LASIK vs. PRK: Which Refractive Surgery Is Right for You?

When you wake up and don’t need glasses or contacts to see your alarm clock, that’s the dream. For millions of people, laser eye surgery makes it real. But not all laser procedures are the same. Two of the most common options - LASIK and PRK - deliver the same end result: clearer vision. Yet how they get there, how long recovery takes, and who’s a good candidate can be wildly different. If you’re considering vision correction, knowing the difference isn’t just helpful - it’s critical.

What’s the Core Difference Between LASIK and PRK?

Both LASIK and PRK use an excimer laser to reshape your cornea so light focuses correctly on the retina. That’s where the similarity ends. LASIK creates a thin flap on the surface of your cornea, lifts it, reshapes the tissue underneath, then lays the flap back down like a hinged lid. PRK removes the outermost layer of the cornea - the epithelium - completely. No flap. Just laser, and then your body regrows that layer over the next few days.

This small technical difference changes everything: recovery time, risk profile, and who can even have the procedure. PRK was the first laser vision correction method approved by the FDA in 1995. LASIK came four years later, improving on PRK by adding the flap technique to speed up healing. Today, LASIK is far more popular - about 78% of all laser eye surgeries in the U.S. are LASIK. But PRK hasn’t disappeared. It’s actually the better choice for a surprising number of people.

Recovery: Hours vs. Weeks

If you’re juggling a busy job, school, or family life, recovery speed matters. With LASIK, most people see well enough to drive by the next day. Blurry vision, discomfort, and light sensitivity? Those usually fade within 24 to 48 hours. You can return to work, watch TV, and even use your phone with minimal disruption.

PRK is a different story. The first three to five days are rough. Your vision will be blurry, your eyes will feel gritty and sore, and you’ll need to wear a bandage contact lens while the epithelium regenerates. Many patients describe it as “feeling like sand in your eyes.” It’s not dangerous, but it’s uncomfortable. Most people need at least a week off work, and full visual clarity can take up to four weeks. Peak vision - the sharpest you’ll ever see - doesn’t stabilize until three to six months after surgery.

That’s why PRK often gets chosen by people who can afford to wait: military personnel, firefighters, or those with jobs where eye trauma is a risk. If you’re in contact sports like boxing or martial arts, or if you’re in the military, PRK is the safer long-term bet. There’s no flap to accidentally dislodge from a punch, a fall, or even a rough night’s sleep.

Who Can Have PRK? (And Why Some People Can’t Have LASIK)

Not everyone’s corneas are built for LASIK. To create a flap, you need a cornea that’s at least 500 to 550 microns thick. After the flap is made, doctors must leave behind at least 250-300 microns of untouched tissue to keep the eye structurally sound. If your cornea is too thin - which happens more often than you think - LASIK isn’t safe. That’s where PRK shines.

PRK doesn’t require a flap. It works on thinner corneas because it only removes the surface layer. About 15-20% of people who want laser vision correction are turned down for LASIK because of corneal thickness. For them, PRK is the only viable option. PRK is also preferred if you have an irregular corneal surface, severe dry eye, or a history of eye injuries.

On the flip side, if your cornea is thick and healthy, and you want to get back to life quickly, LASIK is the faster route. But don’t assume LASIK is automatically better. It’s about matching the procedure to your anatomy and lifestyle.

Cost: What You Pay Up Front

LASIK typically costs $2,600 per eye. PRK? Around $2,200 per eye. That $400 difference per eye adds up to $800 for both eyes. Why the gap? LASIK uses two lasers: one to create the flap (usually a femtosecond laser), and another to reshape the cornea (the excimer laser). PRK only uses one - the excimer laser. Less equipment, less complexity, lower cost.

That said, prices vary by region. In big cities like Cape Town, New York, or London, you might pay 20-25% more. Some clinics offer bundled pricing or financing. But even with discounts, LASIK is consistently more expensive. And while PRK is cheaper, the recovery time might mean taking more unpaid time off work - a hidden cost.

