PRK vs. LASIK: A Comprehensive Guide to Laser Eye Surgeries

Over 230 million American adults have vision problems. About two-thirds wear glasses or contact lenses to combat them. However, laser eye surgery has also become a popular option.

Photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK) are two common vision correction surgery options. If your ophthalmology practice specializes in providing patients with improved vision, they could benefit from one of these types of corrective eye surgery.

So, what are the differences between PRK vs. LASIK? These vision correction procedures share some similarities — for example, both LASIK and PRK procedures involve laser vision correction — but many aspects set them apart.

Let’s compare PRK and LASIK so you can assist patients in picking the correct form of laser eye surgery.

Understanding PRK and LASIK

Since PRK and LASIK are both refractive surgery options that rely on lasers when correcting vision, they sometimes get lumped together. However, spotting the differences between them is easy.

Check out their definitions so your ophthalmology practice’s patients will have no trouble differentiating them.

What Is PRK?

PRK is a type of laser eye surgery. It was developed by Dr. Steven Trokel in the early 1980s. Dr. Theo Seiler performed the first PRK surgery in 1987, and the U.S. Food and Drug Administration approved PRK in 1995.

PRK involves removing and reshaping a person’s cornea with an excimer laser. This laser removes a tiny portion of the epithelium — the cornea’s outer layer — and reshapes the corneal tissue underneath it. Natural regeneration occurs, allowing the epithelium and other corneal tissue to regrow.

PRK was the most popular refractive surgery procedure in the U.S. in the 1990s. PRK laser eye surgery is still used today, especially among those with thin corneas. It treats nearsightedness, farsightedness, and astigmatism.

What Is LASIK?

LASIK is another type of laser eye surgery. Dr. Gholam A. Peyman developed it in the late 1980s. Dr. Ioannis G. Pallikaris performed the first LASIK procedure in 1989, and the FDA approved LASIK in 1999.

LASIK involves reshaping a person’s cornea with an excimer laser and a femtosecond laser. The femtosecond laser creates a small flap in the cornea before the excimer laser removes tissue from the stroma, the cornea’s middle layer. Laser reshaping of the cornea occurs before the corneal flap is repositioned and secured.

Shortly after the FDA approved LASIK, it became the more popular choice over PRK. Over 700,000 LASIK surgeries are performed in the U.S. annually to treat nearsightedness, farsightedness, and astigmatism.

Key Differences Between PRK and LASIK Surgery

PRK and LASIK laser eye surgery might appear identical. However, upon further inspection, it becomes clear that PRK and LASIK eye surgery are not the same.

Both involve different surgical techniques and recovery times. While both can treat similar vision problems, they’re often reserved for those with different circumstances regarding their eye health.

Discover more about each key difference between PRK and LASIK eye surgery.

Surgical Technique

The surgical techniques utilized to carry out PRK vs. LASIK procedures are the first things that make them decidedly different.

During PRK surgery, an ophthalmologist performs surface ablation without creating a flap in a patient’s cornea. Instead, they use an excimer laser to remove a small piece of the cornea’s outer layer before reshaping the tissue underneath.

During LASIK surgery, an ophthalmologist performs surface ablation while creating a flap in a patient’s cornea with a femtosecond laser before utilizing an excimer laser to remove and reshape tissue from the cornea’s middle layer, called the stroma. An eye doctor repositions the LASIK flap before securing it.

However, it’s worth noting that no-flap or flapless LASIK surgery is now possible thanks to the most advanced LASIK technology. This has helped make LASIK and PRK laser eye surgery slightly more similar in some cases.

Recovery Time

There is a simple reason why LASIK quickly usurped PRK in terms of popularity after earning the FDA’s approval: The LASIK recovery process is typically shorter than the PRK recovery process.

Most patients will endure blurry vision following LASIK surgery for a few days at the longest. Those who choose to go through PRK often experience a recovery time that stretches out over weeks.

PRK and LASIK hurt to some degree, but the pain associated with LASIK is usually more tolerable than the pain accompanying PRK surgery. LASIK aftercare tips also make pain from LASIK surgery even more manageable without patients needing pain medications.

