# PRK (Photorefractive Keratectomy)

> Citation bundle for PRK (Photorefractive Keratectomy) on The Treatment Registry.
> URL: https://thetreatmentregistry.com/procedures/prk
> Bundle URL: https://thetreatmentregistry.com/api/citations/procedures/prk

- Category: ophthalmology
- Average recovery: 7 days
- Typical sessions: 1
- Price range (USD international): $1,200–$3,500

## Description

PRK is a refractive laser eye surgery in which the corneal epithelium is removed and an excimer laser reshapes the underlying corneal stroma to correct myopia, hyperopia, or astigmatism. PRK predates LASIK and remains the preferred surface-ablation technique for patients with thin corneas, occupational requirements that contraindicate a corneal flap (military, contact sports), or borderline topography that makes a flap risky. Recovery is slower and more uncomfortable than LASIK because the epithelium has to heal over the treated cornea — typically 3-5 days with a bandage contact lens — but biomechanical integrity of the cornea is preserved.

## Overview

PRK was the first widely-adopted excimer laser refractive procedure (FDA-approved 1995). Modern PRK is a quick outpatient procedure under topical anaesthesia: a brush, alcohol solution, or laser removes the corneal epithelium, the excimer laser ablation is performed in seconds to minutes per eye, and a bandage contact lens protects the eye while the epithelium regenerates over 3-5 days. Mitomycin C is commonly applied at the end of the procedure in higher corrections to reduce haze formation.

## Peer-reviewed outcome rates

- **Complication rate:** 2.00% (range 1.00–5.00%) — from 2 cited sources
- **Revision rate:** 5.00% (range 2.00–10.00%) — from 1 cited source

## Common risks

- Pain during epithelial healing (days 1-4)
- Corneal haze (especially in higher corrections)
- Dry eye
- Slow visual recovery
- Under- or over-correction

## FAQs

### Will PRK hurt?

There is typically meaningful discomfort during days 1-3 — described as a foreign-body sensation, similar to having sand in the eye. Prescribed analgesia and frequent lubricating drops help substantially. By day 4-5 most patients are comfortable. The procedure itself is painless under topical anaesthesia.

### How does PRK compare to LASIK?

PRK produces equivalent final visual outcomes to LASIK in most studies (Cochrane Database, 2017) but takes longer to achieve them. The main advantage of PRK is biomechanical: no corneal flap is created, so there is no risk of flap dislocation later in life. The main disadvantages are slower recovery and more discomfort in the first few days. Modern femtosecond LASIK has narrowed the safety gap considerably.

### Am I a candidate for PRK if I was told 'no' for LASIK?

Sometimes. Patients with thin corneas, borderline topography, large pupils, occupational requirements that exclude flaps, or high-impact-sport involvement may be PRK candidates when LASIK is contraindicated. A corneal topography and pachymetry assessment will identify whether your corneas can safely accommodate the procedure.

### When can I drive after PRK?

Most surgeons advise no driving for 5-7 days post-PRK until vision has substantially recovered and any double vision or significant blur has resolved. Some patients can drive earlier; the test is whether you can read a number plate from 20 metres with the operated eye.

### Is PRK reversible?

PRK is not reversible in the sense of restoring the cornea to its original shape, but the lack of a permanent flap means the cornea retains better biomechanical integrity than after LASIK. If a refractive surprise occurs, an enhancement procedure can address it.

### How much does PRK cost compared to LASIK?

PRK is typically priced 10-20% below LASIK at the same clinic because the equipment cost is lower (no femtosecond flap creation). Total cost per eye varies by country and clinic.

### Can PRK correct astigmatism?

Yes — PRK is FDA-approved for the correction of myopia, hyperopia, and astigmatism. The excimer laser ablation pattern can be calculated to address all three refractive errors in the same procedure, provided pre-operative pachymetry confirms adequate corneal thickness for the planned correction.

### Will my prescription change after PRK?

Final refraction typically stabilises at 1-3 months post-op. A small proportion of patients experience long-term regression toward myopia, particularly in higher corrections. Enhancement procedures are available between 3-12 months post-op if a refractive surprise persists.

## Alternative treatments

- **LASIK** — Faster visual recovery and less postoperative pain when corneal thickness allows flap creation.
- **SMILE** — Flapless alternative with similar surface-impact profile but narrower indication.

## Sources

- [Cochrane Database — LASIK versus PRK for myopia](https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005135.pub3/full) — Cochrane Database of Systematic Reviews (accessed 2026-05-09)
- [American Academy of Ophthalmology — Preferred Practice Patterns including Refractive Surgery](https://www.aao.org/preferred-practice-pattern) — American Academy of Ophthalmology (accessed 2026-05-09)
- [ESCRS — Clinical research and guidelines](https://www.escrs.org/clinical-research/) — European Society of Cataract and Refractive Surgeons (accessed 2026-05-09)