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PRK Vs Lasik (An Honest Comparison)

By Edited Aug 8, 2015 1 1

PRK & Lasik Comparison - What's the Difference?

Are you weighing up the possibility of being away with glasses or lenses and coming round to the eye-dea (sorry) of eye correction surgery? If so, good.

However, as I'm sure you are aware there is an immediate dilemma that becomes apparent when committing to even a little bit of vision surgery and that is... which do I want PRK or Lasik (the two most popular ways of going about this)?

Well, this is where this article aims to 'help you out' with an in-depth comparison of PRK and Lasik, highlighting their differences in all aspects (from costs to recovery time) & hopefully you will get a better comprehension of exactly what each procedure involves.

PRK Vs Lasik Comparison Table

  Lasik PRK
Cost

For most patients the overall cost is between $2,500-$5,000.

For most patients the overall cost is slightly higher than LASIK but can cost up to $8,000 for both eyes in some cases depending on your eye correction needs and if Custom PRK is used.

Surgery Length

The actual procedure of correcting your vision will take about 15 minutes. The laser that is used to shape your cornea is used for only about 1 minute.

The actual procedure of correcting your vision will take about 15 minutes. The laser that is used to shape your cornea is used for only about 1 minute.

Recovery Time

Full recovery for most patients takes 2-7 days.

Full recovery for most patients takes 2-7 days.

Benefits

Provides a rapid eye surgery recovery period in which you can often return to work a regular daily life much faster. Within 3 days you can often be living normal day-to-day life without ever needing eyeglasses again. This procedure is relatively pain-free. Many patients achieve 20/20 vision or better.

Provides sharp vision correction surgery without the danger of flap displacement. This is a great surgery for people who have less corneal tissue and are not a suitable candidate for LASIK. There is also less chance of chronic dry-eyes. Many patients achieve 20/20 vision or better.

Side Effects Flap displacement can occur at anytime if there is any injury to the eye such as getting hit with a ball. Higher chance of having chronic dry-eyes. Chance of halo-like or starburst patterns emerging during low-light situations. PRK has much more pain associated with it then the relatively pain free LASIK surgery. Much more time is needed before eyes are fully recovered and healed from surgery.

What is Lasik?

Lasik stands for laser-assisted in-situ keratomileusis.

Lasik surgery involves a laser that is used to cut a flap in your cornea. The flap is cut into both the outermost layer of the cornea as well as partially into the stroma layer. The flap is then gently lifted and the cornea is then reshaped by the laser. After the laser reshapes the cornea the flap is then set-back in place and will heal up. Your vision is corrected by the reshaping of the cornea by the laser. The actual procedure only takes a few minutes. You will spend more time filling out paperwork then in surgery.

What is PRK?

PRK stands for photorefractive keratectomy.  

The first step in PRK eye correction surgery is to cut into the corneal tissue and this can be done either with a laser or by hand. After the outer layer of corneal tissue is scraped away a laser is used to reshape the cornea. With PRK only the outer corneal layer is removed and this outer corneal layer will automatically regenerate and heal, generally within 3-4 days. With LASIK the cut is deeper and there is a chance of flap displacement, a potential side effect. With PRK there is no chance of this because the stroma layer of your cornea is never cut.

Flap Displacement with PRK

Both types of eye corrective surgery have great long-term effectiveness. The advantage for most people is PRK, as long as they are a candidate for this particular surgery. With PRK there is no chance of flap displacement. Flap displacement can occur at anytime with Lasik surgery.

You may go years without any problems and then one day you may get struck in the eye with a fist, ball, tree limb, etc and it can cause the flap that was cut to either be moved ever so slightly or to even open up entirely. Any type of eye trauma can cause the flap to slide or be dislocated. It is recommended that if you are in martial arts, boxing, or most any sport you consider PRK instead of LASIK because you don’t want to have the danger of flap displacement. Even if you are not athletically inclined you will still need to weigh the risks of flap displacement. Only you and the Doctor can decide on the best individual approach to take for your eye corrective surgery.

In the past flap displacement was very common. With the improvement of modern medicine the chance of flap displacement occurring is much lower than it was even 10 years ago. Although modern equipment and techniques and greatly decreased flap displacement from occurring, it is still a very big concern as it can happen to most anyone who undergoes LASIK.

Lasik Bladeless vs. Blade

There are two types of LASIK, blade and bladeless. LASIK that uses a blade to cut the corneal layer is the original type of LASIK used and is generally referred to as “traditional LASIK”. With traditional bladed LASIK a microkeatome blade is used to cut the flap in your cornea. After the blade is used to cut the flap in the cornea a laser is then used to reshape the cornea.

With Bladeless LASIK a microkeatome blade is not needed. Instead of a microkeatome blade a specialized laser is used to cut the corneal layer and then a separate laser is used to reshape the cornea to correct the vision.

