What’s the Difference Between PRK and LASIK?

Laser refractive eye surgery is a procedure that can decrease your need for glasses or contacts. There are several types of laser eye surgery — including LASIK and PRK. 

LASIK stands for “laser-assisted in-situ keratomileusis.” The FDA approved the procedure in 1998. Every year providers perform about 700,000 LASIK procedures in the U.S, making it the most common laser refractive surgery.

PRK stands for “photorefractive keratectomy.” The FDA approved it in 1996, and it’s another popular laser treatment.

But how do you know which option is right for you? Let’s take a closer look at each procedure and what you should consider when thinking about getting laser eye surgery. 

How do PRK and LASIK work?

Both PRK and LASIK work by reshaping the cornea. The cornea is the clear, front layer of the eye. When light rays enter the eye, the rays pass through the cornea to the retina — the back part of the eye. If light hits the retina in the wrong place, your vision will be blurry. 

This happens in certain eye conditions, like:

• Myopia

• Hyperopia

• Astigmatism

With cornea reshaping, the light will enter the eye at a different angle so that it hits the retina in a better spot. This makes your vision less blurry. 

Glasses and contact lenses temporarily adjust how the light enters your eye. If you take them off, your vision goes back to being blurry. With corneal reshaping, you have a permanent change to how light enters your eye. The hope is that this will decrease (or even eliminate) your need for glasses and contact lenses. 

The only providers who do these surgeries are ophthalmologists — medical doctors who complete specialized training in eye conditions and surgery.  

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How is PRK different from LASIK?

PRK and LASIK use different surgical techniques to reshape the cornea: 

• LASIK: The ophthalmologist makes a small incision in your cornea. This creates a corneal flap, which they fold back. Then a laser removes a portion of the cornea and the ophthalmologist puts the corneal flap back down. 

• PRK: The ophthalmologist uses a blade, alcohol-based liquid, or brush to remove the outer layer of the cornea. Then a laser reshapes the cornea. The procedure doesn’t create a corneal flap. 

Otherwise, the surgery experience isn’t too different. An ophthalmologist does both surgeries in their office. They take about 30 minutes or less. 

You’ll need several follow-up visits to make sure your eyes are healing. You’ll also need to use special eye drops after both types of surgery. 

After PRK, you need to temporarily use a bandage contact lens to help with eye healing. 

What’s the recovery period like for PRK vs LASIK?

One point in favor of LASIK is that recovery is often faster. Some people notice improved vision within a few hours or the morning after the procedure. 

With PRK, it can take a few weeks or even longer to see improvement in your vision. That’s because the cells that the ophthalmologist removed during surgery take time to grow back. You may also notice a scratchy sensation — but your bandage will help make that feeling better.

How long after laser eye surgery can you return to work?

You’ll need to take a few days off work after laser eye surgery. Your eyes may be quite sensitive to light, and using a computer may be difficult right after your procedure. 

Most people return to work 1 to 2 days after LASIK and 4 to 5 days after PRK.

How do I know if PRK or LASIK is right for me?

Despite what some advertisements might claim, there’s no “best” type of laser eye surgery. But there might be a “best” option for your specific situation. Your ophthalmologist will help you decide if PRK or LASIK is a better option for you. 

Some things that will factor into your decision include:  

• Corneal thickness: If your cornea is too thin, PRK might be a better option. Your ophthalmologist will test your corneal thickness as part of your initial exam.

• Lifestyle: If you’re an athlete or very active, PRK might be a better choice. That’s because vigorous exercise can dislodge a corneal flap. 

• Glaucoma: If you have mild glaucoma, you might be a candidate for LASIK. 

Some other things that can help decide if you’re a good candidate for LASIK or PRK include:

• Eye health: Laser eye surgery is safer and more effective if you have good eye health. That means if you have certain eye conditions — like cataracts or a history of eye infections — you might not be able to get laser eye surgery. If you have dry eye, you might still be able to get laser surgery if you have well-treated dry eye.

• Degree of refractive error: If you have a very high refractive error, a more significant myopia, you may not be a good candidate for laser eye surgery. That’s because the surgery might not be able to improve your vision. 

• Age: Most ophthalmologists recommend waiting until you’re at least 21 years old to get laser eye surgery. That’s because your refractive error is more likely to stay the same as you get older. 

• Pregnancy: If you’re pregnant or nursing, you should wait to get laser surgery. That’s because the hormone levels can influence the shape of your cornea and change your refractive error. 

• Keratoconus: If you or a family member have keratoconus, you cannot have LASIK or PRK surgery. Your ophthalmologist will test you for this condition as part of your initial exam.

Both PRK and LASIK are effective. But it’s important to have realistic expectations for your laser eye surgery. Laser surgery might not give you perfect vision. And you may still need to use glasses or contacts sometimes. Laser surgery also can’t correct or prevent presbyopia, so as you get older you might still need reading glasses.

You might also need a second treatment. Studies show anywhere from 3% to 35% of people need a second treatment. If you have a higher refractive error, there’s a higher chance of needing a second LASIK or PRK procedure. 

Insurance doesn't cover laser eye surgery, so it’s important to think about the financial implications of a second treatment. Some centers offer discounts and payment plans — talk to your ophthalmologist about your financial concerns before starting your treatment.

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Written by:

Nishika Reddy, MD

Nishika Reddy, MD, is an attending physician at the University of Utah. She provides comprehensive and cornea medical care at the Moran Eye Center and serves as clinical assistant professor.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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