PRK Laser Eye Surgery Abroad: When LASIK Isn't an Option

What Is PRK?

Photorefractive Keratectomy (PRK) was the first laser vision correction procedure approved by the FDA (1995) and remains a cornerstone of refractive surgery. Unlike LASIK, which creates a corneal flap to access the underlying tissue, PRK removes the outer layer of the cornea (epithelium) and applies the excimer laser directly to the corneal surface. The epithelium naturally regenerates within 3-5 days, covering the treated area. While PRK has a longer recovery than LASIK — typically 1-2 weeks for clear vision vs. 1-2 days — the final visual outcomes are equivalent.

PRK has experienced a resurgence in popularity due to its safety advantages over LASIK for certain patient populations. Because no corneal flap is created, PRK eliminates all flap-related complications (flap displacement, wrinkles, epithelial ingrowth) and preserves more corneal biomechanical strength. This makes PRK the preferred choice for military personnel, first responders, professional athletes, and anyone whose lifestyle involves a risk of eye trauma.

The modern version of PRK has evolved substantially from the original procedure introduced in the mid-1990s. Today's PRK — sometimes marketed under names like Advanced Surface Ablation (ASA), TransPRK, or LASEK — incorporates cutting-edge excimer laser platforms with eye-tracking systems that follow even the smallest involuntary eye movements during treatment. These advanced tracking systems, combined with wavefront-guided or topography-guided ablation profiles, deliver a level of precision that was unimaginable when PRK was first introduced. The Schwind Amaris 1050RS, for example, fires at 1050 pulses per second with seven-dimensional eye tracking, enabling a full correction in under 30 seconds. This speed minimizes corneal dehydration during the procedure, which is particularly important for surface ablation techniques where the corneal surface is exposed throughout the treatment.

TransPRK represents the latest refinement of the PRK technique. In traditional PRK, the surgeon manually removes the epithelium using a dilute alcohol solution or a blunt instrument before applying the excimer laser to the stroma beneath. TransPRK eliminates this manual step entirely — the excimer laser itself removes the epithelium and immediately proceeds to the refractive correction in a single continuous step. This touchless, no-contact approach reduces the risk of irregular epithelial removal, shortens the overall procedure time, and may result in a smoother ablation surface. Dünyagöz Eye Hospital and Veni Vidi Eye Clinics both offer TransPRK alongside traditional PRK and LASIK, allowing the refractive surgeon to recommend the optimal technique based on each patient's corneal measurements and visual demands.

An often-overlooked benefit of PRK is its suitability for enhancement procedures. If a patient requires a retreatment years after the initial correction — due to residual refractive error or age-related changes in prescription — PRK can be performed safely regardless of the original procedure. A patient who previously had LASIK can have a PRK enhancement without needing to re-lift the original flap (which becomes riskier with time), and a patient who originally had PRK can simply have a second PRK. This long-term flexibility is a meaningful advantage for younger patients whose prescriptions may continue to evolve over the decades following their initial treatment.

PRK vs. LASIK

Understanding the clinical differences between PRK and LASIK is essential for making an informed decision about your laser vision correction. Both procedures use the same excimer laser to reshape the cornea and correct refractive errors, but the method of accessing the corneal tissue differs fundamentally. This difference has meaningful implications for safety, recovery, and suitability that extend well beyond the surface-level comparison of recovery times.

• Corneal Flap: LASIK creates a flap; PRK does not. This makes PRK safer for physically active patients and those with thin corneas.
• Recovery Speed: LASIK provides clear vision within 24 hours; PRK requires 5-7 days for functional vision and 2-4 weeks for optimal clarity.
• Discomfort: PRK involves more post-operative discomfort (2-4 days of moderate pain/irritation) due to the exposed corneal surface; LASIK has minimal discomfort.
• Final Visual Outcome: Identical at 3 months. Studies show no difference in final visual acuity between PRK and LASIK.
• Corneal Strength: PRK preserves more corneal tissue and biomechanical integrity, reducing the risk of ectasia (corneal weakening).
• Suitability: PRK is suitable for thinner corneas (down to 470 microns) that may not be safe for LASIK flap creation.
• Dry Eye Risk: PRK causes less post-operative dry eye than LASIK because the corneal nerves are not severed by flap creation. For patients with pre-existing dry eye tendencies, PRK may be the superior choice.
• Long-Term Stability: Multiple long-term studies (10+ years follow-up) show that PRK and LASIK produce equivalent refractive stability over time. Neither procedure has a significant advantage in preventing age-related changes like presbyopia.
• Enhancement Flexibility: PRK enhancements are simpler because there is no flap to re-lift. LASIK flap re-lifts become riskier with time as the flap edge heals and adheres more firmly to the underlying stroma.

