Surface laser eye surgery, particularly suited to thin corneas and athletes, in Paris, with Dr Gozlan.
PRK (photorefractive keratectomy, or PRK) is a technique for laser eye surgery to correct myopia (nearsightedness), offered in particular when LASIK is not suitable. Performed on the surface of the cornea, without creating a flap, it corrects myopia (nearsightedness) and astigmatism and is particularly well suited for thin corneas and individuals exposed to eye trauma. Dr Gozlan, an ophthalmic surgeon holding an Inter-University Diploma (DIU) in Refractive Surgery (Université Paris Cité), explains the principle, indications, procedure, recovery, results, risks and cost of this surgery.
PRK (photorefractive keratectomy) is the oldest and one of the most extensively studied forms of refractive laser eye surgery. Unlike LASIK, it does not create a corneal flap : the thin layer of surface cells on the cornea, called the epithelium, is gently removed, and then the excimer laser reshapes the corneal surface to correct the visual defect. The epithelium regenerates naturally within a few days. The procedure is short and is performed on an outpatient basis.
By acting directly on the corneal surface, PRK preserves as much tissue thickness as possible : this is what makes it the treatment of choice for thin corneas. It has been performed since the late 1980s and has a track record of over thirty years.
Myopia (nearsightedness) is the most common indication for PRK. In a nearsighted eye, which is too long, the image focuses in front of the retina and distance vision is blurred. To correct myopia (nearsightedness), the excimer laser flattens the central cornea at the surface, reducing its optical power and shifting the focal point back onto the retina.
PRK is mainly indicated for correcting mild to moderate myopia (nearsightedness) ; for higher corrections, the surgeon evaluates the available corneal thickness and may recommend an alternative solution (phakic intraocular lens) if needed. As with all refractive laser eye surgery, the correction of myopia (nearsightedness) is long-lasting in the vast majority of cases : the reshaped corneal tissue does not grow back. A slight regression remains possible and can, if needed, be treated with an enhancement.
Astigmatism, frequently associated with myopia (nearsightedness), is corrected at the same time by PRK. The astigmatic cornea has an oval shape ; the excimer laser applies an asymmetric ablation that evens out its meridians and restores a spherical shape, eliminating distorted and doubled vision. Surface PRK is particularly well suited for correcting astigmatism on thin corneas, and also benefits from customized treatments guided by topography or aberrometry.
PRK belongs to the family of surface techniques, which differ in the way the epithelium is removed :
All rely on the same excimer laser and deliver equivalent results ; the choice depends on the surgeon's preferences and the characteristics of the cornea.
PRK is intended for patients wishing to correct myopia (nearsightedness), astigmatism, or hyperopia (farsightedness), whose vision has been stable for at least one year. It is particularly recommended :
For high corrections or corneas too thin even for PRK, a phakic implant may be offered. Only the preoperative assessment can determine the most suitable technique.
No procedure is performed without a thorough and painless preoperative assessment. Before PRK, it includes :
As with any laser eye surgery, contact lenses must be removed several days to several weeks before the assessment to avoid distorting the measurements.
PRK is performed on an outpatient basis, without hospitalization, in six steps. You remain awake ; the procedure is short.
The main distinguishing feature of PRK is its recovery, which is more gradual than that of LASIK. While the epithelium regrows, which is usually complete within 5 days (AAO), discomfort, tearing, and significant light sensitivity are common ; these are relieved by painkillers, eye drops, and the bandage contact lens. After that, vision improves day by day :
The results of PRK are ultimately equivalent to those of LASIK : comparative trials show no difference in visual acuity at one year, with only the speed of recovery differing (Cochrane review, Shortt et al.). The result is usually stable; an enhancement remains possible in the event of slight regression. As with all refractive surgeries, the procedure does not correct presbyopia, which most often develops shortly after age 40 (AAO).
Surface laser eye surgery has been performed for over thirty years. Risks are rare and most often temporary :
Adherence to contraindications and the quality of the preoperative assessment reduce these risks to a minimum.
PRK is not performed in the presence of : progressive keratoconus, unstable refraction, pregnancy or breastfeeding, severe dry eye, certain corneal or autoimmune diseases, and in patients under 18 years of age. In some cases, a phakic implant may be preferable.
PRK and LASIK use the same excimer laser and correct the same refractive errors — myopia (nearsightedness), astigmatism, hyperopia (farsightedness) — but PRK works on the surface of the cornea, whereas LASIK involves creating a corneal flap. The difference is mainly felt during recovery : longer and somewhat uncomfortable during the first few days with PRK, but very fast with LASIK. On the other hand, the absence of a flap makes PRK safer for thin corneas and for those exposed to impacts.
The absence of a corneal flap makes PRK the technique of choice for contact sports participants (boxing, rugby, martial arts) and professions exposed to eye injuries (firefighters, military personnel, law enforcement, certain manual trades), where a flap could theoretically shift upon impact. This is one of the major advantages of PRK over LASIK for these profiles.
As with LASIK, laser eye surgery is not covered by public health insurance, as it is considered an elective procedure. Many private health insurance plans offer a "refractive surgery" package covering all or part of the procedure. The cost depends on the correction needed and the technique used ; a transparent quote is provided during your preoperative consultation, with no obligation.
The procedure itself is painless (topical anaesthesia with eye drops). However, while the epithelium regrows, discomfort, tearing and light sensitivity are common; analgesics and a bandage contact lens provide effective relief.
PRK is mainly indicated for low to moderate myopia (nearsightedness). For higher corrections, the surgeon evaluates the available corneal thickness and may recommend an alternative solution such as a phakic implant.
Yes. Astigmatism, often associated with myopia (nearsightedness), is corrected at the same time through asymmetric ablation. Surface PRK is particularly well suited for treating astigmatism on thin corneas.
Recovery is more gradual than after LASIK: functional vision returns within a few days, then gradually sharpens; stable vision and refraction may take several months (AAO).
PRK is preferred when the cornea is too thin for a flap, in cases of irregular cornea, or for contact-sport athletes and professions exposed to ocular trauma, because there is no flap that could shift.
Yes. In the long term, the quality of vision achieved with PRK is equivalent to that of LASIK; comparative trials show no difference in acuity at one year. Only the speed of recovery differs.
It is a trans-epithelial variant in which the excimer laser itself removes the epithelium and then reshapes the cornea in a single step, with no instrument contact. It simplifies the procedure and may improve healing comfort.
It is a faint cicatricial opacity that can appear on the corneal surface after PRK. Now rare, it is prevented by applying mitomycin C during the procedure and by adequate sun protection in the following weeks.
It is possible, but in PRK the two eyes are sometimes operated a few days apart to maintain comfort during healing. The surgeon decides on a case-by-case basis.
Timescales depend on epithelial healing and on each patient's vision: the surgeon tells you when to resume work, driving, sport and swimming. After PRK on both eyes on the same day, driving may not be possible for several weeks (AAO).
PRK is performed from age 18, with stabilised myopia, which the preoperative assessment checks. Once presbyopia appears, it is factored into the treatment strategy.
No, like all laser eye surgery it is not covered by the French national health insurance (Assurance Maladie). Many supplementary insurance plans offer a dedicated allowance covering all or part of the procedure.
Dr Gozlan, holder of the Inter-University Diploma (DIU) in Refractive Surgery (Université Paris Cité), evaluates your eligibility for PRK during a comprehensive assessment and chooses the technique best suited to your eyes.
Upcoming surgery sessions at the Centre Laser Victor Hugo: November 19 and December 23, 2026. A prior pre-operative assessment is required.
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