Generally the bladeless LASIK is recommended as being better over traditional bladed LASIK. The bladeless model tends to be more accurate and allows the cut flap to heal faster and will have less chance of complications. There are however many people for whom the bladed LASIK is a more viable solution. The bladed LASIK has a high success rate and you should not shy away from considering this method as opposed to bladeless, as long as you have a skilled doctor.

Immediate Aftermath of Corrective Eye Surgery

With LASIK you can usually return back to work either the same day or the following day. You can walk into the surgery and a few minutes walk out with perfect or near-perfect vision. With PRK there is a lot more healing that needs to occur because of the scraping of the outer corneal layer. With PRK you will generally have to wait up to 2 weeks for your vision to fully return and sometimes you may have to wait even longer. Some patients have gone up to 6 months before their vision returned to normal.

When you leave the doctor’s office after the surgery your vision will be cloudy, but you will be able to see and you will not need your glasses anymore. With LASIK you may feel some slight discomfort. With PRK you will feel pain. The pain may even increase over the first few days. It will tend to be very uncomfortable, even with pain pills.

PRK vs. Lasik Long-Term Effectiveness

The long-term effectiveness of both PRK and LASIK are very good. Not all patients get “perfect vision”, but even a drastic improvement is nice to have. With LASIK you need to be careful because of the previously mentioned danger of flap displacement. If you do not experience flap displacement then you can expect you newly corrected vision to remain generally the same.

With both PRK and LASIK there is a small chance your vision will slightly weaken over time, but it will never regress to the pre-surgery vision level you had. This is the same for most people, even those who never had vision correction surgery. As you age there is a chance your vision will weaken slightly over a period of time and this will tend to hold true whether you have LASIK, PRK, or even no surgery at all. Eyes weaken all of the time when you age. You may find that when you get older you will need to wear glasses for reading. This is still a much better option than being forced to wear glasses all of the time.

One study published in the Journal of Refractive Surgery showed that “Almost 90% of eyes recalled for 12-year follow-up maintained or improved best corrected visual acuity”.  Basically if you get corrective surgery then you will get improved vision for the long-term regardless of which procedure you choose.

A small percentage of people will have a second vision corrective surgery to yet again improve their vision again, but this generally doesn’t happen until many years later and most people will never need to undergo a second vision correction surgery.

The long-term effectiveness of both PRK and LASIK is outstanding. Yes your eyes may generally weaken with age but this is true of all people. The important part is that these eye correction surgeries can help you to drastically improve your vision and it will stay with you for the rest of your life. Even when you get old and your eyes begin to weaken you will still have much better vision then if you had never undergone any vision correction surgery.

Potential Side Effects

As with any surgery there is always a risk of negative side-effects. One of the most common is dry eyes. Minor drying of the eyes can easily be eradicated with eye drops to moisten your eyes. More sever drying of the eyes and chronic dry eyes affect a very small portion of people who opt for vision corrective surgery. Some patients undergo and have microscopic punctual plugs added which helps to alleviate the dryness of the eyes. Most reputable doctors will include this in for free as post-op care if you do need it. The “bargain basement” providers will generally charge you extra for this if you need it and it could greatly increase the overall cost for your surgery. Chronic dry eyes tends to occur more often in people who undergo LASIK as opposed to PRK.

A small portion of people report light distortions such as a halo effect or starburst effect of lights at night during low-light conditions. Infections are also a risk when undergoing LASIK or PRK procedures. Although infection is possible, WebMD reported on a study that showed that there is a higher risk of infection by wering contact lenses as opposed to undergoing LASIK. If you are currently wearing contact lenses and have no infections then you should feel very confident that you proaby will not get an infection from LASIK surgery. It is always  possibility but the chances of it occurring seem to be much less than what people generally expect.

In very rare cases it may even be possible to go completely blind. If you get an infection inside of your cornea while undergoing surgery or immediately after then there is a small chance you could lose your vision entirely. The best way to combat this is to choose a reputable doctor who has experience with LASIK and or PRK eye correction and to also follow his or her directions fully when you leave the office after having the surgery.

Another problem, although not necessarily a side-effect is that some people will not acquire perfect 20/20 vision. Although you may not get perfect vision your vision will be greatly enhanced and will make wearing eyeglasses something in your past. Some people not only get perfect vision, but will get better than perfect vision. It is possible you may be one of the lucky ones to end up with 20/15 or even better vision!

PRK Vs Lasik Cost

Although the costs of both PRK and LASIK are very similar, the actual costs can vary drastically depending on many factors. You may have seen advertisements in the paper about $99-$499 per eye correction surgery. This is generally only for people who have no astigmatism. If you have any astigmatism your cost will definitely be much higher than this. For most people you can expect to pay between $2,500-$5,000 for both eyes, of course a custom PRK surgery can cost up to $4,000 or more per eye depending on your individual eyes needs and demands.

