PRK vs. LASIK Eye Surgery: Differences, Benefits & What to Expect

PRK and LASIK are eye surgeries to correct vision problems. These are two of the most common procedures to correct issues including astigmatism, nearsightedness, and farsightedness.

Each surgery reshapes the cornea of the eye, making it easier to see clearly. 

PRK removes the outer layer of the cornea. This surface grows back over time. 

LASIK uses a different approach by creating a thin flap in your cornea. A laser is used to reshape the cornea, and the flap is folded back into place. The flap seals, as it heals.

Both PRK and LASIK are considered safe and effective. Each surgery offers benefits, and each has some risks associated with it. 

Your specific condition and the structural properties of your eye may influence which procedure is best for your eyes. Talk with your doctor to determine which surgery is best for you.

PRK vs. LASIK

PRK and LASIK have distinct differences in terms of the actual procedure, recovery expectations, side effects and cost.

The Procedure

Before either laser vision correction surgery, you will get numbing drops and be offered a relaxing oral sedative.

PRK

With PRK, the very top layer of the cornea is delicately brushed. This gives your surgeon access to the area where an excimer laser will be used. The outer layer repairs itself during the healing process. 

The procedure is typically done in an outpatient setting and takes approximately 10 to 15 minutes. 

LASIK

With LASIK, the surgeon delicately creates a hinged flap on the surface of the cornea. This is often done using an intralase femtosecond laser. In some instances, a handheld device may be used.  

The flap is lifted to access the underlying corneal tissue. The cornea is reshaped via laser to correct vision. The flap is then realigned to seal naturally as it heals.

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Recovery

PRK

Immediately following the procedure, a special lens is placed over the eye. This acts as a bandage to allow the surface to heal. While you’re wearing this, you will be able to see. The bandage will be removed after a few days.

During recovery, you might experience some sensations as the cornea heals, including blurry vision, irritation, and sensitivity to light. Pain medication and medicated eye drops are part of the healing process.

Vision stabilizes during recovery. After the bandage lens is removed, most people resume normal activities. Full recovery can take about one month, with vision slowly improving daily.

LASIK

LASIK recovery is a lot quicker than PRK recovery. Most people resume normal activities the day following the procedure. Even before leaving the surgeon’s office, your vision should be functional and noticeably improved.

After surgery, your eyes may feel uncomfortable or have a mild burning sensation for a few hours. Pain medication and eye drops are available to soothe the eyes.

Cost

PRK

PRK is often several hundred dollars cheaper than LASIK, as it is a simpler procedure. 

Some centers offer either procedure at the same price. For example, Oregon Health & Science University (OHSU) offers PRK and LASIK at an all-inclusive price of $2,250 per eye. Stanford University lists prices for PRK at $2,950 per eye.

LASIK

LASIK tends to be a bit more expensive than PRK. Prices vary around the country, depending on the surgeon’s expertise, regional variations, and follow-up care.
According to Vision Service Plan (VSP), the average cost per eye is $1,000 to $3,000. Stanford University’s fee schedule for LASIK is $2,950 per eye, so in their case, it is the same cost as PRK.

Side Effects

PRK

Side effects of PRK vary for different individuals. They may include the following:

• Vision changes: You may have a hazy vision or see things as a bit cloudy initially. You may see halos and glares around light. You may have difficulty with nighttime vision. 
• Eye pain: Your eyes may feel uncomfortable, painful, irritated, or watery.
• Light sensitivity: You may have increased sensitivity to bright lights.
• Infection: PRK, like every surgery, carries the risk of infection. 

LASIK

LASIK’s potential side effects include the following:

• Eye dryness: For about six months after surgery, you may have fewer tears, creating a sensation of dry eyes. In most cases, this resolves within about six months, but in some cases, it does not resolve on its own.
• Visual changes: After LASIK, you may experience glares around lights, see double, or see halos. Driving at night may be difficult. Typically, these changes dissipate after about a month. 
• Weakened cornea: If too much corneal tissue is removed during surgery, it can weaken the cornea. 
• Undercorrection: If your vision is not significantly clearer, it’s possible that not enough corneal tissue was removed. Talk with your doctor to evaluate what is necessary to achieve the vision results you are after. 
• Flap complications: The corneal flap created during LASIK can become infected. This can be uncomfortable, and it can cause vision problems, so it should be addressed promptly. 

In most cases, side effects resolve in the weeks and months following either surgery. But it’s important to see your doctor, so they can monitor the situation.

Success Rate or Long-Term Outlook

PRK

About 80 percent of patients have improved vision one month after PRK, and about 95 percent have improved vision after three months.

PRK recovery is longer and may be more painful than recovery from LASIK. 

While PRK may be the better choice for people with thinner corneas, the outcomes of both LASIK and PRK are similar after one year.

LASIK

About 90 percent of people who have LASIK enjoy vision that is between 20/20 and 20/40. 

Recovery from LASIK is faster, and the recovery is less painful, than with PRK. 

LASIK is a surgery that enjoys incredibly high rates of patient satisfaction and low risk of complications.

Who Is a Candidate?

PRK

If you have nearsightedness, farsightedness, or astigmatism, you may be a candidate for PRK.

Candidates must meet the following requirements for PRK:

• Be at least 18 years old
• Have realistic expectations for vision outcomes
• Have healthy eyes
• Have healthy corneas

If you are pregnant or breastfeeding, you should hold off on vision correction surgery. You are unlikely to be approved for PRK if your eyes are unhealthy, infected, or scarred, or you have cataracts. 

