#ectasia

The most important thing to know is that the END results are the SAME. There are plenty of studies comparing visual results, and the two techniques are equivalent.

The following factors may influence your decision.  I subjectively put these in order of importance.

Recovery time (LASIK wins)

LASIK is faster.  LASIK is less painful.

PRK hurts, especially the first 3 days.

Remember the main difference in technique is flap (LASIK) versus no flap (PRK).  Think of the LASIK flap like moleskin covering a blister.  In PRK, there is no flap to cover the raw surface of the cornea that was just elegantly and precisely reshaped by the laser.

In LASIK your vision clears up very quickly, within a few days.  In PRK you've got to wait for your cornea surface to regrow, this can take a week.  Your vision will be blurry until this is complete.

Complications (slight edge: PRK)

Both can cause dry eyes, halos, glare, and light sensitivity.

LASIK-specific complications include: flap dislocation, infections and inflammation under the flap, abnormal cell growth at the flap interface, and a condition we ophthalmologists call ectasia.  Ectasia is when the cornea warps and thins out, simliar to a condition called keratoconus.  Thankfully, this is a very rare complication and are now very good at predicting which eyes are more likely to develop ectasia.  In these cases we recommend against LASIK in favor of other options.

PRK complications include: haze, infection, and inflammation.

Any of these complications can compromise vision.

Technique (slight edge: PRK)

LASIK video; PRK video

In LASIK, a flap needs to be created.  This accomplished either with a very precise blade or with a laser.  Either way, the eye needs to be firmly held immobile while the flap is made.  This is accomplished with a suction device the presses down on your eye... hard.  It's the most uncomfortable part of the procedure.  Luckily it's only for a few seconds, depending on the flap cutting technique.  This is an extra step that makes the entire process longer for LASIK than for PRK.

The criteria is a little more strict to be a candidate for LASIK.  Your eye doctor will put you through a battery of preliminary tests to decide which procedure you are a candidate for.

If you get LASIK you have to be comfortable with the idea of having a corneal flap.  There used to be more concerns that even long after the surgery, the flap could get traumatically dislodged.  In actuality, there are very few reported cases of this happening, and with the newer techniques this potential complication is extremely unlikely.  It's been deemed so safe, that LASIK has been approved by the U.S. Navy, even for SEALs and pilots.

My opinion is that if you're a candidate for LASIK, then go for it...  provided you have a good ophthalmologist with plenty of experience, and who does rigorous testing to make sure you are a good candidate.

Related eye doc questions:

what other options do I have besides LASIK and PRK?

what is the technology behind LASIK and PRK?

how much is LASIK and PRK?

can i get "retreated" after LASIK or PRK?