Laser eye surgery: What’s the difference between LASIK and PRK?

Laser eye surgeries have become popular over the last decade.  LASIK and PRK are two options patients have today.  While the end result for patients undergoing either procedure is improved vision, the process and recovery times of the two surgeries differ.  Talk to your eye doctor about the best option for you.


Information Text:

Dr. Francis Price, Price Vision Group:   “LASIK is where we cut a very thin flap and lift it up, do the sculpturing in the rest of the cornea, put the flap back down.  The advantage  of that is  that you have very little discomfort , little discomfort for 4 or 5 hours, and then no pain after that.  Now another way to do that is treatment called PRK—which is where we use the laser directly on the surface of the cornea, and that works well too, but the problem is that when you do the surface, it takes a few days for the skin covering to grow back.  So that you go through a period that typically is a little bit uncomfortable—some people would say real uncomfortable—but it’s different for different people.  The quickness of visual recovery with LASIK which is usually the next day to the first week, whereas PRK can take anywhere from a few weeks to a couple months.” 

On PRK: Price says one consideration when deciding if a patient is a good candidate for LASIK is the thickness of their cornea in relation to their prescription. Price says if a patient’s cornea is too thin to create a flap, the PRK treatment can be applied to the surface of the cornea.

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Laser surgery beneath surface of cornea

Discomfort for 4 to 5 hours

PRK photorefractive keratectomy

Laser surgery on surface of cornea

Discomfort for several days

Vision recovery time:

LASIK:  Next day or within first week

PRK:  Few weeks to a couple of months

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Here is my cautionary tale. After years of considering laser surgery, I finally had Lasik at a place in Montreal. I chose it carefully based on extensive reading…such as you should select a surgeon who had performed at least 10,000 procedures, etc. Initially, I was very happy because I was no longer legally blind without corrective lenses! Unfortunately, it was only a few months before I was wearing glasses to drive because I couldn't see road signs well, especially at night. It has been about 6 years since I had the procedure and I wear contacts all the time now. I wouldn’t mind so much, except I can’t even see a clock from across the room as I could for the first few years. Admittedly, I had the surgery at 41, so I was at the point where vision decreases, but I am disappointed the result didn’t last longer. Two brothers also had the surgery and they have experienced the same thing. I don’t completely regret having it done because I can still see better than I could before and I am not totally dependent on glasses, but I don’t feel I got my monies worth. I am sure many people are happy with the results, but if you’re 40ish, you might want to look at other options because this might not give you the results you’re hoping for. Also, I opted for the more expensive procedure at the time, called Zioptix or something like that. I don’t know if they still do it, but it was supposedly custom mapped to my eyes so less tissue would be removed - meaning I could have my eyes “tweaked” again, if required. Well, given my results, there is no way I’d have more tissue removed so if they try to talk you into that, think about it long and hard. Ironically, it was about three years after my surgery that I found out a lot of people experienced the same issues as my brothers and me.

I too had the lasik surgery at a later age and for a few years was very happy with the result. But as you said, it began to wear off to the point where glasses and or contacts were considered. I am thinking about having my eyes tweaked but am now rethinking this because of your comments. Two of my children also had the surgery and both of them have or should have glasses. Quite disappointing given the expense. I will really think about this now. Thank you for recounting your experiences.

In the U.S. military, they only allow service members to get PRK because LASIK carries certain long-term risks. The detached flap of skin that Dr. Price was describing carries a risk, while slight, of becoming torn and re-detached. This can cause temporary blindness and in some cases, irreversible damage to vision. This risk is greatly enhanced for people who may experience rapid pressure changes through flying or diving. PRK is hands down a *safer* procedure, especially for patients who have thin corneal tissue, or flat corneas. LASIK is hands down a *more comfortable* procedure. So, even though LASIK is certainly less painful, it is also less safe - and for some patients not even a viable option. This is an important distinction to know.

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Rachel Hardy

Angie’s List videographer Rachel Hardy produces videos focused on home improvement tips and trends, health care issues, and pet services.

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