PRK vs. LASIK: What's the Difference?

Glasses and contact lenses are a great way to maintain your vision, but they can be limiting. For outdoor enthusiasts or active professionals, blurry vision isn’t just an inconvenience; it can be a hazard.

Fortunately, laser eye surgeries like PRK and LASIK can eliminate the need for glasses or contacts. Here’s a breakdown of these two surgeries to help you decide which is better.

What’s the Difference Between LASIK and PRK?

LASIK (Laser-Assisted in Situ Keratomileusis) and PRK (Photorefractive Keratectomy) are effective laser vision correction procedures. The main difference lies in how the surgeon accesses your cornea for reshaping:

• LASIK. Creates a thin, hinged corneal flap using either a femtosecond laser or a microkeratome blade. This flap is lifted to reshape the underlying corneal layers with an excimer laser and then repositioned.
• PRK. Removes the outermost corneal layer (epithelium) to expose the corneal surface for reshaping. A special bandage contact lens protects your eye as the epithelium regenerates during the healing process.

Despite these procedural differences, PRK and LASIK use excimer laser technology to precisely correct refractive errors by shaping corneal tissue.

What are the Pros and Cons of Both Procedures?

LASIK has a faster recovery time with minimal discomfort. It’s suitable for a wide range of prescriptions and provides immediate results, with most people seeing visual improvements within 24 hours.

However, LASIK may result in over- or under-correction and isn’t suitable for people with thin corneas, severe dry eyes, or at high risk of vision injuries. In rare cases, LASIK does have a risk of infection and flap-related complications.

Meanwhile, PRK has a low risk of long-term issues, a low risk of flap-related complications, and a low risk of dry eyes. It’s also better for people with high prescriptions or thin corneas.

Unfortunately, PRK can be more uncomfortable during recovery and has a significantly longer recovery time, so you’ll need to attend more follow-up appointments. Lastly, there is a risk of infection. 

Which Procedure is Better for You?

Talk to an ophthalmologist regarding LASIK or PRK. After a thorough eye exam, they can determine which procedure is better for you. 

During the exam, they’ll discuss your health, prescription, lifestyle, and visual needs. However, there are some factors that you should consider when deciding between the two surgeries:

Factors	LASIK	PRK
Vision correction	Significant vision improvement within a day or two.	Vision improvement occurs within 5 days to a week
Recovery time	Full recovery typically occurs within a few weeks.	Complete recovery typically takes about three months, although most achieve usable vision by the end of the first month.
Suitability	Better for people with thick corneas, low to moderate refractive errors, and who participate in low-risk activities.	Better for people with thin corneas, dry eye tendencies, higher prescriptions, and who participate in high-risk activities like contact sports.

Who Is a Good Candidate for Each Procedure?

Not every patient is an ideal candidate for both procedures. Individual factors, lifestyle demands, and medical conditions influence whether LASIK or PRK is more suitable.

Here’s a quick overview of eligibility for both procedures:

LASIK	PRK
Patients who require rapid visual recovery with minimal downtime.	Have thin or irregular corneas.
Have sufficiently thick and structurally normal corneas.	Engage in high-impact or contact activities frequently.
Have mild-to-moderate refractive errors without complicating factors.	Have significant pre-existing dry eye symptoms.
Value comfort and convenience in the initial post-operative recovery phase.	Have an autoimmune condition that may affect healing.
Can protect your eyes from direct impact in your professional or recreational life.	Prefer to avoid flap-related complications entirely.

How to Prepare for Laser Eye Surgery

Here are a few things you can do to ensure you experience a smooth and efficient procedure:

• Stop wearing contacts for a week before the consultation.
• Avoid wearing makeup and lotions 24 hours before the surgery.
• Hydrate and avoid alcohol.

There are also a few things you can do to make yourself more comfortable during the procedure. For instance, avoid using perfumes or scented products on the day of the surgery. 