The choice between PRK and LASIK is not a matter of one being universally better than the other — it is about matching the right technique to the right patient. A thorough refractive surgery consultation at clinics like Çağın Eye Hospital includes corneal pachymetry (thickness measurement), topography mapping, wavefront analysis, pupil size assessment, and a detailed lifestyle discussion. Only after evaluating all these factors will an experienced refractive surgeon recommend PRK, LASIK, SMILE, or an alternative procedure like ICL. Patients who arrive at a clinic and are told that only one procedure is suitable — without a thorough evaluation — should consider seeking a second opinion.

Cost Comparison

PRK Surgery Cost Comparison 2025 (Per Eye)

PRK prices are generally 10-20% lower than LASIK at the same clinic because no femtosecond laser is needed for flap creation. Recovery is longer (1-2 weeks vs. 1-2 days for LASIK) but final visual outcomes are equivalent.

PRK is typically 10-20% less expensive than LASIK because no femtosecond laser is needed for flap creation — only the excimer laser is used. In Turkey, wavefront-guided PRK at leading clinics like Dünyagöz Eye Hospital costs $500-$1,000 per eye, compared to $2,000-$3,500 in the US. Veni Vidi Eye Clinics offers PRK as part of their comprehensive refractive surgery program, with personalized treatment protocols that optimize outcomes for each patient's unique corneal characteristics.

When comparing PRK costs internationally, patients should be aware that some clinics bundle both eyes into a single price while others quote per eye. A comprehensive PRK package should include: pre-operative diagnostic testing (topography, pachymetry, wavefront analysis), the surgical procedure itself, bandage contact lenses, all post-operative eye drops (antibiotic, steroid, NSAID, and preservative-free lubricant), and at least two post-operative follow-up visits. Some premium clinics also include protective UV-filtering sunglasses and omega-3 supplements to support corneal healing. If a quoted price seems unusually low, clarify exactly what is included to ensure there are no unexpected costs on arrival.

The total cost of PRK abroad should also factor in travel, accommodation, and the longer recovery stay compared to LASIK. Because PRK patients are advised to remain near the clinic for 5-7 days (vs. 2-3 days for LASIK), accommodation costs are slightly higher. However, even including flights, a week of hotel accommodation, and meals, the total out-of-pocket expense for PRK in Istanbul typically ranges from $1,500-$2,500 for both eyes — still dramatically less than PRK at a single US clinic. Many Turkish clinics partner with nearby hotels to offer discounted or complimentary accommodation for international PRK patients, further reducing the overall cost.

Who Should Choose PRK?

PRK is the preferred option for several patient groups: those with corneas too thin for safe LASIK flap creation; military and law enforcement personnel; contact sport athletes and martial artists; patients with anterior basement membrane dystrophy (ABMD); patients with borderline corneal topography; and anyone concerned about flap-related complications. Your refractive surgeon will evaluate your corneal thickness, topography, and lifestyle to recommend the best procedure.

Military and law enforcement agencies worldwide have formally endorsed PRK over LASIK for their personnel. The US Department of Defense approved PRK for active-duty service members before LASIK, and many branches still prefer PRK due to the absence of a corneal flap that could be displaced by blast waves, debris, or physical combat. Similarly, professional boxers, MMA fighters, rugby players, and other contact sport athletes are routinely advised to choose PRK because a direct blow to the eye cannot dislodge a flap that does not exist. For these high-risk populations, the trade-off of a longer recovery period is more than justified by the superior structural integrity of the post-PRK cornea.

Patients with corneal irregularities identified during pre-operative screening are another group for whom PRK is often the safer and more effective choice. Conditions such as forme fruste keratoconus (a subclinical form of keratoconus detectable only on topography), pellucid marginal degeneration, and anterior basement membrane dystrophy (ABMD) all represent relative contraindications to LASIK flap creation but can often be safely treated with PRK. At Anadolu Medical Center, the ophthalmology department uses advanced corneal tomography (Pentacam, Orbscan) and biomechanical analysis (Corvis ST) to identify these subtle corneal abnormalities and guide treatment recommendations. This thorough screening process ensures that patients who are not ideal LASIK candidates are offered PRK as a safe, effective alternative rather than being exposed to unnecessary risk.

