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PRK vs. LASIK: What’s the Difference?

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A woman looking into a slit lamp with a light shining in her right eye as her optometrist performs an exam.

If you’re thinking about having laser eye surgery to correct your eyesight, you’ve probably heard of 2 popular options: PRK and LASIK. While both techniques use lasers to improve vision by reshaping the cornea, they do have their differences.

One of the main differences is how the cornea is accessed. In PRK, the outer layer of the cornea is removed, while in LASIK, a flap is created in the cornea.

Additionally, PRK has a longer recovery time and may be more suitable for patients with certain medical conditions, while LASIK has a faster recovery time and may be better for patients who have thicker corneas. 

Understanding these differences is essential in making an informed decision about which procedure is right for you.

What Is PRK?

PRK is an acronym for photorefractive keratectomy. This type of laser eye surgery procedure has been used since the 1980s.

The procedure involves removing the outer layer of the cornea (the epithelium) before using the laser to reshape the cornea underneath.

This aids in the correction of vision issues such as:

  • Nearsightedness
  • Farsightedness
  • Astigmatism

PRK is typically reserved for patients with thinner corneas, dry eye syndrome, or previous eye surgery.

What Is LASIK?

LASIK stands for laser in-situ keratomileusis. Like PRK, LASIK also involves using a laser to reshape the cornea.

However, with LASIK, the surgeon creates a flap in the cornea and lifts it to expose the underlying tissue. The laser is then used to reshape the cornea underneath the flap before the flap is put back into place.

LASIK is typically performed on patients who have thicker corneas and don’t have dry eye syndrome, or significant risk factors for dry eye or other eye conditions.

Differences Between PRK & LASIK

One of the main differences between PRK and LASIK is the way the cornea is treated during the surgery:

  • In PRK, the outer layer of the cornea (epithelium)  is removed before the laser is applied
  • In LASIK, a flap is created in the cornea and lifted before the laser is applied.

The recovery time is another distinction between the 2 procedures:

  • Because PRK involves the removal of the cornea’s outer layer, it may take longer to heal than LASIK. PRK patients may experience discomfort and blurred vision for several days after the procedure.
  • On the other hand, patients who undergo LASIK typically have a shorter recovery time and may experience less discomfort.  However, careful postoperative recovery is still required for excellent healing.
Close up of a woman laying on a surgical bed with a surgical gown and cap on and a surgeon's gloved hands on each side of her face

Which One Is Right for You?

The decision between PRK and LASIK is influenced by a variety of factors, including the condition of your vision and your preferences.

Some patients may prefer PRK because it doesn’t involve the creation of a corneal flap. Others may prefer LASIK because of the shorter recovery time.

Your eye doctor can help you decide which procedure is best for you.

Factors to Consider

Here are some factors your eye doctor will consider when helping you decide between PRK and LASIK:

  • Corneal thickness: If you have a thin cornea, PRK may be a better option since it removes less tissue than LASIK.
  • Dry eye syndrome: PRK may be a better option if you have dry eye syndrome because it has a lower risk of exacerbating dry eye symptoms.
  • Activity level: If you regularly engage in high-impact sports or activities, PRK may be a better option as it does not involve creating a corneal flap that can be dislodged or damaged.

ICL Instead of Laser Eye Surgery

If you don’t think LASIK or PRK is right for you, there is an alternative: implantable collamer lenses (ICL). ICLs are a specific kind of implantable contact lens that are used to treat refractive errors. 

ICLs don’t involve the removal or reshaping of any corneal tissue, unlike PRK and LASIK. The surgery is fairly simple:

  1. Anesthetic drops are applied to the eye to numb it.
  2. A small incision is made in the cornea.
  3. The ICL is inserted through the incision and positioned in front of the natural lens.
  4. The ICL is centred and positioned for optimal vision correction.
  5. The incision in the cornea is microscopic, so it seals without requiring sutures. 

ICLs may also be a good choice for people who aren’t candidates for or interested in laser eye surgery.

Learn More from Vector Eye Centre

Whether you’re considering PRK, LASIK, or ICL surgery, the decision to undergo any kind of eye surgery is a big one. That’s why it’s important to consult with a qualified eye surgeon who can help you make an informed decision about which procedure is right for you.Contact us for a consultation to learn more about your options and get professional advice on which option could be best for you. Our friendly and knowledgeable team is here to help you every step of the way.

Written by Dr. Jamie Bhamra

Dr. Jamie Bhamra is an ophthalmologist with advanced training in cataract and corneal surgery, including refractive surgery, corneal cross-linking, external disease, ocular surface disease, and dry eye disease. He practices comprehensive ophthalmology in Calgary, Alberta.
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