, prevention, and control strategies. Vincent's mission is to create awareness of visual problems and evidence-based solutions shaping the world of ophthalmology. He believes that ophthalmic education offered through research has a greater impact among knowledge seekers.
https://www.visioncenter.org/author/vince/
Author: Vince Ayaga  | UPDATED May 24, 2022
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Medical reviewer: Dr. Melody Huang, O.D.
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Dr. Melody Huang, O.D.
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The information provided on VisionCenter.org should not be used in place of actual information provided by a doctor or a specialist.

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