LASEK / PRK laser eye surgery

What is LASEK / PRK (surface laser eye surgery)?

LASEK and PRK are 'surface' laser eye operations. Like LASIK, they reshape the clear front window of the eye (the cornea) so light focuses better and you rely less on glasses or contact lenses. The difference is that no hinged flap is made.

Instead, the thin surface skin of the cornea (the epithelium) is removed or moved aside, the laser reshapes the surface beneath, and the skin layer then naturally grows back over a few days. In PRK the surface cells are removed; in LASEK they are loosened and repositioned; TransPRK does this with the laser itself. A protective contact lens is worn while it heals.

Because no flap is created, surface laser is often chosen for people with thinner corneas, certain eye-surface shapes, or jobs and sports (such as contact sports or some armed-forces roles) where a flap could be a problem. The trade-off is a slower, more uncomfortable recovery than LASIK.

This is elective, lifestyle surgery on healthy eyes, funded privately. The aim is to reduce dependence on glasses, not to guarantee perfect vision — and almost everyone still needs reading glasses from their mid-40s.

Types & techniques

There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.

Surface laser (LASEK/PRK) vs LASIK

Final vision is usually similar; the main differences are comfort and recovery speed early on, and suitability for thin corneas or flap-related concerns. A responsible surgeon sometimes advises against laser altogether.

Preparing for your surgery

• Stop wearing contact lenses before your assessment and surgery for as long as advised (often around two weeks for soft lenses, longer for hard lenses), as they change the corneal shape.
• Expect a thorough suitability assessment, including corneal thickness and shape, prescription stability, pupil size and a dry-eye check — be wary if this is skipped.
• Plan for around a week off work, because vision will be blurry and the eye sore while the surface heals.
• Tell the clinic about dry eyes, previous eye problems, autoimmune conditions, diabetes, or medicines such as isotretinoin (Roaccutane).
• Tell them if you are pregnant or breastfeeding, as this can change your prescription and is usually a reason to delay.
• Arrange pain relief, lots of lubricating drops and a darkened, restful space for the first few days.
• Ask for the written patient information and Royal College of Ophthalmologists patient checklist, and read it before consenting.

What happens

Surface laser is done while you are awake, lying flat, with numbing drops; no injection or sedation is usually needed. A small clip holds the eyelids open and you focus on a target light.

The surgeon removes or moves aside the thin surface skin of the cornea (the epithelium), then uses a 'cold' laser for a short time (usually under a minute per eye) to reshape the surface. A medicine such as mitomycin C may be applied briefly to reduce haze. A soft 'bandage' contact lens is then placed to protect the eye while the skin regrows over the next few days.

Most people have both eyes treated the same day. The appointment is short, but the eye will be sore and watery for several days afterwards as the surface heals, so you go home with pain relief, drops and clear instructions.

Is this operation right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Anaesthetic choices

The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.

The early recovery from surface laser is genuinely uncomfortable and slower than LASIK — expect several sore days and about a week of blurry vision. Corneal haze is the surface-laser-specific risk to ask about, especially for higher corrections, and it is one reason mitomycin C is sometimes used. As with all laser surgery, dry eye and night glare are common early on and occasionally persist.

Published figures to discuss

Published results vary with the technique, the surgeon, the prescription treated and how outcomes are defined, so figures are cautious guides rather than promises. Reputable reviews find broadly similar effectiveness across modern laser methods, with surface laser carrying a recognised early risk of corneal haze and a slower, more uncomfortable recovery than LASIK; serious complications are rare.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

Recovery — what to expect, and when

Surface laser trades a more uncomfortable, slower start for the advantage of no corneal flap. Expect a sore, light-sensitive eye and blurry vision for the first several days, clearing over a week or two, with the result settling over the following weeks to months.

• A sore, gritty, watery and very light-sensitive eye for the first several days
• Blurry, fluctuating vision for about a week that gradually clears
• Needing pain relief and frequent lubricating drops early on
• Haloes or starbursts around lights at night that fade over weeks to months
• A faint haze or slightly soft vision that improves over the first months

Aftercare

• Use all prescribed drops (lubricating, antibiotic and anti-inflammatory) exactly as directed, including any longer steroid course.
• Take the recommended pain relief in the first few days, when surface laser is most uncomfortable.
• Do not rub your eyes or remove the bandage contact lens yourself.
• Wear sunglasses and rest your eyes, as strong light sensitivity is normal early on.
• Avoid eye make-up, swimming pools, hot tubs and dusty environments for the advised period.
• Do not drive until your vision clearly meets the legal standard and your surgeon agrees.
• Keep all follow-up appointments, including the lens-removal check, so healing and any haze can be monitored.

