PRK vs LASIK, how are they different?

How are PRK and LASIK similar?

PRK (which stands for photo-refractive keratectomy and was FDA-approved in 1995) and LASIK (laser-assisted in-situ keratomileusis was FDA-approved in 1999) are the most two popular laser-assisted procedures to correct vision focusing deficits, known as refractive errors. Both techniques change the shape of the cornea, have very high success rates, and can be used to correct the following vision problems:

• Nearsightedness (myopia) – the inability to see distant objects clearly
• Farsightedness (hyperopia) – the inability to see up close objects clearly
• Astigmatism – an irregularly shaped eye that results in blurry vision
• Presbyopia – the inability to read the fine print that occurs with age

Both laser eye surgeries work by reshaping the cornea (the clear “windshield” over the seeing portion of your eye), which is responsible for two-thirds of your eye’s focusing ability. The two techniques differ in how they access your corneal tissue to achieve vision correction.

Both procedures are performed using numbing eye drops and, if needed, medication to help you relax and maximize your comfort.

How PRK and LASIK differ

With PRK, your eye surgeon removes your cornea's outer layer (epithelium) before reshaping the underlying corneal tissue to correct any irregularities responsible for focusing errors. By removing the cornea's outer layer, PRK exposes the surgical area until the corneal epithelium can regenerate naturally.

With LASIK, a femtosecond laser microkeratome is used to create a micro-thin flap from the outer cornea that is then gently folded back to give the surgeon access to a deeper corneal layer (the stroma) where the reshaping process takes place using a second.

What happens during the PRK surgical procedure?

The PRK procedure has three steps:

1. 1. The outer corneal layer (the epithelium) over the seeing portion of your eye is thoroughly removed to expose the middle corneal layer (the stroma).
   2. Next, an excimer laser is used to smooth out (ablate) irregularities responsible for focusing errors in the newly exposed corneal tissue.
   3. A contact lens bandage is placed over your cornea to promote healing as your outer corneal layer regenerates.

What happens during LASIK? 

The LASIK procedure also has three steps:

1. 1. A femtosecond laser cuts a microscopically thin hinged flap from the outer corneal layer (the epithelium). The flap is flipped open like a book cover with a vertical hinge (imagine the “book’s binding”) just outside the outer border of your iris and outside your field of vision.
   2. Next, an excimer laser smooths out (ablates) irregularities responsible for focusing errors in the newly exposed corneal tissue.
   3. Finally, the surgeon gently tucks the epithelial flap back into place (imagine the book cover closing), where it will re-seal spontaneously.

Which is better: PRK or LASIK? 

The fact is that both techniques are equally effective and have equivalent outcomes for correcting your vision. They differ in their recovery time and the degree of discomfort patients experience.

What is the recovery time of LASIK and PRK to achieve crisp vision 

Whereas most LASIK patients can see clearly and may have near-perfect vision the day after surgery, typical PRK recovery can take two weeks to a month before patients achieve crisp vision. This is important because PRK patients cannot be cleared to drive until their vision has normalized.

Vision will be tested at each postop follow-up to monitor healing progress. Peak vision clarity will typically be attained at three months with a LASIK procedure and can take up to six months with PRK.

Recovering from PRK

PRK procedure recovery can be uncomfortable. Patients will wear a bandage contact lens for a week, which can cause distorted vision, blurriness, and irritation. They’ll also experience light sensitivity during the initial healing process. Your doctor will prescribe pain medications and lubricating or medicated eye drops to help manage discomfort.

Recovering from LASIK

LASIK recovery patients typically don’t experience much post-operative pain or discomfort. Rarely, some patients might feel burning in their eyes which typically resolves within several hours of surgery. As with PRK, lubricating or medicated eye drops will be prescribed to address discomfort, which should resolve within a few days.

What are the risks and side effects of PRK and LASIK?

