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LASIK vs PRK/LASEK: What Is the Difference?

LASIK reshapes the cornea under a flap; PRK and LASEK treat its surface. LASIK recovers faster with less pain; one-year results for short sight are similar.

By Vireon Medical Editorial TeamFirst published Evidence checked through

Short answer

All three use the same kind of laser to reshape the cornea (the clear front window of the eye); the difference is what happens to the surface first. LASIK cuts a thin flap and treats underneath it, while PRK and LASEK remove or loosen the thin outer skin of the cornea and treat its surface, with no flap. LASIK usually means less pain and faster recovery, while PRK and LASEK avoid flap-related problems and may suit thinner corneas; at one year, results for short sight are broadly similar. Which is more appropriate depends mainly on corneal thickness and shape, the prescription, and lifestyle.

Key points

  • PRK and LASEK are “surface” treatments; LASIK works under a flap.
  • Randomised trials show LASIK gives faster visual recovery and less pain than PRK.
  • One-year visual results for short sight are comparable, though trial quality is low.
  • Trials have not shown a clear difference between LASEK and PRK.
  • Surface treatments may suit thin corneas, some dry eyes and very active people.

How the three procedures differ

In all three, an excimer laser (an ultraviolet laser that removes microscopic amounts of tissue) flattens or steepens the cornea so light focuses correctly. NICE groups them together as laser corneal reshaping procedures1.

  • PRK (photorefractive keratectomy): the epithelium (the thin outer skin of the cornea) is removed and the laser treats the layer beneath1. The epithelium is cleared using a laser, instruments or a liquid solution, and grows back within several days4.
  • LASEK (laser epithelial keratomileusis): a variant of PRK in which dilute alcohol loosens the epithelium so it can be lifted as a hinged sheet before the laser is applied1.
  • LASIK (laser in situ keratomileusis): a deeper flap is cut with a blade device or a laser, lifted, the tissue underneath is reshaped, and the flap is laid back without stitches15.
FeatureLASIKPRK / LASEK
Corneal flapYes5No4
Pain after surgeryLess2More, usually peaking around days 2 to 34
Visual recoveryFaster2Slower; most people recover over about 6 weeks4
Bandage contact lensNot usually needed; a protective shield is used5Yes, for the first few days4
Results at 1 year (short sight)Comparable2Comparable2
Specific risksFlap displacement, for example from rubbing5Corneal haze or scarring4
General comparison. Recovery and risks differ between individuals and techniques.

What the evidence says

A Cochrane systematic review of 13 randomised trials, covering 1,923 eyes, compared LASIK with PRK for short sight. LASIK gave faster visual recovery and was less painful, and results at one year were comparable: most analyses favoured LASIK, but the differences were not statistically significant2.

The reviewers rated the certainty of most of this evidence as low, mainly because of bias risks in the trials, and called for new trials using current techniques to establish whether the two are equally safe as practised today2. The faster, more comfortable recovery after LASIK is consistent across sources: Moderate. Equivalence of long-term safety is Insufficient.

A separate Cochrane review of 11 trials in 428 adults compared LASEK with PRK for low to moderate short sight. It found similar vision and accuracy at 12 months, a haze difference at 24 months too small to matter clinically, and overall uncertainty about any real difference between the two. The evidence ranged from very low to moderate certainty3. In practice, LASEK and PRK can be thought of as close relatives.

How recovery differs

After LASIK, burning, itching, watering, light sensitivity and hazy vision are expected and should improve within a few days. Advice on time off varies: the US FDA suggests planning a few days off work until these symptoms settle5, while the Royal College of Ophthalmologists says people having LASIK are often able to return to work the day after surgery8. The FDA says vision may take up to three to six months to stabilise5; the Royal College notes that results of laser vision correction can take up to two years to stabilise fully8.

After PRK, a bandage contact lens protects the eye while the surface heals. Discomfort, light sensitivity, a gritty feeling and blurred vision tend to peak around days 2 to 3, and the surface usually closes by days 4 to 5. Vision improves noticeably over the first two weeks, most people recover over about six weeks, and medicated drops may be continued for one to four months4. Return to work or study is often around a week after surgery4.