PRK and LASIK is one area where you definitely do not want to shop for the lowest price. Although the lower priced doctors are often very competent and are able to offer a better value because of the volume of surgeries they perform, other low-cost doctors may not be as experienced.

Instead of looking for the lowest cost or best bargain it is better to research out doctors in your area who perform LASIK and or PRK and then when you narrow down your list of potential doctors to use go visit them. It is absolutely necessary that you feel comfortable with both the doctor and the staff and you get any questions or concerns resolved before you go in for the surgery. Each case is unique and only the doctor and the staff can advise you on the best way to proceed with your vision correction surgery.

With LASIK and PRK you will have extra costs beyond just the surgery cost. An ophthalmologist will need to assess your eyes to ensure you are a good candidate for vision correction surgery. There may be some other fees also but keep in mind that LASIK and PRK are investments. Although you will pay more upfront, you will spend much less in the long run because you will no longer need to invest in new eyeglasses each year or buy new contact lenses regularly.

Most reputable LASIK and PRK providers will offer a free initial consultation where you can ask questions, meet the doctor and his or her staff, and get guided in the right direction for which type of eye correction surgery is best for you.

PRK vs. LASIK Recovery Time

LASIK has a much less recovery time. With LASIK you are generally under the laser for less than 10 minutes and then can throw on some sunglasses, throw out your eyeglasses, and head back home or even to work in some cases depending on your job work environment. Within 2-3 days you should feel almost fully healed. Complete healing of the cornea and vision acuity and stabilization could take up to 2-3 months.

With PRK the recovery time is a lot longer. Instead of days you are looking at weeks of recovery time and in some cases maybe even up to a few months. The main reason the recovery takes much longer with PRK is because the outer corneal layer is scraped off and it takes time for this layer to regenerate and heal. Although the recovery time is longer it may be a much better option for you as there is no worry of flap displacement. With LASIK you always need to be careful because of the potential for flap displacement. With PRK you will be much more uncomfortable than with LASIK; however, the long-term benefits may far outweigh the short-term discomforts.

What is Custom PRK and Custom LASIK?

There are basically two types of surgery using either LASIK or PRK. You can go the regular route or the custom route. An example of this using LASIK is that you will undergo an eye test such as when you go get a new pair of glasses. The ophthalmologist will measure your eyes and see how much correction is needed. This measurement is also used for basic LASIK and PRK. With custom LASIK and PRK and machine will scan your eye and measure any and all tiny little imperfections. Although you may have the same exact vision as someone else, the way you perceive things may vary.

By using custom LASIK and custom PRK you are having your eyes scanned by a machine that measures countless aspects of your eye, and then these measurements are used by the laser when it is actually correcting your vision with the laser. The results are often astounding but you may not even need to go the custom route. Again talk with a doctor during an initial consultation and see if the custom route is the best way for you to proceed. It does cost more to have custom eye correction surgery done, but it may very well be worth it depending on your individual needs.

Conclusion: Which Vision Correcting Procedure is Better?

Should you choose PRK or LASIK for your vision correction procedure? This is ultimately up to you and the Doctor. Many people are eligible to have either done and it comes down to a choice. LASIK is cheaper, less pain, and will get you back to normal faster. On the other hand PRK is generally more expensive, the recovery is more painful and uncomfortable and takes much longer, but you don’t have to worry about flap displacement. If your eyes make you eligible for both procedures then you can consult with the doctor and staff on your free initial consultation and with the advisement of the doctor, decide which is the better choice of surgery for you. Either way you can expect to have much better vision without having to wear eyeglasses or contact lenses.

Some people may not be medically suitable to undergo LASIK. You may have a scratched cornea, a thick cornea, or some other reason and not be a suitable candidate for LASIK. If you are not a candidate for LASIK then you can usually be able to be medically qualified to undergo PRK eye correcting surgery.

There is no absolute best method overall for vision correction surgery. The right choice will come down to the individual and his or her medical needs. By using a reputable doctor who has experience correcting vision you can be assured of receiving the best medical procedure that fits both your medical needs as well as your budget.

Summary of Differences

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Comments

Jan 9, 2015 1:58pm
wrdsmith1
This is a really good article! You've done your homework. Thanks for all of the information!
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Bibliography

  1. "Lasik Versus PRK." Journal of Refractive Surgery . (2006): 871-877.
  2. "Comparing PRK and Lasik." Ocular Surgery News. (2007): 34.
  3. "LASIK Surgery: Safer Than Contacts?." WebMD. 4/05/2014 <Web >
  4. "Lasik Halo." USA Eyes. 4/05/2014 <Web >
  5. Refractive Correction With C-Ten. Schipper MD & Thomann MD, September Edition: Refractive Surgery, 2010.

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