• Around a week off work booked
• Pain relief and plenty of lubricating drops collected
• All prescribed drops and a dosing plan understood
• Sunglasses and a darkened restful space ready
• Lift home and help for the first few days arranged
• Lens-removal/follow-up appointment booked
• Clinic's urgent/out-of-hours number saved in case of pain or vision change

⚠ Get urgent help if…

• Severe or increasing eye pain beyond the expected first few sore days
• Sudden drop in vision, or vision getting worse rather than better
• Growing redness, thick discharge or worsening light sensitivity (possible infection)
• The bandage contact lens falling out before your check-up
• Increasing haze, glare or distortion that is worsening rather than settling
• Any of these in the first days and weeks should prompt urgent contact with your clinic

Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your surgeon gives you.

Results & realistic expectations

A good result means clearer distance vision with much less reliance on glasses or contact lenses, usually reaching the legal standard for driving. Once fully healed, surface laser results are broadly similar to LASIK, with most suitable eyes reaching driving-standard vision unaided — but a minority are left slightly over- or under-corrected and may still need glasses for some tasks.

Surface laser cannot stop the eye ageing. Distance vision can drift slightly over years, reading glasses become necessary from the mid-40s, and it does not prevent later eye disease such as cataract or glaucoma, so regular eye checks remain important.

For most people the corneal reshaping is long-lasting, but not always permanent. A small number of eyes drift back towards needing correction and may be offered an enhancement if the cornea is thick enough. Because everyone develops age-related reading difficulty (presbyopia) and may develop cataract later, surface laser does not mean you will never need glasses or further eye care.

Combining with other procedures

Both eyes are usually treated in the same appointment, though some surgeons treat surface-laser eyes a few days apart because of the slower recovery — ask what your surgeon advises. Surface laser is sometimes considered as an alternative to LASIK or lens-based surgery; the right choice depends on your corneal thickness, prescription and lifestyle rather than a marketed package.

Follow-up & long-term care

You will be seen within about a week to remove the bandage contact lens and check healing, then again over the following weeks and months to monitor vision, any haze and the final result. Good clinics include these reviews, and any enhancement discussion, in what they arrange from the start. Report pain or worsening vision immediately.

• Continue routine sight tests and eye-health checks with an optometrist after surgery.
• Expect to need reading glasses from your mid-40s regardless of laser surgery.
• Use lubricating drops as advised if dryness lingers.
• Keep records of your treatment, as past laser surgery affects later cataract lens calculations.

Revision and secondary surgery reality

• A minority of people need an enhancement (top-up) laser treatment, only possible if enough corneal tissue remains.
• Some over- or under-correction may be managed with glasses for certain tasks rather than more surgery.
• Haze and soft vision usually improve over months, so the final judgement takes time.
• Distance vision can drift slightly over years, and reading glasses are still needed with age.

Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.

What good aftercare looks like

• Clear pain-relief and dry-eye advice for the uncomfortable first days.
• A prompt check to remove the bandage contact lens and confirm the surface has healed.
• Reviews over the following weeks and months to monitor vision and any haze.
• An honest enhancement policy if fine-tuning is needed, with criteria explained.
• A named contact route and written instructions on when to seek urgent help for pain or vision change.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• The exact surface technique and laser technology used
• Your prescription strength and how complex your eyes are to treat
• Whether a medicine such as mitomycin C is included
• The surgeon's experience and seniority
• Whether the assessment, both eyes, follow-up appointments and any enhancement are included
• The clinic and facility fees, and whether long-term aftercare and a clear complications policy are included

• Whether the full suitability assessment is included or charged separately
• Whether the price covers both eyes
• Which surface technique is included and why it suits you
• Whether all follow-up appointments, including the lens-removal check, are included
• Whether an enhancement (top-up) is included if needed, and for how long
• The named operating surgeon
• What happens, and what it costs, if there is a complication or you are not happy with the result

On the NHS? Surface laser surgery (LASEK/PRK) to reduce dependence on glasses or contact lenses is not normally funded by the NHS and is an elective, self-funded procedure; the NHS treats eye disease rather than lifestyle vision correction.

You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a surgeon safely

• Check your surgeon is on the GMC Specialist Register for this area.
• Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
• You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
• Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good surgeon will welcome every one of these.

• Given my corneal thickness, shape and lifestyle, is surface laser the right choice for me rather than LASIK or a lens option?
• How uncomfortable will the first week be, and what pain relief and time off should I plan for?
• What is my risk of corneal haze, and will you use mitomycin C?
• What result can I realistically expect, and what happens if I am over- or under-corrected?
• What is your enhancement (top-up) policy, and is it included if I need one?
• Who will perform my surgery, and who do I contact for pain or worsening vision afterwards?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the surgeon who carries out my operation, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this operation not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Laser eye surgery and lens surgery Royal College of Ophthalmologists — Refractive surgery (patient information) Royal College of Ophthalmologists — Professional Standards for Refractive Surgery (2024) NICE — Photorefractive (laser) surgery for refractive errors (IPG164) Photorefractive keratectomy — StatPearls (NCBI) Dry eye disease following LASIK, PRK and LASEK — observational study (PMC) Care Quality Commission (CQC) — England regulator Healthcare Improvement Scotland — independent healthcare regulator Healthcare Inspectorate Wales (HIW) RQIA — Northern Ireland regulator

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.