LASIK and PRK are two different (but similar) types of laser eye surgery. Here you’ll learn what the difference is, and why different surgeries are better for different people.
If you’re thinking about getting laser eye surgery, it’s crucial to get two different opinions from two different clinics. I went to LASIK MD in Vancouver, BC for my first opinion, and was told that either surgery (PRK or LASIK) would be fine for my eyes. LASIK was cheaper, but much more expensive than their advertised price. They advertise one eye for $495, but the person who examined my eyes told me that it’s their way of getting customers to come in. For laser eye surgery to cost $495 per eye, the person would have to have excellent vision already, and not need surgery to correct their vision! For me, one eye would cost $1,395.
So, I decided I should get a second opinion — especially since I didn’t see a surgeon at LASIK MD. The person who would be operating on my eyes wouldn’t even see me until the actual surgery.
So, I consulted Dr Michael Boyd at BoydVision in Burnaby, BC. He did most of the preliminary eye tests himself, and showed me the maps of my eyeballs. My eyes are extremely irregularly shaped (which LASIK MD also told me). But, the LASIK ladies didn’t tell me what that means, or how that would affect the outcome of my surgery. Dr Boyd explained why the shape of my eyeballs would made LASIK a risky procedure — far riskier than PRK. He highly recommended PRK.
Dr Boyd’s price for both surgeries is $995. His price doesn’t fluctuate depending on the type of surgery or the person’s vision.
See how important it is to get two different opinions before getting laser eye surgery?
What is PRK?
PRK or photorefractive keratectomy involves the removal of the superficial tissue on the surface of the cornea (this was mildy painful for me! Dr Boyd burned it off with some sort of acid, which felt like torture. But it was worth it). The laser reshapes it to correct nearsightedness, farsightedness, or astigmatism.
At the beginning of this type of laser eye surgery, drops are used to numb the surface of the eye. An instrument is used to painlessly remove the outermost layer of the cornea (called epithelium) in the area that will receive laser treatment. The epithelium regenerates quickly, taking usually three to five days to reseal the surface of the eye.
Once the epithelium has been removed, the laser is used to reshape the underlying surface. No discomfort is experienced during the procedure, but an odor similar to burnt hair may be detected. Be reassured that the excimer laser is considered a cold laser and therefore nothing is burning. If the odor is smelled, it typically lasts about a minute. (I could smell it — yuck. Again, though, it was worth it).
Why PRK Instead of LASIK?
Some people will choose PRK over LASIK simply because they don’t like the “flap” idea (see the “What is LASIK? below) Most people who choose PRK have work issues or concerns; for instance, some jobs or vocations recognize PRK but not LASIK. Other people may want to have the same procedure as a friend/relative had.
Others, like me, are advised to have PRK instead of LASIK for various reasons, such as the shape of their eyeballs. If your doctor or examiner suggests PRK over LASIK, it may be because your corneas aren’t thick enough (how high your prescription is), or possibly because your corneas aren’t of optimum health.
Advantages of PRK
- Simple technique – very little surgical risk.
- No longterm flap risk – a consideration for certain situations (such as martial arts, construction, law enforcement, and dry eye syndrome)
- Surgery happens on the top, superficial layer of the cornea, making it generally safer.
Disadvantages of PRK
- Slower recovery than LASIK – most people take one week off work; full vision recovery can take weeks/months for some.
- Potentially more discomfort in first few days.
- “Corneal haze” in some cases (much less likely with current techniques compared with earlier procedures).
- Small risk of recurrent corneal erosion (like a scratch on the eye)
What is LASIK?
LASIK (laser assisted in-situ keratomileusis) is the most popular type of laser eye surgery; it reduces or eliminates glasses and contact lenses. The surgeon creates a thin “corneal flap” at the beginning of the procedure, perform the laser surgery, and then rolls the flap back into position.
The laser aspect of LASIK is the same as it is for PRK. The difference is in how the doctor exposes the layer of the cornea he wants to reshape with the laser. Using the flap-making process with LASIK, the recovery time is drastically reduced compared to PRK. Most people who have had LASIK are able to see 20/20, or very close to it, when they are checked the day after surgery.
The majority of people who are candidates for LASIK choose it over PRK. It has quicker recovery and, if any pain is experienced it lasts for the matter of hours rather than days.
Regardless of which type of laser eye surgery is performed, antibiotic and anti-inflammatory eye drops are required, for about a week after the surgery to prevent infection/inflammation.
LASIK is a more complex 3-step procedure:
- The creation of a flap that is peeled to the side (like an orange peel),
- The laser removes tissue on the exposed surface,
- The flap is rolled back into position.
Advantages of LASIK
- FAST, virtually painless recovery
- Less chance of scarring or corneal erosion (like a scratch) compared to PRK
Disadvantages of LASIK
- Potential for flap complications
- Tissue is removed deeper in the cornea causing a weaker structure compared with PRK
When Dr Boyd told me that he recommended PRK over LASIK, I was disappointed. I thought I wouldn’t be able to work for about 10 days — which is the case for some people! But, three days after PRK, I’m back at work and feeling great! My vision is almost perfect. Since it takes about a week to get perfect vision after laser eye surgery, I’m not complaining.
To learn how I healed, read Laser Eye Surgery – Tips for Healing After PRK or LASIK.
If you have any questions or thoughts about the difference between LASIK and PRK, or if you’re considering laser eye surgery, please comment below…
The definitions of PRK and LASIK are from Dr Boyd’s website, BoydVision.