How surface treatment works
The thin outer skin of the cornea is moved aside (LASEK) or gently removed (PRK, and the no-touch version, TransPRK). The same kind of laser used in LASIK then reshapes the cornea. A soft bandage contact lens goes on to protect the eye while the surface grows back over three to four days.
Who it suits
People whose corneas are on the thin side for LASIK, people in contact sports or uniformed jobs where a flap could be knocked, and people with a slightly irregular corneal surface the surgeon wants to smooth. It treats short sight, long sight and astigmatism.
Who should look at something else
- Anyone under 18. Laser eye treatment is for adults, and most clinics want you a little older, once the prescription has settled.
- Anyone whose prescription changed in the last year. Wait until it has held steady.
- Pregnancy and breastfeeding, when hormones can change the prescription. Wait until things have settled.
- Keratoconus, or a cornea the scans show is too thin or irregular for laser.
- Uncontrolled diabetes, or an autoimmune condition or medicine that affects healing, without extra assessment first.
- Anyone who can't take most of a week off. Surface treatment needs about five days before most desk jobs.
Recovery, day by day
- Days 1 to 3: the eyes are sore, watery and light-sensitive, worst around day two or three. Painkillers and drops help.
- Days 4 to 5: the surface has healed and the bandage lens comes out at a check-up.
- Week 1: most people drive and go back to work between day 3 and day 7, once the clinic is happy.
- Weeks 4 to 6: sight keeps sharpening.
- Months 3 to 6: the result is considered stable. Steroid drops for some weeks or months reduce the chance of haze.
The risks, honestly
The same side effects as LASIK (glare and halos at night, dry-feeling eyes, a chance of needing a top-up), plus more pain in the first days and a small chance of haze on the cornea, which the drops are there to prevent. There is no flap, so there is no flap complication. Infection is rare but more likely in the first days while the surface heals. No laser can make you see better than you already see with your glasses on. It can only take the glasses away.
What it costs
LASEK and PRK cost €800 to €2,600 per eye, so €1,600 to €5,200 for both eyes. The lowest prices are for low prescriptions. Tax relief at 20% applies.
Choosing a surgeon
Ask for the surgeon's name and check it on the Medical Council's register. By law a doctor can only practise independently as a specialist with specialist registration, and an eye surgeon should be on the Specialist Division of the register in ophthalmology.
The Royal College of Ophthalmologists advises taking at least a week after the consultation with your surgeon before you decide, and checking that any deposit is refundable if you change your mind.
Questions people ask
What is the difference between LASEK and PRK?
Both treat the surface. In LASEK the surface layer is loosened and moved aside; in PRK it is removed and regrows. The recovery is much the same.
Why would a surgeon choose PRK over LASIK?
Usually because the cornea is thin, the surface is irregular, or your sport or job carries a risk of a blow to the eye.
How long off work after PRK?
Plan on about five working days, more if your job is outdoors, dusty or involves driving.
Is the end result as good as LASIK?
For suitable eyes, the final sight is usually similar. It simply takes longer to get there.