PRK vs. LASIK: What’s The Difference?

PRK and LASIK are two of the most popular vision corrective procedures on the market. Both laser eye surgeries correct refractive errors and provide relief for patients with myopia, hyperopia, and astigmatism.

While the two surgeries offer an effective way to enjoy clear vision without glasses or contacts, the procedures themselves are not the same. Prospective patients will need to take into account a few key differences when deciding between PRK vs. LASIK.

With over 700,000 procedures a year, LASIK is the most commonly performed refractive eye surgery. LASIK surgery improves vision by using a laser to reshape the cornea and fix irregularities on the eye’s surface.

During surgery, the ophthalmologist creates a flap on the surface of the cornea. The flap is then moved to the side to operate on the stroma — the deep layers of the cornea. Once the procedure is complete, the doctor will put the flap back in place.

Like LASIK, PRK surgery corrects refractive errors by operating on the eye’s cornea. The surgery is not as popular as LASIK but has a longer history and equally impressive success rate.

Rather than creating a flap, during PRK the ophthalmologist removes a layer of superficial tissue at the top of the cornea, called the epithelium.

With this tissue removed, the doctor uses a laser to operate on the deeper layer of the cornea. Because the layer of removed tissue regenerates on its own, the eye doctor doesn’t repair it at the end of the surgery.

Patients can expect a swift recovery from LASIK surgery. At the end of the procedure, the thin flap cut in the eye is realigned. This shortens the recovery time and allows patients to notice improvements in vision quickly.

Visual recovery usually happens within 24 hours of the procedure. Patients can resume day-to-day activities shortly after surgery.

Most patients will not suffer acute pain or irritation in their recovery. Some may feel a slight burning sensation after the surgery, but in most cases, this goes away within a few hours.

This fast, smooth recovery is one of the reasons LASIK has become the most widely-performed vision corrective surgery.

PRK surgery is just as safe and effective as LASIK. However, it has a significantly longer recovery time — which can make some prefer LASIK vs. PRK.

Following PRK, the ophthalmologist will give patients a small bandage — similar to a contact lens — to wear as the eye heals. During this time, patients may experience discomfort, irritation, blurry vision, and light sensitivity.

To help with discomfort, and keep the eyes moist, doctors may prescribe eye drops and pain medication.

Visual recovery can take anywhere from 10 to 14 days. People may notice periodic improvements to their vision. However, they will not be able to engage in daily activities such as exercise and driving until the eye fully heals.

When comparing PRK vs. LASIK, the cost can be a defining factor. These surgeries have similar but not identical costs.

LASIK is often more expensive than PRK upfront. This is because the surgeon needs to use an additional laser to create a flap during the procedure.

On average, LASIK costs $1,500 to $3,500 per eye — $3,000 to $7,000 total. Whereas PRK surgery ranges from $1750 to $5,000 in total.

Both LASIK and PRK are considered elective surgeries and therefore, are not covered by insurance.

However, there are payment plans available for those who cannot cover the cost upfront. For instance, our office offers several financing options for LASIK and PRK. These include:

• Paying for the procedure through CareCredit.

• Using the funds from an HSA (health savings account) as payment.

• Using the pre-tax funds you set aside in an employee flex account to pay.

Using flex account or HSA dollars provides a substantial discount because you are paying with funds before you’ve paid taxes on them – you’re subtracting them from your overall taxable income amount. This is why they’re referred to as “pre-tax dollars.”

For example, let’s say your tax rate is 30% and you want to pay for a $5,000 surgery. If you transfer $5,000 to your HSA or Flex account for the procedure, that money is protected from being taxed. At a 30% tax rate, that means you’re avoiding $1,500 in taxes on that money. Therefore, you’ll ultimately pay $1500 less than if you had taken the money home and put it into your regular checking account.

Essentially, using pre-tax monies on a $5,000 procedure costs you $3,500.

LASIK is the more popular of the two surgeries — but popular doesn’t always mean better. The differences in the procedures, cost, and recovery time mean each surgery comes with advantages and disadvantages.

There are a number of factors to consider when choosing between LASIK vs. PRK and making a final decision on which option is better for your eye care needs.

LASIK surgery is considered the more convenient of the two options. Because ophthalmologists reposition the flap of the eye during surgery, patients can enjoy a swift, often same day-recovery.

This allows them to:

• Resume driving the day after surgery.

• Avoid taking time off work.

• Return to normal activities more quickly.

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

PRK has been around for more time than LASIK. The procedure was first introduced in 1987 and has a long history of success.

Experts also believe PRK has fewer long-term complications. Following LASIK surgery, the realigned flap in the cornea can cause issues for some patients. Thus, PRK is considered the safer of the two surgeries.

Additionally, not all patients are considered good candidates for LASIK. PRK surgery is 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 LASIK flap, such as athletes and pilots.

Both surgeries are safe and effective — with over a 98.5% success rate for patients who wish to enjoy sharper vision.

The decision will usually be made on a case-by-case basis depending on a patient's history, vision, and personal life.

If you are considering either surgery, it’s best to contact your eye doctor. They can give a more detailed list of pros and cons and help make a more informed choice about which surgery best fits your unique circumstances.