Before LASIK existed, there was PRK. Photorefractive keratectomy has been performed in the US since 1995 — three years before LASIK received FDA approval — and it’s still performed today, not as a consolation prize, but because there are specific situations where it actually outperforms LASIK. The price difference between them is smaller than most patients expect, and in certain clinical contexts, choosing PRK is the smarter decision.
Here’s the full cost picture and when the math changes.
PRK vs. LASIK: What You’ll Actually Pay
The key procedural difference: PRK removes the outer layer of the cornea (epithelium) directly, without cutting a flap. That eliminates the flap-creation step — which sounds like it should reduce cost, but doesn’t, because the laser time and surgeon skill required are roughly equivalent.
| Procedure | Cost Per Eye | Both Eyes (Total) |
|---|---|---|
| Standard PRK | $1,800–$2,500 | $3,600–$5,000 |
| Custom Wavefront PRK | $2,000–$3,000 | $4,000–$6,000 |
| Standard LASIK (bladeless) | $2,000–$3,000 | $4,000–$6,000 |
| Premium Custom LASIK | $2,500–$3,500 | $5,000–$7,000 |
In most practices, PRK runs $200–$500 per eye less than equivalent-tier LASIK. That’s $400–$1,000 total savings — real money, but it needs to be weighed against what comes with it.
The True Cost of Recovery: PRK Is Slower
LASIK patients typically drive themselves home the next day. Most return to desk work in 24–48 hours. PRK patients spend 3–5 days with significant blurred vision and discomfort while the epithelium regrows. Stable, clear vision can take 2–4 weeks to achieve.
For someone who works remotely and can schedule around it, this may be manageable. For someone who can’t take five days off — or who’ll burn a week of PTO — that recovery time has a real dollar cost. Factor that into your comparison.
Surgeons recommend PRK over LASIK based on specific clinical findings, not cost preference:
- Corneas too thin for a safe LASIK flap — typically under 500–510 microns of residual stromal bed after flap creation
- Significant dry eye syndrome — the LASIK flap disrupts more corneal nerves and can worsen dry eye more than PRK
- High flap-dislodgement risk — military personnel, combat sports athletes, contact sport players
- Prior LASIK flap — enhancement after LASIK is often safer via PRK surface ablation than lifting the original flap
These are medical indications. When your surgeon recommends PRK, the recommendation is based on your corneal anatomy and medical history — not on what’s available or convenient.
Recovery Medications Add to PRK’s Cost
After PRK, you’ll use prescription antibiotic drops and steroid drops for several weeks post-operatively. Bandage contact lenses (worn for 4–5 days while the epithelium heals) are typically included in your surgery fee, but drop prescriptions may not be.
Budget $50–$150 for post-operative medications depending on what your surgical package includes. Ask specifically before you sign.
Don’t evaluate PRK vs. LASIK primarily on the cost difference. If your surgeon recommends PRK based on corneal thickness, dry eye, or anatomical findings, that recommendation exists because LASIK carries greater risk for your specific eye. Choosing a different surgeon who’ll offer LASIK to save $400 per eye is optimizing the wrong variable. Trust the candidacy assessment.
Enhancement Rates: Is PRK More Likely to Need a Touch-Up?
Enhancement (retreatment) rates are similar for PRK and LASIK — roughly 1–3% within five years per ASCRS outcomes data. PRK may have a slight stability advantage for certain higher prescription ranges, meaning somewhat lower regression rates long-term. That said, most major refractive surgery centers include enhancements in their pricing packages regardless of which initial procedure you had, so this consideration rarely affects total cost.
10-Year Cost Comparison
When you amortize the one-time cost across a decade, both procedures compare favorably to the ongoing expense of contacts:
- PRK (wavefront custom): ~$5,000 one-time → about $500/year over 10 years
- LASIK (wavefront custom): ~$5,500 one-time → about $550/year over 10 years
- Annual contacts + exams: $450–$650/year ongoing, indefinitely
Both laser procedures beat long-term contact lens wear financially for most patients — and both eliminate the day-to-day friction of lenses and lens care entirely.
See also: LASIK Eye Surgery Cost for the full LASIK breakdown, and LASIK vs. PRK Cost for a direct head-to-head comparison.
Bottom Line
PRK costs $1,800–$3,000/eye — marginally less than LASIK, with a significantly longer recovery. The real decision isn’t about the price gap. It’s about whether your corneal anatomy, dry eye status, and lifestyle make PRK the correct medical choice. When a surgeon recommends PRK, the modest savings are a bonus — not the reason to choose it. If you’re selecting PRK solely to save $300 per eye, you’re solving the wrong problem.