Wear comfortable clothing and arrange for someone to take you home after. It also helps to shower before surgery.

What to Expect During Recovery?

Recovery experiences differ significantly between PRK and LASIK, especially in the initial days and weeks following the procedures. LASIK patients might experience minimal discomfort, mild irritation, and dryness for one to two days.

Within 24 hours of the procedure, many patients achieve functional vision around 20/40 or better. Meanwhile, PRK involves a more prolonged and uncomfortable recovery. 

Since the surface layer of the cornea is entirely removed, patients usually experience significant discomfort, tearing, and sensitivity to bright lights for the first 2 to 4 days after surgery. 

Your vision will be blurry as the epithelium heals, and the protective bandage contact lens is usually removed around day 4 or 5, significantly improving comfort and clarity.

How to Manage Discomfort During Recovery

While LASIK generally offers faster healing, both procedures can involve some temporary discomfort. Here are our recommendations to make recovery go as smoothly as possible:

• Follow your surgeon’s recommendations for pain medication.
• Get plenty of rest and avoid activities that strain your eyes while prioritizing sleep. 
• Wear sunglasses when you go out. Your surgeon may also provide temporary contact lenses or eye shields, especially for PRK.
• Smoking can affect the healing process, so if you’re a smoker, consider quitting. 
• Follow your surgeon’s detailed post-op instructions to ensure proper healing and attend all scheduled follow-up appointments.

Things to Avoid During Recovery

Your doctor will recommend avoiding certain activities while recovering from PRK and LASIK. These include:

• Avoid driving for 1 to 2 days after LASIK and 4 to 5 days after PRK.
• Limit your use of computers and mobile devices for 1 to 2 days after LASIK and 2 to 3 days after PRK.
• Avoid strenuous activities or exercise for 1 week after LASIK and 2 to 3 weeks after PRK.
• Avoid swimming or any contact sports for at least 2 weeks after LASIK and 3 to 4 weeks after PRK.

What’s the Outcome for PRK and LASIK?

Long-term studies consistently show that visual outcomes for PRK and LASIK are nearly identical after healing. Around 90% of patients achieve 20/20 or better vision one year after surgery, regardless of the chosen method. 

While LASIK offers quicker visual recovery initially, final visual acuity and stability over time are comparable for both procedures.

How Much Do PRK and LASIK Cost?

The cost for PRK and LASIK tends to be similar, averaging around $2,200 to $2,500 per eye in the United States. Most vision centers price PRK and LASIK identically due to comparable technologies and resources used.

You might see different pricing models:

• Bundled pricing. Includes all visits, procedures, and standard follow-up care. Enhancements within a specified period (usually one year) may also be included.
• Tiered pricing. Lower initial price with separate costs for technology upgrades (wavefront-guided, femtosecond laser flap).

Other Ways to Pay For LASIK or PRK

Regardless of your choice, there are other ways to lower the cost of the procedure. For example:

• Flexible Spending Account (FSA) or Health Savings Account (HSA). Using pre-tax dollars reduces overall surgery cost by approximately 20-30%.
• Healthcare financing. Providers such as CareCredit or Alphaeon Credit offer plans with low monthly payments or interest-free periods.
• Special promotions. Discounts for military personnel, first responders, and educators may lower the total cost further.

Unfortunately, LASIK and PRK are considered elective surgeries, so most insurance plans don’t cover these procedures. However, some insurance companies may offer vision plans or cover some of the cost for specific circumstances. Check your insurance policy for more details.

How to Find an Eye Doctor Near You?

Look for a surgeon who is board-certified by the American Board of Ophthalmology. This ensures that the surgeon has the necessary expertise for a successful procedure.

You should ask about their track record of successful PRK or LASIK procedures. Don't be afraid to ask questions regarding the procedures, recovery times, risks, and benefits.

You should also discuss fees, payment options, and whether your insurance covers the procedure. Lastly, many practices offer additional consultations at no extra cost if you need time to make a decision.