LASIK & PRK
Laser vision correction, and when it is the right choice · Gurpal Virdi, MD · San Francisco Bay Area, California
Medically reviewed by Gurpal Virdi, MD, refractive and cataract surgeon and ICL-sizing researcher · Last reviewed: 25 August 2026
How does LASIK work?
LASIK corrects vision by reshaping the cornea, the clear front window of the eye. A femtosecond laser creates a thin hinged flap, an excimer laser removes a precisely calculated amount of tissue underneath, and the flap is laid back into position without stitches. Because the surface epithelium is largely undisturbed, vision typically recovers within a day or two, which is the main reason LASIK became the default laser procedure.
How is PRK different from LASIK?
PRK reaches the same optical destination by a different route. Rather than creating a flap, the surgeon removes the thin surface layer of epithelium, applies the same excimer treatment, and allows the epithelium to regenerate over several days under a bandage contact lens. Recovery is slower and more uncomfortable in the first week, and vision sharpens over weeks rather than days. Long-term visual outcomes are equivalent. PRK is often the better choice for thinner corneas, certain corneal irregularities, or people in contact-sport or occupational settings where a flap is a liability.
Am I a candidate for laser vision correction?
Candidacy depends on corneal thickness, corneal shape, prescription magnitude and stability, pupil size, and the health of your ocular surface. Topography is what usually decides it: subtle irregularity that would predispose a cornea to instability after treatment is the single most important thing to exclude. Untreated dry eye should be addressed first, both because it distorts measurements and because it worsens after surgery.
When is EVO ICL a better option than LASIK?
Laser vision correction removes tissue, and there is a finite amount to remove. At higher prescriptions, with thinner corneas, or in eyes already prone to dry eye, the EVO ICL is often the better answer because it adds a lens rather than subtracting cornea, and it is reversible. A great many people told they are not LASIK candidates are excellent ICL candidates. That is worth knowing before accepting a flat no.
LASIK and PRK in the San Francisco Bay Area
I completed ophthalmology residency at the University of Missouri, where I served as chief resident, and refractive surgery fellowship training at Parkhurst NuVision in San Antonio under Dr. Gregory Parkhurst, principal investigator of the FDA EVO ICL trial. I offer LASIK and PRK alongside EVO ICL, SMILE, refractive lens exchange and premium cataract surgery.
If a laser procedure is not right for your cornea, that is a reason to look at EVO ICL or refractive lens exchange, not a reason to give up on vision correction.
Common questions
Is LASIK permanent? The corneal reshaping is permanent. Your eyes still age, so reading glasses become necessary in your forties or fifties regardless, and a cataract can develop later in life.
Does LASIK hurt? The procedure itself is done with anaesthetic drops and is not painful. Most people describe pressure. Some scratchiness and watering is normal for a day afterwards; PRK is more uncomfortable for the first several days.
How long does LASIK take? The laser treatment itself takes well under a minute per eye, with most of the visit spent on preparation and positioning.
What is the difference between LASIK, PRK and SMILE? All three reshape the cornea. LASIK uses a flap, PRK treats the surface with no flap, and SMILE removes a small lenticule through a tiny incision. See SMILE for more.
Can I have LASIK if I have astigmatism? Yes. Modern excimer platforms treat astigmatism alongside nearsightedness and farsightedness within their approved ranges.
Educational information, not medical advice. Discuss your specific eyes with a qualified ophthalmologist.