Photorefractive keratectomy (PRK) and laser-assisted in situ keratomileuses (LASIK) are laser eye surgery procedures used to help correct eyesight. PRK has existed longer, but both are widely used today.
LASIK and PRK are both used to correct the cornea of your eye. The cornea comprises five thin, transparent layers of tissue over the front of your eye that bend (or refract) and focus light to help you see.
PRK and LASIK use different techniques to help correct a patient’s vision by reshaping the corneal tissue.
With PRK, the surgeon removes the epithelium. He then uses lasers to gently reshape the other layers of your cornea and fix irregular curvatures in your eye.
These lasers create a small flap in the cornea with LASIK. With LASIK, the surgeon raises the flap and then gently uses lasers to reshape the cornea. The corneal flap is lowered back down after the surgery is complete, and the cornea repairs itself over the next few months.
Either technique can help resolve some eye issues related to:
- nearsightedness: inability to see distant objects
- farsightedness: inability to see near things
- astigmatism: is an irregular shape that causes a slightly blurry vision
How do these two procedures work?
The two laser procedures are similar because they reshape some irregular cornea tissues using lasers. But they differ in some ways:
- In PRK, surgeons have to remove a part of the cornea tissue.
- In LASIK, surgeons create a flap to open the tissues below and close the flap once the procedure finishes.
What happens during PRK?
- You will receive numbing drops, so do not feel pain during the procedure. You may receive drugs to help your nerves relax.
- The epithelium is entirely removed. That takes up to 30 seconds.
- An exact surgical tool, called an excimer laser, is used to fix any irregularities in the deeper corneal tissue layers. That also takes about 30-60 seconds.
- A special bandage is put on the cornea to heal the tissues beneath the cornea.
What happens during a LASIK procedure?
- You are given medications to numb your eye.
- A small corneal flap is cut into the epithelium using a femtosecond laser tool. That lets your surgeon move this layer to the side and reshape the other layers with lasers. Because it is attached, the epithelium can fix back in its proper place after the surgery finishes, rather than being entirely removed as it is in PRK.
- An excimer laser helps reshape your corneal tissues and fix eye curvature issues.
- The surgeon restores your corneal flap in the epithelium to heal with the rest of the tissues.
You will feel a little bit of pressure or discomfort during each surgery. You can also see changes in your new vision as the surgeon modifies your eye tissue. But you will not feel any pains.
Complete recovery will take about a month with PRK. Recovery from the LASIK procedure is faster and only takes a few days to have a clearer vision, though complete healing takes three months. Visit http://anwarcataractcenter.com/the-most-important-things-to-do-before-lasik-surgery/ to read about The Most Important Things to do Before LASIK Surgery.
Following PRK, you will have a contact-like bandage over your eyes which can cause irritation and sensitivity to direct light for some days as your epithelium recovers. Your vision can be a little blurry until you remove the bandage some weeks later.
Your surgeon can prescribe medicated eye drops to keep your eye moist as it recovers. You can also get medications to relieve your pain and discomfort.
Your vision might be better right after the surgery. However, it may worsen until your eye fully heals. Your ophthalmologist might instruct you to avoid driving until your vision gets better.
The complete recovery process lasts for up to a month. Your vision then slowly gets better each day. You will have o see your ee doctor regularly for checkups and reports until your eyes fully heal.
You’ll probably see much more right after LASIK surgery than you could, even without eyeglasses or contact lenses. You might have close to your desired vision the day after the surgery.
You might not experience much pain as your eye heals. In most cases, you might feel some burning sensation in your eyes for some hours after the LASIK surgery, but it shouldn’t last for too long. Your eye doctor will then give you medicated eye drops to take care of irritation, which may last for days.
You should fully recover within a few days following your procedure.
Which procedure is more effective?
Both procedures are effective in correcting your vision. The main difference is the healing time.
LASIK surgery takes days to see, while PRK takes about a month. The final results won’t differ if the procedure is done correctly by a licensed, experienced surgeon.
Overall, PRK is safer in the long term because it does not leave a flap in the cornea. The corneal flap left behind by the LASIK procedure can be subject to complications.
What are the risks?
Both procedures come with some risks. LASIK surgery might be a little riskier because of the step required to create a flap in your cornea.
The potential risks that come with both laser procedures include:
- Eye dryness. LASIK surgery can produce some tears for up to six months after the surgery. This dryness can be permanent.
- Visual changes or disturbances. That includes reflections off objects, seeing double or halos around lights; you might not be able to see well at night. That often disappears after some weeks but can become permanent.
- Under-correction. Your vision might not seem that much clearer if your surgeon didn’t remove enough corneal tissue, primarily if the surgery aims at correcting nearsightedness.
- Visual distortion. The surgeon may remove more tissue than necessary, which may cause distortions to your vision, known as ectasia. That can make your cornea too weak and make your eye bulge from pressure inside the eye. Your doctor needs to resolve the ectasia to prevent possible vision loss.
- Astigmatism. Your eye curvature can change if your surgeon doesn’t remove the corneal tissue evenly. You may need a follow-up surgery or wear glasses or contacts to correct your vision completely if that happens.
- LASIK flap complications. Issues with the corneal flap made during LASIK can lead to infections or produce too many tears
- Permanent vision loss. As with any eye surgery, there’s a small risk of complications that can lead to a partial loss of your vision. Your sight is maybe a little more or blurry than before.
In general, both laser surgeries cost up to $2,500-$5,000. PRK might be more expensive than LASIK surgery because it requires more post-op check-ins. Health insurance plans usually cover LASIK and PRK because they are considered elective.
If you have some health savings accounts, you may use one of these options to help cover the cost. These plans are peculiar to employer-sponsored health packages.