PRK (or photorefractive keratectomy) is laser vision correction similiar to LASIK.

PRK is used to correct nearsightedness, farsightedness and astigmatism. It differs from LASIK surgery in that no corneal flap is created prior to the laser vision correction treatment.

PRK can be performed on thinner corneas.  Since no corneal flap is required, more of the patient's corneal thickness is available for laser treatments.  An alternative to PRK is IntraLase LASIK.  IntraLase LASIK is also known as "bladeless LASIK" and is also be used for patients with thinner corneas.

How is PRK performed?

  • Anesthetic eye drops are applied to the eye to numb the cornea and prevent discomfort during the procedure.
  • A small instrument is used to hold both eyelids open throughout the procedure.
  • During the PRK procedure, the surgeon gently removes the thin, outer layer of corneal cells (called the epithelium) that has been softened with the anesthetic eye drops and / or a weak alcohol solution.  This is performed manually with a surgical spatula or rotating brush.
  • After the epithelium has been removed, the Excimer laser changes the shape of the cornea in order to correct the vision.  This part of the procedure takes less than one minute for most patients.
  • Following the laser vison correction procedure, the surgeon places a clear, bandage contact lens on the eye for improved comfort.  This contact lens is left on the eye for 3 to 4 days while the epithelium grows back over the surface of the cornea.
  • Antibiotic and anti-inflammatory eye drop medications are prescribed for use for a period of time after PRK to reduce the risk of infection and facilitate the healing process.  Only eye drops approved by the doctor should be used.
  • Any post-operative discomfort is usually treated with over the counter pain relievers such as Tylenol.

Most patients need to continue using medicated eye drops for 6 to 12 weeks after PRK.  Some patients may need to continue to use the drops for up to 6 months or longer.   Typically, patients who have higher amounts of nearsightedness, farsightedness or astigmatism will need to use medicated eye drops longer than patients who have mild prescriptions prior to surgery.

The eyes are dry after PRK, even though they may not feel that way.  Punctal plugs and / or preservative-free rewetting drops are used to treat this condition.  Keeping the corneas well hydrated is important to the healing process.

The majority of patients return to everyday activities within 2 to 5 days after surgery. Following PRK vision may fluctuate between clear and blurry for the first few weeks following surgery. Glasses for night driving or reading may be helpful until vision stabilizes. Vision will gradually improve, but your best vision may not be obtained for up to 6 weeks to 6 months following surgery.

PRK is an excellent alternative when neither LASIK or IntraLase LASIK are options.

If you’re considering LASIK, the first step is to schedule a one-on-one free LASIK  screening consultation with us.  During your consultation we will provide OrbScan and WaveScan analysis, discuss treatment options, as well as any available insurance discounts and financing options. And, of course, we are happy to answer any questions you may have. 


To schedule your complimentary LASIK screening consultation give us a call at (208)377-8899.  Saturday appointments available. 


Watch The Video: An Artisan Optics Patient Talks About Life After LASIK

PRK | LASIK Without a Flap

PRK Laser Eye Surgery: LASIK Without a Flap

PRK (or photorefractive keratectomy) is the second most popular laser eye surgery in the United States, behind LASIK. The question of PRK Vs LASIK is common for consumers interested in laser vision correction. Like LASIK, PRK uses an excimer laser to reshape the cornea. But in PRK, no corneal flap is created with a microkeratome or femtosecond laser prior to the corneal reshaping.Instead, the central portion of the thin outer layer of the cornea (the epithelium) is removed from the eye, usually after being loosened with a dilute alcohol solution. The excimer laser treatment is then applied to the underlying corneal tissue (the stroma) to reshape the eye. After the laser treatment, the cornea is covered with a bandage contact lens. Within days, new epithelial cells grow back and the bandage contact is removed.

Pros and Cons of PRK vs. LASIK

PRK has one distinct advantage over LASIK: because no corneal flap is created, there is no risk of flap complications during or after the procedure. This may be important for people who are engaged in activities that put them at risk for eye injuries (and potentially, LASIK flap dislocations) after surgery. Boxing and martial arts are good examples.