Risks and Long-Term Outcomes

Both procedures are safe. Complication rates are below 2% when done by experienced surgeons. But they carry different risks.

LASIK’s biggest concern is flap-related issues: wrinkles, dislocations, or epithelial ingrowth (where cells grow under the flap). These are rare - about 0.8% of cases - but they can require additional procedures to fix. Dry eye is also common after LASIK, though it usually improves within months.

PRK has a higher chance of temporary corneal haze during healing - a cloudiness that can slightly blur vision. This happens in about 1.2% more cases than with LASIK, but modern techniques and steroid eye drops have made it very manageable. The good news? Long-term, PRK patients often report less chronic dry eye than LASIK patients. A 2022 review by Dr. Robert Steinert found PRK had a slight edge in long-term comfort.

And here’s the big one: after one year, both procedures deliver nearly identical results. Studies show no meaningful difference in final visual acuity. Whether you get LASIK or PRK, you’re just as likely to achieve 20/20 vision or better.

Real People, Real Choices

Reddit’s r/Lasik community is full of honest stories. One user, u/EyeSurgery2022, had PRK as a firefighter. “Days 1-3 were miserable,” they wrote. “But by week four, my vision was 20/15. I’d choose PRK again - no flap means no fear if I get hit in the eye on the job.”

Another, u/QuickVisionFix, had LASIK and went back to their desk job the next day. “I had 20/20 vision by morning. The higher cost? Totally worth it for my schedule.”

Even in high-stakes fields, choices differ. In the NFL, 78% of players choose LASIK because they need to get back on the field fast. In the Marine Corps, 63% of pilots choose PRK because safety protocols ban flap procedures for flight duty.

What Happens Before Surgery?

You can’t just walk in and get laser surgery. A full screening is required. This includes:

• Corneal topography - a 3D map of your cornea’s shape
• Pachymetry - measuring corneal thickness (critical for LASIK eligibility)
• Dry eye tests - if your eyes are too dry, you might need treatment first

If you wear contact lenses, you must stop wearing them before your evaluation. Soft lenses: stop 1-2 weeks ahead. Rigid gas permeable lenses: stop 4 weeks ahead. Contacts change the shape of your cornea. If you don’t stop wearing them, your measurements will be off - and that could lead to poor results.

Aftercare: What You’ll Need to Do

LASIK aftercare is simple. Avoid rubbing your eyes. Don’t swim for two weeks. Use prescribed eye drops for a few days. Most people are back to normal life in under a week.

PRK aftercare is more involved. You’ll wear a bandage contact lens for 3-5 days. You’ll need steroid and antibiotic drops for several weeks to prevent haze and infection. You’ll be told to avoid bright sunlight, dust, and strenuous activity for at least a week. It’s not hard, but it’s more time-consuming.

What’s New in 2025?

PRK isn’t stuck in the past. New techniques like trans-epithelial PRK use the excimer laser to remove the epithelium without alcohol or blades. This reduces healing time by about 25%. It’s becoming more common in top clinics.

The U.S. military fully covers PRK for all service members as of 2024. That’s a huge shift - it means PRK is now the standard for military vision correction, not just an alternative.

Meanwhile, LASIK continues to evolve with better flap creation tools and customized wavefront-guided lasers. But the core choice hasn’t changed: flap or no flap?

Final Decision: It’s Not About Which Is Better - It’s About Which Is Right for You

There’s no single “best” procedure. LASIK wins for speed and convenience. PRK wins for safety in active lifestyles and for people with thinner corneas. Both deliver excellent, lasting results.

Ask yourself:

• Do I need to see clearly in 24 hours - or can I wait a few weeks?
• Do I play contact sports or work in a high-risk job?
• Have I been told I have thin corneas or dry eyes?
• Am I willing to pay more for faster recovery?

Talk to a surgeon who offers both procedures. Don’t let a clinic push you toward the more expensive option. Ask them: “Based on my corneal thickness and lifestyle, which procedure do you recommend - and why?”

The right choice isn’t about popularity. It’s about matching your eyes to the right method - and knowing what recovery will really look like.