LASIK

Candidates must meet the following requirements for LASIK:

• Be at least 18 years old
• Have healthy eyes
• Have corneas that are adequately thick
• Have a steady eye prescription

Again, you should hold off on LASIK if you are pregnant or breastfeeding. You might not qualify if your eyes are unhealthy, or you have a history of severe dry eye or eye infections.

Pros & Cons of PRK & LASIK

PRK Pros

• Works for people with thinner corneas
• No risk of complications with the corneal flap
• Suitable for people with a high corrective prescription

PRK Cons 

• Longer recovery time 
• More painful recovery
• Risk of eye infection after surgery
• No exposure to bright sun for four to six weeks after surgery
• Need to possibly take more time off work
• No driving for at least a week

LASIK Pros

• Short recovery time 
• Almost immediate vision improvement
• Less risk of infection
• No bandage lens needed
• Less medication needed
• Fewer follow-up appointments
• No need to take extended time off work
• Driving usually possible the next day

LASIK Cons

• May not be advised for people with thin corneas
• Risk of corneal flap complications
• Risk of overcorrection or undercorrection
• Risk of dry eyes following surgery
• Risk of poor night vision

PRK vs. LASIK Eye Surgery

	PRK	LASIK
Recovery	4–6 weeks	1–2 days
Cost	$2,250–$3,000 per eye	$1,000–$3,000 per eye
Procedure time	About 30 minutes	About 15–20 minutes
Possible risks	Longer recovery time Post operative discomfort Light sensitivity Dry eyes Night blindnessInfection	Light sensitivity Dry eyes Night blindness Infection Corneal flap complications
Success rates	Very high	Very high
Criteria	18 years or older Not pregnant or breastfeeding Good eye health Good overall health	18 years or older Not pregnant or breastfeeding Good eye health Good overall health
Pros	Works for thin cornea No complications from corneal flap	Faster recovery Decreased postoperative discomfort Can do both eyes at the same time
Cons	Longer recovery Postoperative discomfort May need to take time off work May need to wait 1–2 weeks between eyes	Possible complications from corneal flap May result in dry eye  May result in problems with ectasia

How to Find a Provider

MyVision.org offers many resources to help answer questions about LASIK surgery, including what type of LASIK is right for you. Consulting with an eye care professional prior to undergoing LASIK will ensure all your questions are answered, and you have all the instructions and directions you need to set yourself up for a successful procedure. We can help you find a highly rated LASIK surgeon near you.

To find a quality provider for either PRK or LASIK, it pays to do some research ahead of time. Keep these things in mind as you research providers:

• Cheaper is not necessarily better. Be wary of any price that seems too good to be true. It likely is. 
• Evaluate several providers. Don’t sign up with the first surgeon you meet. Compare costs, patient ratings, experience, technology, and success rates.
• Confirm what is included in the cost. Some surgery centers charge for every pre-op and post-op appointment, so a low surgery price might not end up being that low after all. 

Set realistic expectations. Communicate your specific vision goals with your doctor. Set clear expectations about your goals for surgery and how you can reach them.

PRK vs. LASIK FAQs

Which is better: PRK vs. LASIK?

Both procedures can help you achieve clearer vision and less reliance on corrective lenses. Depending on the structural characteristics of your eyes, your surgeon may recommend either LASIK or PRK. 

People with thinner corneas may not be suited candidates for LASIK. Talk with your doctor to determine which surgery is best and safest for you. 

Patients are usually happy with the results of both PRK and LASIK.

Is PRK worse than LASIK?

While both surgeries can improve vision, PRK has a longer recovery time than LASIK. Recovery from PRK is also more uncomfortable than recovery from LASIK. As a result, more people choose LASIK compared to PRK. 

Is PRK or LASIK more expensive?

LASIK tends to be a bit more expensive than PRK. Prices vary across the country, and some providers charge the same amount for each procedure. Confirm pricing with prospective providers, and check if any discount programs are available through your insurance provider.

References

1. LASIK vs. PRK: Which Vision Correction Surgery Is Right for You? (December 2017). Michigan Health.

2. What Is Photorefractive Keratectomy (PRK)? (April 2022). American Academy of Ophthalmology.

3. LASIK. (October 2022). U.S. Food and Drug Administration.

4. LASIK — Laser Eye Surgery. (August 2022). American Academy of Ophthalmology.

5. LASIK. Casey Eye Institute, Oregon Health & Science University.

6. Refractive Fee Schedule. Stanford Eye Laser Center, Stanford Medicine.

7. How Much Does LASIK Cost? Vision Service Plan.

8. Laser Vision Correction Components. Wilmer Eye Institute. Johns Hopkins.

9. Lasers (Surgery). EyeWiki, American Academy of Ophthalmology.

10. Photorefractive Keratectomy. EyeWiki, American Academy of Ophthalmology.

11. Laser-Assisted in Situ Keratomileusis (LASIK) Versus Photorefractive Keratectomy (PRK) for Myopia. (January 2013). Cochrane Library.

12. LASIK Eye Surgery. (September 2021). Cleveland Clinic.

13. Photorefractive Keratectomy (PRK) Eye Surgery. (June 2021). Cleveland Clinic.

14. Photorefractive Keratectomy. (June 2022). StatPearls.

15. A Clinical Follow Up of PRK and LASIK in Eyes With Preoperative Abnormal Corneal Topographies. (June 2003). British Journal of Ophthalmology.

16. A Comparison of Visual Outcomes and Patient Satisfaction Between Photorefractive Keratectomy and Femtosecond Laser-Assisted In Situ Keratomileusis. (September 2017). Cureus.