PRK, which stands for photorefractive keratectomy, is a type of laser vision correction that can treat nearsightedness (myopia), farsightedness (hyperopia), and astigmatism, eliminating the need for eyeglasses or contact lenses.
Pros
Cons
Some experts say PRK is cheaper because unlike LASIK, it doesn’t involve the additional step of creating a corneal flap, but there are more follow-up visits needed, so the total cost is very similar. Your surgeon’s experience level and practice location also factor into the final price.
Refractive eye surgery is typically considered elective, not a medical necessity, so it’s usually not covered by insurance. However, if you need vision repair due to an injury or can’t physically wear glasses or contact lenses (such as an allergy or impairment), your plan may cover the procedure.
PRK surgery was FDA-approved in 1995, a few years before LASIK eye surgery came into existence. However, LASIK quickly became the more popular of the two refractive surgery options. The main difference between the two? During LASIK, the surgeon cuts a flap in the cornea before treating the underlying tissue with the laser. With PRK, the surgeon removes the thin outer layer of the cornea, called the epithelium, before addressing the corneal tissue with the laser. PRK is easier to tolerate, less painful than LASIK, and delivers very similar results to LASIK, but PRK recovery time is a lot longer, so it’s not as popular.
Experts say PRK is a good option for those who aren’t good candidates for a LASIK procedure, which requires a certain level of corneal thickness. If you have thin corneas, you’re likely a better candidate for PRK. Unlike LASIK, this procedure doesn’t involve cutting a flap into the cornea, so the same-strength treatment (your glasses prescription) doesn’t impact the corneal architecture the same way. PRK technically leaves your anatomy more “intact” than LASIK does.
Dr. Lee Katzman, an ophthalmologist in San Diego, says PRK is also a better choice for someone with a job that involves regular physical contact with the face or eye area because there’s no risk of the corneal cap becoming dislodged, like there is with a LASIK flap.
Your procedure will start with numbing eye drops and an oral sedative if you’re especially anxious. Your surgeon will then remove your epithelium, the outermost layer of your cornea. “It sounds scary, but it’s actually not painful at all,” says Dr. Katzman. Most commonly, it’s done by swiping the surface of the eyes with an alcohol-based solution.
The next step in PRK surgery is identical to the second part of a LASIK procedure: The surgeon uses an excimer laser to reshape your cornea. “The patient looks straight ahead, and the laser will fire for less than 10 to 20 seconds,” says Dr. Katzman.
After that, a chemical called mitomycin C is placed onto the corneal tissue for 10–20 seconds, followed by a sterile water flush to remove it from your eye. A temporary “bandage” contact lens is then placed onto the eye, to help heal the surface, and you’re given eye drops.
Someone will have to take you home from the appointment, and you won’t be able to drive for at least one week, possibly two. You can expect some eye pain and discomfort for the first two or three days. Some eye doctors even prescribe prescription pain medication for that period.
At a one-week follow-up appointment, your doctor will remove the bandage contact lens. “At this point, your vision will likely be legal to drive by DMV standards, but you may need a few more days to recover, especially if you plan to drive at night,” says Dr. Katzman.
RealSelf members also report the common side effects of dry eye, tearing, and irritation post-procedure. “The dryness can be effectively controlled, in most cases, by using preservative-free artificial tears,” says Dr. Katzman.
Hazy vision is another common complaint, but new technology in lasers and medications has made it less of an issue in recent years. “Most surgeons now use a drug called mitomycin, which reduces the chance of haze substantially,” says Dr. Mark Golden, an ophthalmologist in Chicago.
RealSelf Tip: If you're over age 40, it's possible that you'll still need glasses to manage presbyopia (difficulty focusing on nearby objects) after PRK surgery--unless your eye surgeon uses a PRK technique called monovision. This corrects the nondominant eye for reading distances and the dominant eye for distance. This may not completely reverse presbyopia, but it will reduce your dependence on glasses when you're reading or using a computer.
“It is an amazing feeling to wake up and be able to read a clock!”—FutureMrs, RealSelf member
RealSelf Tip: If you wear contact lenses, you’ll have to stop wearing them prior to your procedure. If they’re gas-permeable lenses, your surgeon may have you stay out of them for one to three months, depending on how long you have been wearing them; stop wearing all other types three days before your surgery.
With every passing week after your procedure, your vision should get clearer. “After one week, the tissue is mostly regrown, but there is often a small central area that is not completely intact. This can make vision worse after one week than it was in the previous days,” says Dr. Jay Bansal, an ophthalmologist in San Francisco, in a RealSelf Q&A.
By one month, you should have the majority of your vision back, and it’ll get even better by the second month. “At one month, most of my patients are happy and have 90% of their vision correction potential; the additional 10% will happen by month two,” says Dr. Katzman.
Your results should be long-lasting, but as you age and your vision changes, you may need an enhancement procedure.
If you don’t want the downtime of PRK, there are a few other procedures to help correct your vision.
Updated February 21, 2024