PRK also can be performed safely on corneas that may be too thin for LASIK. Since no LASIK-style flap is required, the entire thickness of the underlying corneal stroma is available for treatment. A person who has PRK surgery rather than LASIK will have a thicker residual "stromal bed" after the excimer laser treatment.

In LASIK, on the other hand, the corneal flap contains both epithelial and stromal tissues, so the underlying corneal stroma is reduced in thickness. The same amount of excimer laser reshaping with LASIK leaves less residual stroma under the corneal flap, which may affect the biomechanical strength and stability of the eye in some cases. Excimer laser treatments that cause too much reduction in the residual stromal bed have been indicated as a potential cause of a serious LASIK complication called corneal ectasia, which can severely distort vision and cause permanent vision loss. It's important to know that PRK causes more discomfort than LASIK the first few days after surgery, and complete visual recovery after PRK surgery can take a few weeks longer than LASIK recovery time.

The PRK Procedure

The basic steps in PRK surgery are:

  1. Anesthetic eye drops are applied to the eye to prevent discomfort during surgery.

  2. A central area of corneal epithelium is removed either with a laser or manually after being softened with a dilute alcohol solution.

  3. An excimer laser is used to reshape the underlying corneal tissue.

  4. Antibiotic and anti-inflammatory drops are applied to the eye, and the eye is covered with a bandage contact lens.

Two or three days later (after the epithelium has had a chance to grow back), the bandage contact lens is removed.

Considerations After PRK Surgery

Before consenting to PRK surgery, be aware that:

  • PRK causes more post-operative discomfort than LASIK. This may last for a week or longer.

  • It can take three to six months to achieve optimal vision after PRK. Blurred vision, glare and sensitivity to light are common for several days or longer after the procedure.

  • You may be required to use medicated eye drops for up to six months after PRK to prevent or reduce corneal haze or scarring.

PRK Cost

The cost of PRK is comparable to the cost of LASIK eye surgery. Like LASIK and other laser vision correction surgery, PRK is considered an elective procedure and therefore costs associated with the surgery typically are not covered by health insurance. You can lower your PRK costs by setting up a Health Savings Account (HSA) at your bank or contributing to flexible health benefits program at work. Many refractive surgeons also offer financing programs that allow you to pay for PRK and other vision correction procedures over time at attractive interest rates or interest-free.

Other PRK Facts

Here are a few other PRK surgery facts to consider:

  • PRK has been performed longer than LASIK. It gained FDA approval for use in the United States for the correction of nearsightedness in 1995 and for the treatment of farsightedness in 1998.

  • Studies show the visual results of PRK and LASIK six months after surgery are comparable. (But vision returns to normal faster after LASIK, with less post-operative discomfort.)

  • PRK typically is used to correct up to -7.00 diopters (D) of nearsightedness and up to +4.00 D of farsightedness, with or without astigmatism.

  • Just like LASIK, PRK can be used as a type of presbyopia laser surgery for treatment for age related myopia (presbyopia).

  • During PRK, the excimer laser can be programmed to deliver a standard laser treatment (or ablation) or a customized, wavefront-guided ablation, like that used for wavefront LASIK.

Because PRK eliminates the risk of flap complications, some refractive surgeons prefer PRK to LASIK for many patients, especially those with marginally thin corneas.

PRK also is recommended by many surgeons to improve vision after cataract surgery. When PRK and cataract surgery are combined it is sometimes called refractive cataract surgery. (It is important to note that the laser used for PRK is different than that used for laser cataract surgery.) PRK can also be recommended to improve vision after previous refractive procedures on the same eye, including radial keratotomy (RK), refractive lens exchange (RLE) and phakic IOL implantation.

Note: This information is for general education purposes only. It is not to be used as a substitute for medical advice from your eye doctor or refractive surgeon.