Suitability for Patients

Not everyone is eligible for LASIK eye surgery. To qualify, a person must have a corneal thickness within a specific range.

The ideal LASIK eye surgery candidate has a corneal thickness between 500 and 600 microns. If a patient’s corneal thickness is below this, it could make them ineligible for LASIK. Patients must understand who can get LASIK eye surgery.

A PRK laser eye surgery candidate won’t face these same limitations. Those with thin corneas may still be eligible since an eye doctor won’t have to worry about creating a corneal flap.

PRK is also an option for those who participate in contact sports, but the same doesn’t apply to LASIK.

Pros and Cons of PRK and LASIK

As an eye doctor, you should familiarize your patients with more than just the differences between PRK and LASIK eye surgery. It’s also important to discuss the pros and cons of these distinct medical procedures.

Advantages of PRK

PRK surgery offers a few advantages that make it a more worthwhile option than LASIK eye surgery for some patients. Here are the pros of PRK:

• Provides a suitable option for patients with thin corneas
• Lowers the risk of post-eye surgery dry eye
• Eliminates the chances of corneal flap complications

PRK surgery is also a quick outpatient eye surgery that usually takes under 15 minutes, making it especially convenient.

Disadvantages of PRK

While PRK eye surgery will deliver several advantages, patients must live with a few drawbacks. These are the disadvantages of PRK:

• Creates more initial discomfort following surgery than LASIK
• Forces patients to endure a longer recovery time than LASIK

Unlike LASIK patients, PRK patients might have no choice but to take more time off from work or school than they would otherwise. It’s a simple fact that blurry vision lasts longer for PRK patients post-surgery.

Advantages of LASIK

Although PRK surgery provides some advantages when comparing PRK vs. LASIK, LASIK eye surgery has its fair share of advantages. Here are the benefits of LASIK:

• Offers a quick healing process
• Results in minimal post-eye surgery discomfort

Like PRK, LASIK is a quick eye surgery, often completed within 30 minutes. Another big benefit is the high success rate, which hovers around 95%.

Disadvantages of LASIK

Similar to PRK surgery, LASIK eye surgery isn’t without its drawbacks. These are a couple of disadvantages of LASIK:

• Comes with a risk of LASIK flap complications
• Fails to accommodate patients with thin corneas

A LASIK procedure may also produce night vision symptoms, such as difficulty seeing in low-light conditions, negatively impacting those working in specific fields. For instance, long-haul truckers who drive at night aren’t excellent LASIK candidates.

Factors To Consider When Choosing Between LASIK and PRK

Sometimes, patients experiencing vision problems have no choice but to undergo either PRK or LASIK eye surgery. Their refractive errors will dictate what an eye doctor recommends.

However, in other instances, patients must carefully consider key factors before settling on one option over the other (or neither, as the case might be). Encourage patients to take their time when considering these factors.

Corneal Thickness

Those with thin corneas should choose PRK over LASIK. LASIK is not ideal for anyone with a corneal thickness below 500 microns.

Lifestyle and Occupation

Another factor patients considering PRK vs. LASIK must consider is their lifestyle. Those who play contact sports for a living or work in high-risk professions may need to choose PRK surgery due to the risks of LASIK flaps.

Recovery Preferences

Patients should consider how long they can afford to wait for laser eye surgery to produce results and how much time they can miss at work or school.

LASIK surgery is effective at correcting vision within days and has a shorter recovery time.

Medical History

Patients’ medical histories must also play a part when considering PRK or LASIK eye surgery. Dry eye syndrome and other ocular conditions could limit their options.

Make sure your ophthalmology practice utilizes medical history forms to learn about your patients’ medical histories so you can steer them in the right direction.

PRK or LASIK: Which Is the Better Vision Correction Surgery?

There are many differences between PRK vs. LASIK eye surgery. Both procedures feature different surgical techniques and recovery times and are ideal for different types of ophthalmology practice patients.

Schedule PRK or LASIK consultations with patients to ensure they make the right decisions when considering their options. Weave’s communication solutions will enhance your practice’s patient engagement and streamline your operations, making communicating with your patients more effective.

Get a demo to experience Weave’s platform and see how it will benefit your practice!