As with any surgery, both procedures carry some risks. That’s why choosing a highly skilled surgeon you trust is critically important. Ophthalmologists agree that both laser vision correction procedures share the following risks:

• Postop eye dryness. Disruption of corneal nerves can reduce tear production for six months or more following surgery and is seen more with LASIK patients. With the latest generation of LASIK surgery called EagleVision LASIK (available only at Assil Gaur Eye Institute), we have seen a reduction of postop dry eye symptoms.
• Visual disturbances. Reduced night vision, glare, double vision, or seeing halos around lights at night can last for weeks or even indefinitely. These also seem to occur more frequently in LASIK patients.
• Under-correction. Insufficient visual acuity can occur among nearsighted patients if their surgery does not remove enough corneal tissue. This requires an enhancement procedure to attain better vision.
• New-onset visual distortion. If too much corneal tissue is removed, it can weaken corneal tissue and make the eye bulge due to pressure within the eye. The resulting vision distortions are known as ectasia and require prompt aggressive treatment to avoid vision loss.
• Astigmatism. If corneal tissue isn’t removed evenly, it can result in alterations in corneal curvature, warranting further surgery or the need to wear glasses or contacts.
• Permanent vision loss. With every eye surgery, there’s a risk of complications that can lead to partial or total vision loss, no matter how infinitesimal. This includes the possibility that your vision may seem a bit cloudy or blurrier than before.

How to know if I’m a good candidate for PRK versus LASIK surgery? 

You and your eye doctor must consider several important factors when selecting whether PRK or LASIK is right for you. These include:

• How bad is your vision? People needing high vision correction (say -8.00 or -9.00 diopters) are often better candidates for PRK. Their corneas lack sufficient depth to safely reshape the middle layer after creating the LASIK flap. This is also true for patients with naturally thin corneas.
• How much downtime can you spare for recovery? LASIK patients can usually see clearly within a few hours and can, for the most part, return to work the day after surgery, not so with PRK patients, who experience more discomfort and a longer healing time. PRK patients are usually 70 percent healed within a week postop and 90 percent after one month. This means they must wait at least a week or more before being cleared to drive.
• Are you good at following doctor’s orders? LASIK patients will be asked to refrain from rubbing their eyes during recovery to avoid disrupting their flap. PRK patients must wear an uncomfortable bandage contact lens for a week and refrain from entering bright sunlight for four to six weeks. Unprotected UV exposure can lead to permanently hazy vision.
• Are you an extremely active person? Professional athletes, or those with occupations placing them at higher risk of eye injury, have often opted for PRK to avoid the possibility of flap complications such as dislodging the LASIK corneal flap. The good news is that this concern is becoming a thing of the past thanks to EagleVIsion LASIK, the choice of many high-contact professional athletes, including NBA stars such as LeBron James and Chris Paul.
• Is cost an issue? Medical insurance doesn’t usually cover PRK and LASIK and considers them elective. If budget is a concern, PRK surgery is more economical because it involves only one laser (instead of two for LASIK: the laser for flap creation and another laser for corneal ablation) and less time for surgical planning (due to the more customized nature of LASIK surgery).

How will I know if PRK or LASIK eye surgery suits me? 

The truth is that researching refractive surgery can be daunting, given all the surgery options currently being marketed and the dizzying claims being tossed about. We can’t stress enough the importance of doing your homework before undergoing irreversible surgery on your eyes.

At Assil Gaur Eye Institute, we pride ourselves on offering the most advanced surgical techniques and state-of-the-art refractive technology to provide our patients with the safest, most effective procedure designed to optimize their surgical experience and visual outcomes.

We invite you to request your complimentary LASIK consultation and eye exam at Assil Gaur Eye Institute. Our eye doctors will ask about your overall health, lifestyle, and vision goals before advising you regarding your eligibility for different vision correction procedures. Our American Academy of Ophthalmology member LASIK surgeons will also explain how they perform the surgery and answer your questions. We want to make sure you feel comfortable that you have the information you need and that you are confident that you’re in the right hands for all your vision needs.

Why choose Assil Gaur Eye Institute for your eye care?

At AGEI, you will experience state-of-the-art eye health that brings revolutionary ophthalmology technologies together with experienced vision care professionals. Our goal is to help you achieve your best possible vision. 

Please call 866-945-2745 or visit us here to make an appointment online at our Beverly Hills or Santa Monica eye centers. If you are experiencing any concerning symptoms, contact us immediately to determine the best time to schedule an exam.

The Assil Gaur Eye Institute is California’s premier eye institute for glaucoma, cataract surgery, retina conditions such as macular degeneration, diabetic eye conditions, dry eye, and many others, with the best patient care available anywhere.

We are conveniently located for patients throughout Southern California and the Los Angeles area in or near Beverly Hills, Santa Monica, West Los Angeles, West Hollywood, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, and Downtown Los Angeles.