Prk vs Lasik – which Option is Best for You?

If you’re contemplating laser eye surgery, one of the options you need to consider is PRK vs Lasik , and decide which one is better for you.

While Lasik is currently the most popular form of laser eye surgery, it is not necessarily the right solution for everyone wanting to move away from the inconvenience of corrective glasses or contact lenses.

PRK vs Lasik – quick summary:

Lasik is less painful;
The recovery time is shorter after lasik;
There is no corneal flap – so there is no chance of flap complications ;
PRK is more suitable for people involved in activities or sports that might result in some kind of impact on the eye (boxing, martial arts);
The PRK procedure can be used on corneas that are too thin for Lasik;

PRK vs Lasik – from Scalpel to Laser

PRK is an improvement on the original process, which was called radial keratotomy (the RK part of PRK). In this procedure surgeons used a scalpel to make a radial pattern of fine cuts in the cornea to improve a patient’s vision.

The obvious risk was that the procedure relied completely on the eye surgeon’s experience, skill – and steady hands.

The newer PRK process (photorefractive keratectomy) uses a laser.

For most people weighing up the PRK vs Lasik options, the big difference between the two is that in Lasik surgery, the doctor cuts a flap in the surface of the cornea, lifts the flap out of the way, and then uses a laser on the inner tissue the cornea.

The flap is then folded back into place and is held there by corneal suction, so no stitches are needed.

In PRK, on the other hand, there is no need for a flap, as the laser is used directly on the surface of the cornea to reshape it.

PRK vs Lasik – the PRK Procedure

The surgeon removes the top layer of the cornea, which is called the epithelium. This later is only a few cells thick, and is usually softened with alcohol and then removed by hand or with a laser.

The surgeon then uses an excimer laser to reshape the surface of the cornea. After anti-biotic and anti-inflammatory treatment the eye is covered with a bandage contact lens. This lens stays in place for a few days and is removed once the epithelium has had a chance to grow back.

You will probably need to use medicated eye drops for anything up to six months after the procedure to stop or minimize haze or possible scarring.

PRK vs Lasik – the Lasik Procedure

Your eye (or eyes) will be numbed so that you do not feel any pain. The surgeon will then cut a flap in the front of the cornea using either a microkeratome (a blade) or a femtosecond laser in a procedure that normally takes less than a minute for each eye.

The flap is folded back and the surgeon then uses an excimer laser to remove minute bits of the cornea and reshape it.

The flap is put back in place and the procedure is finished; it probably lasts no more than 15 minutes per eye.

Most people feel no pain, although there may be some prescribed eye drop medications.

Follow your eye doctor’s instructions; most surgeons recommend staying away from work for a few days, and no strenuous activity for a week or so.

Anyone involved in contact sports will need to give the eye a longer healing time.

PRK vs Lasik – the Pros and Cons of the Two Procedures

Lasik

By far the most common reason for choosing Lasik is that the procedure is virtually painless.

The second major advantage is that healing takes place much faster, and there is much less discomfort after the procedure.

A third benefit is that patients commonly start seeing better very quickly, sometimes within hours of the operation.

On the other hand, lasik does result in a reduction of the thickness of the corneal stroma, which is the middle of the five layers that make up the cornea itself.

When you consider that the cornea of the average adult is only half a millimetre thick, it is easy to appreciate the extreme accuracy that is needed in any form of laser eye surgery, and the possibility of a less than optimum outcome.

Lasik has a re-treatment rate of somewhere between 5 and 10%, versus the 1 to 2% of PRK.

There are more likely to be glare and dry eye problems (see separate articles) with Lasik than with PRK.

But haze issues can be more of a problem with PRK than with Lasik.

PRK

First and foremost, because there is no flap, there are no flap problems.

If your degree of shortsightedness (myopia) is low to moderate and your cornea is thinner than normal, then PRK is probably safer than Lasik.

Your eye or eyes will be painful (unlike Lasik) for a week or more. Visual recovery will take longer; you could need anything up to six months to achieve optimal vision. During that period you could suffer from blurred vision, have problems with glare, and be sensitive to light.

PRK vs Lasik – a Summary

Here is a neat summary from a practitioner:

“LASIK was developed to give faster results with less discomfort,” says Dr. Neil Griffin, corneal disease, Lasik and cataract specialist with Carolina Eye Associates.

But he also warns:

“Both surgical options, PRK and Lasik, have their advantages and disadvantages.”

A common theme in chat rooms is the fear of something going wrong during the procedure.

Remember that both procedures involve surgery, and there are never any guarantees with surgery.

Both procedures give broadly the same results in the long term.

Lasik offers freedom from pain and a quicker recovery.

PRK offers freedom from any chance of a dislodged flap or flap complications, and the option of laser eye treatment for patients who have thin corneas and for whom Lasik would be too risky.

Before deciding which one is right for you, talk to your surgeon, who will help you balance out the pros and cons of PRK vs Lasik.

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