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

When you’re tired of glasses or contacts, laser eye surgery feels like a game-changer. But with two main options-LASIK and PRK-it’s easy to get stuck wondering which one actually fits your life. Both fix nearsightedness, farsightedness, and astigmatism using the same laser to reshape your cornea. The big difference? LASIK cuts a flap. PRK removes the surface layer. That small change affects everything: how fast you see clearly, how much it costs, and even who’s eligible.

How LASIK Works (And Why It’s So Popular)

LASIK starts with a thin flap on the surface of your cornea. A femtosecond laser or a tiny blade lifts it back like a hinged door. Then, an excimer laser zaps the inner layer to reshape it-correcting how light hits your retina. The flap is laid back down. No stitches. It sticks naturally.

That’s why most people choose LASIK. Vision improves fast. Most patients see well enough to drive by the next day. By 48 hours, 90% are at 20/20 or better. You’re back to work, scrolling on your phone, watching TV-almost no downtime. That speed is why over 650,000 LASIK procedures happen in the U.S. every year.

The catch? You need enough corneal thickness. Surgeons need at least 500-550 microns to safely create the flap and still leave 250-300 microns of healthy tissue underneath. If your cornea is too thin, LASIK isn’t safe. That rules out about 1 in 5 people who think they’re good candidates.

How PRK Works (The Original Laser Vision Fix)

PRK was the first laser vision correction approved by the FDA-in 1995. It doesn’t make a flap. Instead, the outer layer of the cornea (the epithelium) is gently removed-using alcohol, a brush, or the laser itself. Then the same excimer laser reshapes the cornea underneath.

Afterward, your body grows a new epithelium over the next 3-5 days. During that time, you wear a bandage contact lens. Your vision is blurry. Your eye feels scratchy, light-sensitive, even painful. It’s not fun. Most people need 3-7 days off work. Full clarity can take weeks, and it may take 3-6 months to reach your best vision.

But here’s the thing: once healed, your vision is just as sharp as LASIK. Studies show no difference in long-term results. In fact, PRK has a slightly lower risk of chronic dry eye over time. And because there’s no flap, there’s no risk of it getting dislodged-something that matters if you play contact sports, work in construction, or serve in the military.

Recovery: Fast vs. Slow

Recovery is where the real trade-off lives.

LASIK: You wake up the next day with 20/20 vision. You can go back to your desk job, drive, watch Netflix. You avoid rubbing your eyes for a week and skip swimming for two weeks. That’s it.

PRK: Days 1-3 are rough. Bright lights hurt. Vision is foggy. You can’t drive. You need pain meds and artificial tears. You’re on antibiotic and steroid drops for weeks to prevent haze and infection. Most people take 5-7 days off. It takes a month to feel normal. Peak vision? That’s 3-6 months out.

One firefighter in Sydney told me: "I chose PRK because I don’t want a flap that could pop open if I get hit in the face during a rescue." He had his surgery in January 2022. By week four, he was seeing 20/15. "Worth every day of discomfort," he said.

Compare that to a software engineer who had LASIK last July: "I was back at my computer 24 hours later. My vision was perfect. I didn’t miss a single workday. The higher cost? Totally worth it."

Who’s a Better Fit for PRK?

PRK isn’t just the "slower" option. It’s the safer option for certain people:

• Corneas thinner than 500 microns
• Irregular corneal shape (like mild keratoconus)
• Chronic dry eye-PRK causes less long-term dryness
• Athletes in contact sports: boxing, MMA, rugby
• Military personnel-especially pilots and special forces

The U.S. military now covers 100% of PRK for service members, thanks to the lack of flap risk. In Australia, while not publicly funded, many veterans and police applicants are encouraged to choose PRK for the same reason.

PRK also works better for people with physically demanding jobs-firefighters, electricians, construction workers-who can’t risk trauma to their eyes.

Who’s a Better Fit for LASIK?

LASIK wins if you need speed:

• You’re a business professional who can’t take more than a day off
• You’re in your 30s or 40s and hate wearing glasses for work
• You have thick, healthy corneas (over 550 microns)
• You want to resume sports like running, cycling, or swimming quickly
• You’re not comfortable with days of blurry vision

Over 78% of NFL players choose LASIK. Why? They need to get back on the field fast. Same with corporate workers, teachers, and parents who can’t afford a week of visual fog.

Cost Differences

PRK is cheaper. Why? It uses one laser instead of two. No flap creation means less equipment, less time in the operating room.

In 2023, average prices in Australia were:

• PRK: $2,200 per eye
• LASIK: $2,600 per eye

That’s a $800 difference for both eyes. In Sydney or Melbourne, prices can be 20-25% higher. Some clinics offer payment plans, but insurance rarely covers either. Only 12% of U.S. plans pay for refractive surgery-and even then, mostly for military personnel.

Don’t just pick based on price. A $500 discount isn’t worth 6 weeks of blurry vision if your job demands clear sight.

Complications: What Can Go Wrong?

Both procedures are extremely safe. Complication rates are under 2% when done by experienced surgeons.

LASIK risks:

• Flap dislocation (rare, but possible after trauma)
• Epithelial ingrowth (cells grow under the flap)
• Temporary dry eye (more common than with PRK)

PRK risks:

• Corneal haze during healing (usually temporary, treatable with drops)
• Slower visual recovery
• Higher discomfort in the first week

A 2021 study of 12,000 patients found LASIK had a 0.8% flap-related complication rate. PRK had a 1.2% higher rate of haze-but that haze faded in 95% of cases with proper care.

Pre-Op Screening: What They Check

You can’t just walk in and get surgery. Both procedures require a full eye exam:

• Corneal topography-maps your cornea’s shape
• Pachymetry-measures corneal thickness (critical for LASIK)
• Dry eye test-PRK is better if you have this
• Contact lens history-you must stop wearing them for 1-4 weeks before (rigid lenses need 4 weeks)

If your cornea is too thin, or your dry eye is severe, you’ll be steered toward PRK-even if you want LASIK.

What’s New in 2025?

Technology keeps improving. Trans-epithelial PRK is now available in some clinics. Instead of using alcohol or a blade to remove the epithelium, the laser does it all-no touch. This reduces healing time by 25% compared to old-school PRK.

Meanwhile, LASIK is getting smarter. Wavefront-guided and topography-guided lasers now correct not just your prescription, but tiny irregularities in your cornea that cause glare or halos at night.

But here’s the truth: neither procedure is going away. Even with new options like SMILE or ICLs, LASIK and PRK remain the gold standard. They’ve been around for decades. The data is solid. The outcomes are predictable.

Final Decision: It’s Not About Which Is Better

There’s no "best" option. Only the right one for you.

Choose LASIK if:

• You need vision back fast
• Your corneas are thick and healthy
• You can afford the higher cost
• Your lifestyle demands quick recovery

Choose PRK if:

• Your corneas are too thin for LASIK
• You’re in a high-risk job or sport
• You’re okay with a slower recovery
• You want lower long-term dry eye risk

Both give you freedom from glasses and contacts. Both are safe. Both work. The only real question is: how fast do you need to see?