Eye health resource
Understanding LASIK and How It Differs From PRK
LASIK and PRK both use a laser to reshape the cornea, but LASIK creates a corneal flap while PRK treats the surface after the epithelium is removed. Learn how recovery, candidacy, risks, and co-management differ.
Reviewed for accuracy by Justin Bazan, OD on .
LASIK and PRK are both laser refractive-surgery procedures that reshape the cornea to change how light focuses in the eye. The key difference is how the surgeon reaches the corneal tissue being treated: LASIK creates a thin corneal flap, while PRK removes the outer epithelial layer and allows it to regrow after treatment.
Park Slope Eye provides LASIK and PRK co-management. The laser procedure itself is performed by an ophthalmic surgeon, not in our office.
How Does LASIK Work?
During LASIK, the surgeon creates a thin flap in the cornea, usually with a femtosecond laser. The flap is lifted, an excimer laser reshapes the underlying corneal tissue, and the flap is repositioned.
Because the surface tissue is largely preserved within the flap, many patients have relatively rapid early visual recovery. That does not mean the eye is fully healed immediately, and postoperative restrictions and follow-up still matter.
How Does PRK Work?
PRK does not create a corneal flap. Instead, the surgeon removes the corneal epithelium, the thin outer surface layer, and uses an excimer laser to reshape the tissue underneath.
A soft bandage contact lens is commonly placed while the epithelium regrows. Early recovery is generally slower and more uncomfortable than LASIK, and vision can fluctuate while the surface heals.
Is PRK Better Than LASIK?
Neither procedure is automatically better. The safer or more appropriate choice depends on the individual eye.
Factors that may influence the recommendation include:
- corneal thickness and shape;
- the amount and type of refractive error;
- dry-eye and ocular-surface health;
- history of corneal disease, injury, or surgery;
- occupation, sports, and the likelihood of eye trauma;
- how quickly the patient needs functional vision during recovery; and
- the surgeon's examination and treatment plan.
PRK may be considered for some patients in whom creating a LASIK flap is less desirable, but candidacy cannot be decided from one factor alone.
Who May Be a Candidate for Laser Vision Correction?
Refractive surgery is generally considered only after the eyes and prescription are sufficiently stable. The evaluation also looks for conditions that could make surgery less predictable or less safe, such as keratoconus or other abnormal corneal shape, significant dry eye, certain healing problems, or an unstable prescription.
Pregnancy, breastfeeding, medications, and medical conditions can also affect prescription stability, candidacy, or timing. The operating surgeon should receive a complete medical and medication history.
What Risks Do LASIK and PRK Share?
Both procedures can reduce dependence on glasses or contact lenses, but neither can guarantee perfect vision or permanent freedom from corrective lenses.
Possible problems can include dry-eye symptoms, glare or halos, night-vision complaints, under-correction or over-correction, infection or inflammation, haze with PRK, flap-related complications with LASIK, and the possible need for additional treatment when appropriate.
Presbyopia also develops with age. Laser treatment that provides excellent distance vision does not stop the natural age-related loss of near focusing ability.
How Does Recovery Differ?
LASIK usually provides faster early visual recovery and less early surface discomfort. PRK usually requires more time for the epithelial surface to heal, so discomfort, light sensitivity, and blur can be more noticeable during the first several days.
Longer-term visual outcomes can be excellent with either procedure in appropriately selected patients. Recovery instructions, medications, and the timing of driving, exercise, eye makeup, swimming, and other activities should come from the surgical team.
How Park Slope Eye Fits Into LASIK and PRK Care
Park Slope Eye can help evaluate general eye health, discuss whether refractive surgery is worth exploring, refer to an ophthalmic surgeon, and provide postoperative co-management when appropriate.
If you are considering laser vision correction, learn more about our LASIK/PRK co-management or book an appointment online.
Originally published . Substantially updated .