PRK (Photorefractive Keratectomy)

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PRK (Photorefractive Keratectomy)

If you’ve been told you’re not an ideal candidate for LASIK because of thinner corneas, dry eyes, or active lifestyle.

PRK is often the better option.

In some cases, it is safer.

It’s one of the oldest laser vision correction procedures.

Its long track record, combined with newer refinements, has kept it relevant even as newer technologies have emerged.

What Is PRK?

PRK vs LASIK: A comparison

Photorefractive keratectomy (PRK) is a laser eye surgery used to correct myopia (nearsightedness), hyperopia (farsightedness), and astigmatism.

Unlike LASIK, a thin flap is created in the cornea before reshaping tissue underneath.

PRK works directly on the corneal surface.

The outer layer of cells (the epithelium) is gently removed.

The excimer laser reshapes the cornea beneath it, and the epithelium is left to regenerate naturally over the following days.

Because there’s no corneal flap involved, PRK avoids flap-related complications altogether, which is one of the main reasons it remains the preferred choice for certain patients.

What Causes the Need for PRK (Rather Than LASIK)?

PRK tends to be recommended, rather than LASIK, in patients who have:

  • Thinner corneas, where there isn’t enough tissue to safely create a LASIK flap
  • Higher risk of trauma, such as athletes, military personnel, or those in contact sports
  • Certain corneal surface irregularities where preserving corneal biomechanical strength matters more
  • A family history of keratoconus or subtle topography changes, where avoiding a flap reduces the risk of future complications
  • Chronic dry eye, since PRK tends to affect corneal nerve sensitivity less than LASIK

How the Procedure Works

PRK procedure overview

PRK is performed as an outpatient procedure and typically completes in about 10–15 minutes per eye, similar to LASIK.

The surgeon removes the corneal epithelium after numbing drops are applied.

They may use mechanical scraping, an alcohol solution, or trans-epithelial PRK (TPRK).

TPRK reshapes the cornea in one pass.

Additionally, recent studies report this newer approach, using advanced excimer laser platforms, yields excellent visual outcomes.

Once the reshaping is complete, a protective contact lens (bandage lens) is placed over the eye to shield it while the epithelium heals over the following several days.

Why Patients Choose PRK

  • No corneal flap = no flap-related complications, ever, even years later
  • Preserves more corneal tissue and biomechanical strength, which matters for long-term corneal stability
  • Excellent long-term outcomes — studies following patients 8 to 10 years after PRK show refractive results remaining highly stable over time
  • Well suited for thinner corneas and patients considered borderline or unsuitable for LASIK
  • Lower long-term risk profile for patients with risk factors for corneal ectasia

What Recovery Looks Like

Recovery from PRK takes longer than LASIK, and it’s important to go in with the right expectations:

  • The first 3–5 days involve some discomfort, light sensitivity, and watering as the epithelium regenerates — this is the main trade-off compared to LASIK’s faster comfort curve
  • A bandage contact lens is worn during this healing window and removed once the surface has re-epithelialized
  • Vision is blurry initially and gradually clears over 1–2 weeks, though it can take up to a few months to reach its sharpest, most stable point
  • Anti-inflammatory and antibiotic drops are used for several weeks after surgery, and in select cases, a brief course of medication is used to minimize the risk of corneal haze
  • Most patients can return to non-strenuous work within a week, though full visual stabilization takes longer than with LASIK

Who Is a Candidate?

You may be a good candidate for PRK if you:

  • Have myopia, hyperopia, or astigmatism you’d like to reduce your dependence on glasses or contacts for
  • Have corneas that are too thin for LASIK
  • Have a lifestyle or occupation with higher risk of eye trauma
  • Have mild dry eyes or corneal surface concerns that make LASIK less suitable
  • Are willing to accept a somewhat longer, more gradual recovery in exchange for a strong long-term safety profile

PRK has been performed for decades, and unlike many procedures that fade out as newer techniques arrive, it has only gotten more refined — better lasers, better epithelial removal techniques, and a genuinely excellent long-term track record. If you’ve been curious about laser vision correction but were told LASIK isn’t right for you, it’s very much worth a conversation about whether PRK is.