Procedures: PRK / LASEK Surgery

PRK / LASEK vs. LASIK

The key difference between PRK (also called LASEK) and LASIK surgery has to do with where the laser sculpting takes place. With LASEK, the laser energy is applied directly to the surface of the cornea, whereas with LASIK, the outer corneal layer is spared and the laser energy is applied to the middle corneal layer.

The distinction between LASEK and LASIK has to do with the first step of the procedure. In LASIK, the first step involves creating a thin flap from your cornea's outer layer (known as the epithelium). This flap is then peeled back so that the laser can sculpt the corneal tissue that lies underneath (the stroma layer). Once the LASIK sculpting is complete, the flap is repositioned to cover the site and the outer corneal layer remains intact.

The LASEK procedure, on the other hand, involves no flap creation from the cornea’s outer layer. In LASEK, your surgeon carefully swabs your outer cornea with a chemical to gently dissolve the tissue and expose the underlying layer. Next, the laser works directly on the stromal layer, precisely sculpting it to achieve vision correction.

Because there is no protective flap created in the LASEK process, your surgeon puts a clear soft contact lens bandage on your freshly sculpted cornea to cover the site until the outer layer grows back. This occurs in about three or four days when the contact bandage is removed by your surgeon. 

It’s important to know that at AGEI, our surgeons use the same cool ultraviolet iFS Intralase excimer laser in both LASEK and LASIK procedures, so the final vision correction results are quite similar for both.

What happens during PRK eye surgery?

At the start of the PRK procedure, your surgeon uses anesthetic drops to numb your eye. Next, the thin outer layer of your cornea, called the epithelium, is gently removed using chemicals in order to make way for laser sculpting of the middle corneal layer, called the stroma, that lies just below.

You are then asked to focus on a light source as the excimer laser gently sculpts the stromal layer of your cornea. The entire process takes about 10 minutes per eye.

At the end of the procedure, a clear bandage contact lens is placed over your cornea to help with post-op discomfort, which can be mild to moderate.

PRK / LASEK recovery

Immediately following the procedure, you may feel like there is something in your eye (the protective contact lens) and you may also experience tearing, light sensitivity, a moderate amount of blurred vision, and seeing halos around bright objects at night. All of that is normal.

These symptoms can last for the first 3 days after surgery and are usually worst on the second and third days, but they quickly improve as the corneal surface heals, usually by post-op day four or five.

To help decrease discomfort during the healing process, chilled lubricating and medicated eye drops are prescribed by your doctor. These drops also help promote healing and reduce the risk of scar formation and infection.

It's important to know that you won’t be able to drive or work on the day of your surgery. Many patients also feel like they need to take several days off from work to recuperate. This recovery time should be taken into consideration when planning a LASEK procedure. 

By the time your bandage contact lens is removed (on post-op day 4 or so), your vision will be much improved, generally ranging between 20/30 and 20/50, depending on the extent of correction done. By then, you will be comfortable enough to return to work.

As your cornea's surface continues to heal and smooth out over the next 4-6 weeks, your vision will progressively improve. Our patients typically achieve their best possible vision around 3 months following surgery. Because everyone heals at different rates, some folks might take a little longer to obtain their best visual acuity. By the time you are one-year post-surgery, your eye is considered to be stable.

Why should I have PRK surgery performed at AEI?

AGEI offers a group of highly trained eye surgeons headed by Dr. Kerry Assil, a world-renown specialist recognized for his contributions to the field of laser refractive surgery. In fact, Dr. Assil has been involved in dozens of FDA clinical trials for laser devices and has developed new techniques in laser refractive surgery.

Today, AGEI is a celebrated ophthalmology practice recognized for its standard-setting level of care and continuous efforts to advance the fields of laser refractive surgery and artificial lens implantation.

People from around the world seek out Dr. Assil to perform surgery on their eyes. Our patients include other eye surgeons, industry leaders, athletes, medical professionals, and celebrities. But, more important to Dr. Assil, every day Los Angelinos seek out AGEI to manage their eye health.