PRK vs LASIK: the Difference Between LASIK and PRK

When you think of laser eye surgery, what’s the first thing that comes to mind? If your answer is LASIK, you’re not alone. But, there’s another kind of laser eye surgery that was actually a predecessor of LASIK called Photorefractive Keratectomy or (PRK). Both of these procedures can help reduce the need for glasses or contact lenses, a benefit that has made both procedures widely popular.  LASIK and PRK can treat the following vision problems:

• Myopia (nearsightedness).
• Hyperopia (farsightedness).
• Astigmatism (uneven lens or cornea, resulting in blurred vision).

As safety is always a priority,  sometimes certain structural characteristics can disqualify someone from being a good LASIK candidate. In these situations, you and your doctor might consider PRK as an alternative procedure to correct your vision. Both LASIK and PRK involve reshaping your cornea, the front part of the eye that enables you to see. Your surgeon will review all of your tests and  measurements and will only recommend the procedure he thinks is safest for your eyes.

Considering the cost and benefits, the choice of PRK surgery vs LASIK should not be made lightly, your eyes should be treated with the utmost care, after all. Although the methods used to perform LASIK vs PRK are very different, they are both refractive eye surgeries.

In this article, we’ll explain the differences between these two procedures and evaluate the pros and cons of LASIK vs PRK.

So if LASIK and PRK are both a form of laser corneal surgery, what exactly makes them different from one another?  The basic difference is this:

• PRK requires the surgeon to remove the surface cells of the cornea.
• LASIK requires the creation of a small flap on the cornea to grant access to the underlying tissue.

What Happens During PRK?

1. Before PRK eye surgery, you will be given several numbing eye drops to make sure you don’t feel any pain or discomfort during the procedure. You may also be given some oral calming medication.
2. The eye doctor will place an eyelid holder into your eye to gently hold your eyelids open during the procedure.
3. Your ophthalmologist will remove the outer layer of your cornea, the epithelium, using a gentle brush
4. Using a highly accurate laser, the eye surgeon reshapes your corneal tissue.
5. After surgery, your ophthalmologist will place a contact-lens-like bandage over your eye to allow it to heal, and to aid in your comfort following the procedure.

What Happens During LASIK?

1. As with PRK, the doctor will use numbing drops in your eyes and an eyelid holder to gently hold your eye open.
2. Using a laser, the eye doctor will create a small flap in the epithelium. The difference between PRK eye surgery vs LASIK is that, unlike  PRK, the epithelium remains intact during LASIK. The flap is gently lifted.
3. The same excimer laser that  is used for PRK, is utilized to reshape the corneal tissue and address any refractive errors.  The flap is then folded back into place, aligned precisely,  and the surgery is complete.

Both PRK and LASIK have significant long-term benefits that outweigh the temporary discomfort of surgery. PRK vs LASIK recovery times are very different. Unlike PRK, LASIK eye surgery recovery can be as short as just a few hours. However, regardless of PRK vs. LASIK, complications can occur if you aren’t careful. Wear sunglasses and avoid rubbing your eyes after surgery.

PRK Recovery

With PRK, a special bandage, similar to a contact lens, is placed over the eye to help the surface layer of the cornea regenerate and heal. This special bandage lens is placed by Dr. Kraff immediately after completion of the procedure. Dr. Kraff removes the lens when the surface has re-healed. As the eyes heal and you’re wearing the bandage contact, you will have functional vision.

You may experience some blurriness, irritation, and sensitivity to light for a few days as the cornea heals. After a few days, the bandage will be removed. You will be given some pain medication to take for the first day or two after the procedure. You will also be using eye drops.

All in all, the initial recovery takes a few days. The vision stabilizes but is very functional after that initial healing. Although full recovery can take about a month, most patients can resume normal activities, including going back to work, after the bandage lens is removed. Your vision should slowly get better day by day throughout the recovery process.

LASIK Recovery

With LASIK, the hinged flap is simply realigned. Recovery from LASIK is a lot quicker than PRK, as most patients can resume their normal activities by the next day. Your vision can be dramatically better and functional before leaving the office.

You may experience some discomfort or mild burning for a few hours after surgery. You will be given some pain medication and eye drops to use after the procedure.

As with any medical procedure or surgery, you should be aware of possible LASIK and PRK side effects.  PRK vs LASIK surgery have some differences, but many side effects can be similar.