Who each approach may suit

Surface treatments may be considered for people with thin corneas, where cutting a flap carries more risk; for some people with dry eyes, because making a flap can disrupt corneal nerves involved in moisture; and for very active people, since a LASIK flap can be dislodged by injury4. LASIK remains more widely chosen because recovery is faster and usually less painful4.

Some people are not suitable for any laser corneal procedure. The American Academy of Ophthalmology lists, among others, an unstable prescription, very high prescriptions, severe dry eye, thin or diseased corneas such as keratoconus, and poorly controlled diabetes6. NICE describes ectasia (progressive weakening and bulging of the cornea) as a serious complication of refractive surgery that can lead to loss of vision1, which is one reason corneal thickness and shape are measured so carefully beforehand.

When to seek medical advice

Contact the treating eye team straight away for severe pain or symptoms that get worse rather than better after surgery5. Some soreness after PRK is expected in the first few days, but it should then fade4.

Common questions

Is PRK more painful than LASIK?

Yes, usually; randomised trials found LASIK less painful2, and PRK discomfort typically peaks on days 2 to 3 before settling4.

Is LASEK the same as PRK?

Almost; LASEK is a variation of PRK that loosens the surface layer with dilute alcohol rather than removing it outright1, and trials have not shown a clear difference in results3.

Is one more accurate than the other?

Not clearly; at one year, LASIK and PRK give comparable results for short sight2, and NICE notes final unaided vision is similar across all three techniques1.

Are these treatments available on the NHS?

Usually not; the NHS says laser eye surgery is generally only available privately, except where glasses or contact lenses cannot correct the problem or for certain eye conditions7.

Bottom line

LASIK trades a flap for a quicker and more comfortable recovery; PRK and LASEK avoid a flap at the cost of a slower, sorer first week. For short sight the end results are broadly similar, so the choice usually turns on the cornea itself and on how a person lives and works.

Sources

  1. National Institute for Health and Care Excellence. Photorefractive (laser) surgery for the correction of refractive errors (IPG164). NICE; 2006. https://nice.org.uk/guidance/ipg164/resources/photorefractive-laser-surgery-for-the-correction-of-refractive-errors-pdf-1899863340595909. Accessed 5 November 2026.
  2. Shortt AJ, Allan BDS, Evans JR. Laser-assisted in-situ keratomileusis (LASIK) versus photorefractive keratectomy (PRK) for myopia. Cochrane Database of Systematic Reviews; 2013;(1):CD005135. https://doi.org/10.1002/14651858.CD005135.pub3.
  3. Li SM, Zhan S, Li SY, Peng XX, Hu J, Law HA, Wang NL. Laser-assisted subepithelial keratectomy (LASEK) versus photorefractive keratectomy (PRK) for correction of myopia. Cochrane Database of Systematic Reviews; 2016;(2):CD009799. https://doi.org/10.1002/14651858.CD009799.pub2.
  4. Cleveland Clinic. Photorefractive keratectomy (PRK) eye surgery. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/photorefractive-keratectomy-prk-eye-surgery. Accessed 5 November 2026.
  5. US Food and Drug Administration. LASIK: What should I expect during and after surgery? FDA. https://www.fda.gov/medical-devices/lasik/what-should-i-expect-during-and-after-surgery. Accessed 5 November 2026.
  6. American Academy of Ophthalmology. LASIK (laser eye surgery). AAO EyeSmart; 2026. https://www.aao.org/eye-health/treatments/lasik. Accessed 5 November 2026.
  7. NHS. Laser eye surgery and lens surgery. NHS website; reviewed 2024. https://www.nhs.uk/tests-and-treatments/laser-eye-surgery-and-lens-surgery/. Accessed 5 November 2026.
  8. The Royal College of Ophthalmologists. Laser vision correction: patient information. RCOphth. https://rcophth.ac.uk/laser-vision-correction-patient-information. Accessed 5 November 2026.

Article history

  • — First published.