What Exactly Are LASIK and PRK?
Both LASIK and PRK are laser eye surgeries designed to fix blurry vision caused by nearsightedness, farsightedness, or astigmatism. They work by reshaping the cornea - the clear front surface of your eye - so light focuses correctly on the retina. The end result? Less dependence on glasses or contact lenses.
PRK came first. Approved by the FDA in 1995, it was the first laser procedure to reshape the cornea without using a blade. LASIK followed in 1999, improving on PRK by adding a flap technique. Today, over 10 million Americans have had LASIK, and about 90% of them see 20/20 or better after surgery.
How Do They Work Differently?
The big difference between LASIK and PRK comes down to how the surgeon gets to the cornea.
In LASIK, a thin flap is created on the surface of the cornea. This flap can be cut with a tiny blade or made with a femtosecond laser. Once lifted, the excimer laser reshapes the tissue underneath. Then the flap is gently laid back down. It sticks naturally - no stitches needed. The whole process takes about 15 to 30 minutes per eye.
In PRK, there’s no flap. Instead, the outermost layer of the cornea - the epithelium - is completely removed. This is done using alcohol, a brush, or the laser itself. Then the excimer laser reshapes the cornea just like in LASIK. Afterward, a soft bandage contact lens is placed over the eye to protect it while the epithelium grows back over the next few days.
Recovery Time: Hours vs. Weeks
If speed matters to you, LASIK wins by a mile.
Most LASIK patients wake up the next day with vision clear enough to drive. Around 90% see 20/20 within 24 to 48 hours. There’s minimal discomfort - maybe a slight scratchy feeling for a few hours. You can usually return to work the next day, even if you sit in front of a computer all day.
PRK is slower. For the first 3 to 7 days, your vision will be blurry and your eyes may feel sore or sensitive to light. The bandage contact lens stays on until the surface heals. It takes about a week before you can see well enough to drive. Full clarity? That can take 1 to 4 weeks. Some people don’t reach their sharpest vision until 3 to 6 months later.
One Reddit user, a firefighter who had PRK in January 2022, wrote: "Days 1-3 were miserable. But by week 4, I was seeing 20/15. Worth it for my job."
Who’s a Better Candidate for PRK?
PRK isn’t just a "slower LASIK." It’s often the better choice for certain people.
If your corneas are too thin - under 500 microns - LASIK isn’t safe. Creating a flap requires enough tissue to leave a strong base behind. PRK doesn’t need a flap, so it’s safer for thinner corneas. About 15-20% of people who want laser vision correction fall into this group.
PRK is also preferred if you have an irregular cornea, chronic dry eyes, or work in a high-risk job. Military pilots, firefighters, boxers, and martial artists often choose PRK because there’s no flap that could lift or dislodge from trauma. The U.S. Marine Corps, for example, has made PRK the standard for pilots since 2024.
Even if your corneas are thick enough for LASIK, PRK might still be the smarter long-term choice. Studies show PRK causes less long-term dry eye than LASIK. One 2022 review by Dr. Robert Steinert noted that PRK’s complication rate for dry eye is slightly lower over time.
What About Risks and Complications?
Both procedures are safe when done by experienced surgeons. Complication rates for both are under 2%.
LASIK’s main risk is flap-related. About 0.8% of patients experience issues like epithelial ingrowth (cells growing under the flap) or flap dislocation. These are rare, but they can happen if you rub your eye too hard in the first week.
PRK’s main issue is corneal haze - a slight cloudiness that can appear during healing. It’s usually temporary and fades with time and steroid eye drops. The risk is about 1.2% higher than LASIK, according to a 2021 study of 12,000 patients.
Neither procedure causes blindness. Serious complications are extremely rare. The biggest risk? Choosing the wrong surgeon. Always pick someone with at least 50 PRK or 100 LASIK procedures under their belt.
Cost: What You’ll Actually Pay
PRK is cheaper. On average, it costs $300-$500 less per eye than LASIK.
In 2023, Kraff Eye Institute charged $2,200 per eye for PRK and $2,600 for LASIK. In big cities like London or New York, prices can be 25% higher. That’s because LASIK uses two lasers - one to make the flap, one to reshape the cornea. PRK only needs one.
Insurance rarely covers either. Only 12% of U.S. health plans pay for laser vision correction, mostly for military personnel. Most people pay out of pocket.
Who Chooses What? Real People, Real Choices
People pick based on their lives.
A 32-year-old office worker in Brighton told me she chose LASIK because she couldn’t afford a week off work. "I had it on a Friday. Monday morning, I was back at my desk with 20/20 vision. No blur, no pain. Worth every penny."
A 28-year-old Royal Navy recruit chose PRK. "I train with live gear. I don’t want a flap that could pop open if I get hit. I knew the recovery would be rough, but I’m in this for life."
Surveys show 78% of NFL players pick LASIK. Why? They need to get back on the field fast. Meanwhile, 63% of Marine Corps pilots pick PRK - safety over speed.
What About Newer Options?
There’s a newer version of PRK called trans-epithelial PRK. Instead of using alcohol or a brush to remove the epithelium, the laser does it all. This reduces healing time by about 25% compared to traditional PRK. It’s becoming more common in the UK and the U.S.
Another option gaining ground is SMILE - a flapless procedure that uses only one laser to remove a small lens-shaped piece of cornea. It’s good for moderate nearsightedness but doesn’t work for farsightedness or astigmatism yet.
For people with very high prescriptions or thin corneas, implantable collamer lenses (ICLs) are an alternative. These are tiny lenses placed inside the eye, not on it. They’re not laser surgery, but they’re becoming popular for those who don’t qualify for LASIK or PRK.
What Happens Before Surgery?
You can’t just walk in and get it done. First, you need a full eye exam.
Your doctor will measure your corneal thickness (pachymetry), map its shape (topography), and check for dry eye. If you wear contacts, you must stop wearing them before the exam:
- Soft lenses: stop for 1-2 weeks
- Rigid gas permeable lenses: stop for 4 weeks
This lets your cornea return to its natural shape. If you don’t, your measurements will be off - and that could lead to poor results.
Aftercare: What to Expect
LASIK aftercare is simple. No rubbing your eyes. Avoid swimming for 1-2 weeks. Use prescribed eye drops for a few days. Most people don’t need more than that.
PRK requires more care. You’ll use steroid and antibiotic drops for 2-4 weeks to prevent haze and infection. The bandage contact lens stays on for 3-5 days. You’ll need to take it easy - no heavy lifting, no dusty environments, no intense exercise for at least a week. Your vision will be fuzzy for days, but that’s normal.
Final Thoughts: Which One Should You Pick?
There’s no "best" procedure. Only the best for you.
Choose LASIK if:
- You want vision back fast
- Your corneas are thick enough (over 500 microns)
- You have a busy job or schedule
- You’re not in a high-risk sport or job
Choose PRK if:
- Your corneas are thin
- You play contact sports or serve in the military
- You have dry eyes
- You’re okay with a longer recovery for long-term safety
Both give the same final vision. The difference is in the journey. Talk to your eye doctor. Get a full scan. Ask about your corneal thickness. Ask about your lifestyle. Then decide - not based on what’s popular, but what’s right for your eyes and your life.
Shelby Price
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