• You might have dry eyes and difficulty producing tears for a few months following surgery. Using artificial tear drops will help with this.
• Visual disturbances such as halos or glares can occur for a month or so after surgery. Talk to your doctor if this persists, as this may be a symptom of a different problem.
• Your doctor may remove too little corneal tissue, leading to undercorrection.
• Overcorrection can lead to ectasia, causing distortions in your vision and creating pressure in the eye. If diagnosed, contact your doctor immediately to prevent future vision loss.
• You could develop astigmatism if the corneal tissue is not removed evenly. This could result in the need to wear  glasses or contacts.
• If the flap created during LASIK heals poorly, you may increase the risk of infection. You may produce excessive tears or feel discomfort in the eye. This issue predominantly affects LASIK vs PRK patients.  
• Like all surgical procedures, eye surgery can occasionally have  serious, though rare complications. Though these occurrences are highly unlikely, decreased visual acuity may happen, leaving you with cloudy or blurry vision.

A candidate for eye surgery must meet the following requirements:

• Above the age of 20
• Has not experienced a significant change in their prescription for several years
• Average pupil size of 5- 6 mm
• Not pregnant or nursing

If you’re deciding between LASIK eye surgery vs PRK surgery, it is also worth noting that certain patients are not good candidates for the LASIK procedure. The following are conditions that would make you a candidate for  PRK but not for LASIK:

• Thin corneas
• Large pupils
• High potential for trauma near the eye
• Though someone with an extremely high prescription is not disqualified, PRK  may be recommended over LASIK

Rarely,  people are  disqualified from having either laser surgery, as this may put them at high risk for other medical complications. Laser eye surgery may not be  an option for individuals  with eye conditions like glaucoma or severe allergies, it's always best to discuss this with your doctor and follow their recommendation. Autoimmune conditions like rheumatoid arthritis or lupus can significantly affect the healing process, and anyone with these conditions should discuss risks associated with their condition in detail with their doctor.. This also applies to patients with uncontrolled diabetes.

A number of factors can affect the final PRK vs LASIK cost. With LASIK surgery, the surgeon is using two different LASERS, the LASER that creates the flap and then the LASER that reshapes the cornea. During PRK, there is only one LASER  used; the LASER that reshapes the cornea. Since only one laser is used during PRK, the Kraff Eye Institute passes the lower expense on to their patients.

If you’re wondering if PRK and LASIK are covered by insurance, the short answer is typically no, since they are both considered elective surgeries. If interested, financing options are available that allow you to make payments over time. You should also know that HSA funds and FSA funds can be applied to the surgery to help you with the cost of PRK vs LASIK cost.

It may be tempting to look for the cheapest, lowest cost, or most discounted options when it comes to PRK and LASIK procedures, but keep in mind this is your valued vision.

Dr. Kraffs extensive experience, along with using  the latest and most up to date technology available, allows him  to deliver the best outcomes for  his patients, while providing the highest level of safety. He feels that low-cost lasers, cheaper technology, and discounts are not options when it comes to something as important and precious as your eyesight.

The difference between PRK and LASIK goes beyond the procedure itself. There are distinct pros and cons to each corrective eye procedure, and in certain scenarios, one procedure may be more effective or have greater advantages than the other. These situations can be indications of the PRK vs LASIK difference and which is right for you as an individual, and your individual needs. Take a look at the benefits and drawbacks of each procedure below to help you determine whether PRK or LASIK may be more appropriate for your needs and goals.

PRK Pros & Cons

• It’s better for patients with thin corneas.
• There is no risk of complications with the corneal flap.
• There is less risk of negatively affecting corneal thickness.
• Recovery time is  longer, which may be disruptive.
• You cannot drive until your bandage contacts are removed.
• You may need to take time off work after PRK.
• You can be sensitive to bright light for a few days after surgery.
• It can be a more uncomfortable recovery overall.
• There is increased risk of eye infection for the first few days after surgery.

LASIK Pros & Cons

• The recovery time is very quick.
• While you are not able to drive immediately after LASIK surgery, many patients are able to drive one day after surgery.
• You are not likely to have to take off work after LASIK.
• Your vision is noticeably improved within a few hours.
• There is less risk of infection.
• Bandage contact lenses are not needed.
• Fewer follow up appointments are typically needed.
• It may not be suitable for people with thin corneas.
• There can be an increased risk of complications with the corneal flap.
• There can be a greater risk of poor night vision.
• There can be an increased chance of having dry eyes.

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While the vast majority of patients report permanently improved vision after LASIK surgery, there may be a few cases where someone would need additional procedures to obtain their desired outcome. PRK after LASIK is absolutely possible, and in fact it may be the safest option.

In some cases, performing another LASIK surgery several years after the first one is not advisable, as the risk of epithelial ingrowth is much higher. In that case, PRK would be the recommended option as a second eye procedure.

Consider this side-by-side comparison of PRK vs LASIK.  The best procedure  for you should, of course,  be determined by your doctor.

We recommend speaking to your eye doctor to determine which option is the safest, and most effective for you. Your doctor can also further elaborate on the differences between LASIK and PRK. The Kraff Eye Institute offers free consultations for both the PRK and LASIK procedures with their team of experts. To schedule your complimentary consultation now, call (312) 444-1111 or use their Vision Correction Consultation form.