LASIK vs. LASEK vs. PRK: What’s The Difference

LASIK, LASEK, and PRK are three of the most common laser eye surgeries used to correct refractive errors in the eyes.

The three surgeries have the same goal and similar procedures, but they are not identical. Similarities in the naming, in particular LASIK vs. LASEK, add another layer of confusion for patients trying to understand the different surgeries.

Knowing the details of each, as well as their similarities and differences, will keep patients informed and help them choose the procedure that best suits their eye care needs.

With over 700,000 procedures a year, LASIK (laser-assisted in-situ keratomileusis) is the most commonly performed refractive eye surgery. The surgery improves vision by using a laser to reshape the cornea and fix irregularities on the surface of the eye.

During surgery, the doctor cuts a flap on the cornea's surface to operate on the stroma — deep layers of the cornea. The flap is repositioned after the treatment is finished.

PRK is a surgery that corrects refractive errors in the eye. It is not as popular as LASIK but has a longer history and equally impressive success rate.

During the surgery, ophthalmologists remove a layer of superficial tissue in the cornea to operate on the stroma. The layer of removed tissue will regenerate on its own, so the doctor does not repair it.

LASIK vs. LASEK. The procedures share nearly identical names, but LASEK (laser epithelial keratomileusis) differs from its more well-known counterpart,

In fact, LASEK has more in common with PRK surgery than LASIK. The two surgeries are nearly identical, with some minor distinctions.

Both LASEK and PRK are laser-assisted surgeries that correct for refractive errors.

Unlike LASIK, in both PRK and LASEK, the eye doctor operates on a layer of superficial tissue at the top of the cornea, called the epithelium.

LASEK and PRK differ in how they deal with the epithelial tissue.

In PRK, the doctor removes the epithelium and allows it to grow back on its own. For some, this is considered a more natural form of healing. Since the epithelium is allowed to grow back on its own, recovery is often slightly more predictable than LASEK.

In LASEK, the doctor pushes the epithelium to the side and replaces it at the end of surgery. Some prefer LASEK because sliding the epithelium to the side can create a smoother surface for the laser to operate on. This can lead to a more comfortable recovery for certain patients.

Of the three surgeries, LASIK is by far the most popular. There are around 700,000 LASIK surgeries performed every year in the United States.

When given the option of refractive surgery, only around 10% of patients opt to have PRK or LASEK surgery.

Because the doctor repairs the torn flap, patients enjoy a swift recovery from LASIK surgery. This is the primary reason LASIK is the most popular of the three surgeries.

Visual recovery happens within 24 hours of a LASIK procedure. Patients can usually resume day-to-day activities shortly after surgery. Pain and irritation are uncommon during LASIK recovery.

Both PRK and LASEK are just as safe and effective as LASIK, but they have longer recovery times. Patients may experience discomfort 24 to 48 hours after the surgeries. Visual recovery can take anywhere from 10 to 14 days as the epithelium is repaired.

All surgeries have similar costs. On average LASIK costs $1,500 to $3,500 per eye — $3,000 to $7,000 total. In comparison, PRK and LASEK surgery range from $1750 to $5,000 total.

PRK and LASEK are often cheaper upfront because they require fewer incisions, but patients may pay more in the long run for post-surgery checkups.

LASIK, LASEK, and PRK are considered elective surgeries and are not covered by insurance. However, there are payment plans available for those who wish to receive one of the procedures but cannot pay for everything upfront.

LASIK surgery is considered the more convenient of the three options. This is because ophthalmologists reshape the flap of the eye during LASIK surgery. This allows patients to enjoy a swift, often same-day recovery. This means patients can:

• Drive themselves to and from surgery.

• Avoid taking time off work.

• Resume normal activities more quickly.

• Have fewer follow-up visits to the eye doctor.

PRK and LASEK surgery may have less potential for long-term complications and are considered safer by some. This is because the doctor does not leave a flap in the cornea.

Additionally, not all patients are considered good candidates for LASIK. Experts consider PRK or LASEK a better option for:

• People with thin corneas

• Patients at a greater risk for eye injury

• People with active jobs who may be affected by the flap in the eye — which moves with physical activity. These include athletes and pilots.

LASIK vs. PRK vs. LASEK — which is the best choice?

There is not a clear choice that can apply to all patients and scenarios. The three surgeries are all considered safe and effective, with over a 90% success rate for patients who wish to enjoy sharper vision.

If a patient is considering one of the surgeries, the best course of action is to contact their eye doctor for an opinion. The doctor can go into more detail about each procedure and help the patient make an informed choice about which best suits their unique goals and circumstances.