Recovery Timeline

PRK recovery is the primary trade-off compared to LASIK. Days 1-3: Moderate discomfort, light sensitivity, and blurry vision. A bandage contact lens is placed over the treated cornea to reduce pain and protect the healing epithelium. Eye drops (antibiotic, steroid, NSAID, preservative-free lubricant) are used frequently. Days 4-5: Bandage contact lens removed. Vision improves significantly but may still be slightly hazy. Discomfort subsides. Week 1-2: Functional vision returns. Most patients can drive and return to desk work. Weeks 2-4: Vision continues to refine. Some patients notice mild haze that resolves with steroid drops. Months 1-3: Vision reaches its final level, equivalent to what LASIK achieves in the first week.

At Çağın Eye Hospital and Memorial Şişli Hospital, PRK patients receive comprehensive post-operative care including bandage contact lens fitting, mitomycin-C application (to prevent corneal haze), and detailed recovery instructions. International patients are advised to stay 5-7 days after PRK to ensure stable healing before flying home.

Managing post-PRK discomfort effectively is crucial for a positive patient experience. The first 48-72 hours are the most uncomfortable period, as the exposed corneal nerve endings are highly sensitive while the epithelium regenerates. Modern pain management protocols have significantly improved the PRK recovery experience compared to earlier decades. Clinics typically prescribe a combination of topical NSAID drops (ketorolac or diclofenac), oral analgesics (ibuprofen or acetaminophen with codeine), and cold compresses to minimize discomfort. The bandage contact lens is the single most important comfort measure — it acts as a protective shield over the healing epithelium and dramatically reduces pain compared to leaving the corneal surface exposed. Patients should avoid removing or touching the bandage lens and allow the surgeon to remove it at the scheduled follow-up visit, typically on day 4 or 5.

Corneal haze is a potential side effect unique to PRK that does not occur with LASIK. Haze develops when the corneal wound healing response produces excessive scar tissue in the anterior stroma, resulting in a slight cloudiness of the cornea that can temporarily reduce visual clarity. The risk of clinically significant haze is highest with larger corrections (above -6 diopters) and in patients with darker irises. Mitomycin-C (MMC), a medication applied to the corneal surface for 20-40 seconds immediately after laser ablation, has virtually eliminated significant haze in modern PRK. MMC modulates the wound healing response and prevents excessive scarring. All reputable international clinics include MMC application as a standard part of the PRK protocol — if a clinic does not use MMC with PRK, this should be considered a concern.

Planning your PRK recovery abroad requires slightly more preparation than LASIK. Because vision fluctuates during the first week and you cannot drive or engage in detailed visual tasks, plan for a comfortable, restful recovery environment. Choose a hotel within walking distance of the clinic or arrange reliable transport for follow-up visits. Bring audiobooks, podcasts, or downloaded music rather than relying on reading or screen time during the first few days. Sunglasses with UV protection are essential for outdoor activities during recovery, as the healing cornea is more sensitive to light. Most Turkish eye clinics provide comprehensive recovery kits including preservative-free lubricant drops, prescribed medications, protective eyewear, and detailed written instructions in English.

Best Clinics for PRK Abroad

Turkey leads in affordable PRK with high-volume eye hospitals offering the procedure at 75-80% savings compared to the US. India provides the most affordable option, while South Korea offers cutting-edge technology. The key factor in choosing a PRK clinic is the excimer laser platform — newer platforms like the Schwind Amaris 1050RS and Alcon EX500 deliver faster, smoother ablations with better visual outcomes than older lasers.

When selecting a PRK clinic abroad, prioritize clinics that perform PRK regularly rather than as a rare alternative to LASIK. A clinic where PRK represents only a small fraction of total refractive procedures may lack the specific expertise in surface ablation management — including optimal MMC application protocols, bandage lens selection, and steroid tapering schedules — that ensures the best outcomes. At Dünyagöz Eye Hospital, PRK is performed daily across multiple branches by surgeons who are experienced in all surface ablation techniques including TransPRK, conventional PRK, and LASEK. This high volume of surface ablation cases ensures that every aspect of the PRK pathway — from patient selection to recovery management — is refined through continuous clinical experience.

South Korea deserves special mention for PRK patients seeking the absolute cutting edge of surface ablation technology. Seoul-based clinics were among the first to adopt TransPRK and have extensive experience with wavefront-optimized surface ablation profiles. Korean ophthalmologists have published extensively on advanced PRK techniques and their outcomes, contributing significantly to the global evidence base for surface ablation. For patients with complex refractive needs — such as high myopia combined with thin corneas — South Korean clinics offer some of the most sophisticated diagnostic and treatment protocols available anywhere in the world.

As an active-duty Marine, I was advised against LASIK due to flap risk. I had PRK in Istanbul for $800 total — both eyes. The first week was tough, but by month two I had 20/15 vision. No flap worries, no restrictions on my duties. Worth every penny.

Staff Sergeant James R., PRK in Turkey