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LASIK vs LASEK vs PRK: What Are The Differences

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The main difference between LASEK and PRK is that LASEK preserves the epithelial layer and replaces it after surgery, while PRK fully removes this layer and allows a new one to regenerate. Both procedures are pain-free and take about 10-30 minutes.

On the surface, LASIK, LASEK and PRK are all types of laser eye surgery, but there are some essential differences between the procedures.

So what are the differences between LASIK, LASEK and PRK?

What is LASIK?

LASIK surgery has been performed for over 30 years. The procedure can treat long-sightedness, short-sightedness, and astigmatism. LASIK even helps those with plain-old reading glasses.

During LASIK treatment, your surgeon will use a femtosecond laser to create a thin flap on your cornea. After lifting the flap, the second laser will be used. 

An older technique utilising a blade to create a flap has inferior results. Blade-based LASIK is now obsolete; you should avoid visiting any clinic offering this approach.

The second laser (called an excimer laser) is the one that corrects your need for glasses. Your cornea’s new shape allows clear vision by correctly focusing light onto the retina inside the eye.

After the laser has reshaped your cornea, the flap is folded back into position and fits perfectly. Don’t worry; it sounds much more gruesome than it actually is, and thanks to anaesthetic drops, patients don’t feel any pain.

The Results

Speaking from experience here at Focus Clinic, we’ve achieved incredible results from the advanced A-LASIK procedure. 

One hundred per cent of our patients with common short-sighted prescriptions achieved 20/20 or better vision in published research analysis. We know of no other clinic that has yet matched these results.

The Benefits of LASIK

There are various benefits to undergoing LASIK eye surgery. These are:

  1. Patients don’t usually experience any significant pain with LASIK.
  2. You can generally see results as soon as one to four hours after the treatment and often immediately.
  3. No bandages or stitches are required after your treatment.
  4. It’s cost-efficient as you no longer have to update your frames and prescription or buy contact lenses.
  5. The results are considered permanent for short-sight and astigmatism, and follow-up procedures are rare. Age-related problems such as long-sightedness are often amenable to enhancement in the future.

Not Sure Which Treatment Is Right For You?

We offer a number of vision correction treatments at our London Clinic.

We can give you a good idea of your suitability over the phone and schedule you for an initial consultation.

What is LASEK?

LASEK eye treatments reshape the cornea to correct your focus abnormalities. These treatments are less popular than LASIK due to the post-treatment pain. The healing process is also considerably longer than LASIK and can take four to seven days.

These treatments are sometimes called “surface laser procedures” to distinguish them from the LASIK approach. Surface laser treatments, such as LASEK, are only used in approximately 10% of cases. LASEK benefits those with thin corneas, engaging in contact sports, or highly active lifestyles.

During the procedure, the surface skin cells are removed to expose the collagen underneath. After the laser application, the skin is left to heal for three to seven days.

You’ll start to see improvements in your vision after three to five days, and the pain will tend to wear off three days after your treatment. 

LASEK (or PRK) treatment is usually chosen for patients with thinner corneas, e.g. less than 490-500 microns.

The Results

LASEK surgery has been around for 30 years and is a relatively simple procedure. At Focus Clinic, we’re one of only a handful of clinics in the country with a 5 out of 5 rating and ranked #1 on Trustpilot. 

Our results and outstanding aftercare are why we’re the UK’s most trusted laser eye surgery clinic, supported by our excellent reviews.

The Benefits of LASEK

As with LASIK, there are also various benefits to having LASEK eye treatment:

  • It can correct the vision of people with thinner corneas.
  • It may be an option if you’re severely short-sighted.
  • Beneficial for patients participating in contact sports.

What Is PRK & How Is It Different To LASEK?

LASEK and PRK are both corrective eye surgeries that aim to reshape the cornea permanently; however, there are some differences between procedures.

They are both ‘surface laser’ treatments that do not require a LASIK-type cornea flap.

The terms are often used interchangeably. The results are the same, but there are technical differences during the surgery.

During LASEK, the surgeon uses an alcohol solution to loosen and detach the surface skin layer of the corneal (epithelium). An excimer laser is then used to reshape the cornea and correct your vision, and the epithelium is then replaced and will heal on its own.

PRK is very similar to LASEK. The surgical difference is that the cornea’s surface layer is removed instead of replaced. The excimer laser is still used to reshape the cornea, and new epithelial cells grow back to repair the eye within five days.

The reason that LASEK evolved from PRK was to reduce the risk of haze (surface scarring). It was found that replacing the epithelial skin layer modified wound healing and reduced the incidence of haze after surgery. 

However, most surgeons now perform PRK, removing the epithelium and allowing it to grow back naturally, after discovering that the drug mitomycin C (MMC) could more effectively inhibit haze formation.

MMC is now widely used to prevent post-ablation haze around the world. MMC was first shown to be beneficial in PRK in a 2000 research paper and has essentially removed the need to perform LASEK.

Many clinics may still describe offering LASEK as the term is established, but the procedure performed is likely PRK with MMC. Your consent form and discussion will clarify this.

What Are The Differences Between LASIK, LASEK and PRK?

So, what are the differences between LASIK and surface laser treatments (LASEK and PRK)? 

The main difference is how the cornea is opened to allow access to the laser – is the surface skin layer removed or not?

During LASIK surgery, a corneal flap is created with a femtosecond laser before an excimer laser is used to reshape the shape of your eye and correct your vision. The upper epithelial skin layer remains in place. Vision recovery is much faster, and post-op discomfort is limited to a few hours rather than days.

LASEK and PRK surface laser procedures involve softening the epithelial skin layer with alcohol and detaching it.

The most appropriate method often depends on the thickness of your corneas, which you can’t control. Therefore, the different types of treatment suit different people.

Recovery Times After LASIK, LASEK and PRK

The recovery times are also a significant difference too.

LASIK patients tend to be able to see full results after just four hours of having undergone the procedure, whereas LASEK or PRK patients tend to start seeing a difference after three days. Plus, LASEK and PRK treatments are regarded to be more painful postoperatively than LASIK.

Eyes are unique.

Your unique eye qualities can make you unsuitable for the more popular LASIK treatment. You’ll likely only be referred for LASEK (PRK) treatment if you’re unsuitable for LASIK.

It’s essential to choose the safest procedure for your eyes. If you have thin corneas, surface laser treatments such as PRK and LASEK are safer. Your corneas will decide, not whether you want a pain-free procedure.

Be Sure to Choose the Right Specialist and Clinic

You should always look for and choose a qualified and experienced LASIK or LASEK/PRK surgeon for your vision correction. 

Your sight is paramount to living a hassle-free life. Having this worked on is no mean feat, so you must be confident in a surgeon you can trust.

At Focus Clinic, we’re the only clinic in the country with a 100 per cent success rate and have a 5 out of 5 rating. We also offer a comprehensive aftercare package to ensure that your recovery goes smoothly without hidden costs.

Learn more about Focus Clinic’s treatment offering and our superior service by downloading our free information pack. If you want to learn more about the ins and outs of laser eye surgery before speaking to a clinician, download it below.

About the Author

Mr David Allamby is the founder and medical director of Focus Clinic - the leading provider of laser eye surgery in London. Focus’ commitment is to be the #1 clinic for vision outcome results with 100% of patients achieving 20/20 vision or even better. He is one of a limited number of UK surgeons who work in laser refractive surgery full-time.

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