PRK vs. LASIK: Dry Eye Risks and Recovery

PRK vs. LASIK: Understanding Dry Eye After Surgery

PRK vs. LASIK dry eye risk is an important consideration when choosing laser vision correction. Both procedures can improve vision, but their recovery patterns and potential side effects differ.

A recent study published in the American Journal of Ophthalmology examined postoperative complications following both procedures. Researchers found that PRK was associated with a higher incidence of dry eye disease during months one through three after surgery. Early visual disturbances were also more common after PRK.

However, these findings do not mean PRK is the wrong choice for everyone. The most appropriate procedure depends on your corneal health, prescription, tear film, and individual needs.

At Precision Eye Care in Baltimore, Dr. Maria Soledad Romero helps patients understand their vision correction options. Her extensive ophthalmology experience supports an individualized approach to evaluating eye health and discussing treatment options.

PRK vs. LASIK Dry Eye Risk: What Does Research Show?

The study, published in August 2026, analyzed medical records from 48,892 eyes belonging to 27,372 patients. Researchers used data from the American Academy of Ophthalmology’s IRIS Registry, covering surgeries performed between 2013 and 2024.

The investigators compared dry eye disease, visual disturbances, and ocular pain after PRK and LASIK. They also examined when these complications occurred during postoperative recovery.

Key Findings From the Study

The findings highlighted several differences between the two procedures:

• Dry eye disease: It was the most frequently documented complication after both procedures.
• First three months: PRK was associated with a higher incidence of dry eye disease during months one through three.
• Early visual disturbances: These occurred more frequently during the first month after PRK.
• Ocular pain: This complication was uncommon after both procedures, although differences emerged during later follow-up.
• Overall complications: Most other complication rates were comparable between the procedures.
  

Across the 12-month follow-up period, dry eye disease was documented in 16.1% of LASIK eyes and 15.6% of PRK eyes. These overall figures highlight an important distinction: the timing of symptoms can differ even when overall rates appear similar. PubMed

Nevertheless, the results should be interpreted carefully. The study relied on medical records, which may not capture every symptom or every patient’s experience. The main takeaway: Both procedures can cause dry eye symptoms, but the early recovery period may differ.

Why Can Dry Eye Develop After Laser Eye Surgery?

Dry eye disease occurs when tears do not adequately lubricate the eye’s surface. This may happen because tear production is insufficient or tears evaporate too quickly. The cornea contains sensory nerves that help regulate tear production and protect the ocular surface. Laser vision correction changes the cornea, temporarily affecting these processes.

As a result, some patients experience dryness, irritation, or fluctuating vision after surgery.

Common Symptoms of Dry Eye After Surgery

Symptoms can vary in intensity and duration. Common signs include:

• Burning, stinging, or scratchy sensations.
• A feeling that something is trapped in the eye.
• Redness or irritation.
• Blurred or fluctuating vision.
• Sensitivity to light.
• Watery eyes, which can occur as a response to irritation.

Importantly, watery eyes do not always indicate adequate lubrication. Sometimes, excessive tearing occurs when the ocular surface becomes irritated. These symptoms may improve as healing progresses. However, persistent or worsening symptoms should be evaluated by an ophthalmologist.

What Is the Difference Between PRK and LASIK?

PRK and LASIK are laser vision correction procedures designed to reduce dependence on glasses or contact lenses. Both reshape the cornea to improve how light focuses on the retina. However, they use different surgical techniques.

How PRK Works

Photorefractive keratectomy, or PRK, is a surface-based laser procedure. The surgeon removes the cornea’s outer epithelial layer before reshaping the underlying tissue with an excimer laser.

The epithelium then regenerates during healing. Because the surface must heal, patients typically experience a longer initial recovery than after LASIK. Temporary discomfort, light sensitivity, and fluctuating vision may occur.

PRK may be considered for patients whose corneal characteristics make LASIK less suitable. Nevertheless, eligibility must be established through a comprehensive eye examination.

How LASIK Works

LASIK involves creating a thin flap in the cornea. The surgeon then uses a laser to reshape the underlying corneal tissue before repositioning the flap. Because the epithelial surface remains largely intact, initial visual recovery is generally faster than with PRK.

However, LASIK also affects corneal nerves and can contribute to postoperative dry eye. Therefore, faster visual recovery does not necessarily mean a lower risk of every complication. Neither procedure is universally better. Instead, the choice should reflect your eye health, anatomy, and visual goals.

How Can You Reduce Dry Eye Risk After PRK or LASIK?

Although postoperative dryness cannot always be prevented, careful preparation and follow-up can help manage symptoms. Before surgery, your ophthalmologist should evaluate your ocular surface and identify potential risk factors.

For example, existing dry eye disease may require treatment before laser vision correction is considered.

Steps to Support a Healthy Recovery

To protect your eyes during recovery, follow your surgeon’s recommendations:

• Complete a preoperative evaluation. Discuss existing dryness, contact lens use, medications, and previous eye conditions.
• Follow your prescribed treatment plan. Use recommended lubricating drops and other medications as directed.
• Avoid rubbing your eyes. Rubbing can irritate healing tissues and interfere with recovery.
• Take screen breaks. Looking at digital devices for extended periods can reduce blinking and worsen dryness.
• Attend follow-up appointments. Your ophthalmologist can assess healing and adjust treatment when necessary.
• Report persistent symptoms. Pain, worsening redness, or changes in vision warrant prompt medical attention.

Additionally, your doctor may recommend preservative-free artificial tears or other dry eye treatments, depending on your condition. Never start, stop, or change prescribed eye medications without professional guidance.

Who Is a Good Candidate for PRK or LASIK?

The best procedure depends on several factors beyond the risk of dry eye.

During your evaluation, your ophthalmologist may assess:

• Corneal thickness, shape, and overall health.
• Your glasses or contact lens prescription.
• Tear film quality and existing dry eye symptoms.
• Eye health and medical history.
• Lifestyle, occupation, and visual expectations.

For some patients, PRK may offer advantages based on corneal anatomy or lifestyle requirements. For others, LASIK may provide a more appropriate option.

If neither procedure is suitable, alternative vision correction options may be discussed. A comprehensive evaluation is particularly important for patients with existing ocular surface disease. Treating dryness before surgery may improve comfort and help establish a healthier starting point.

Laser Vision Correction in Baltimore: Personalized Eye Care

Choosing between PRK and LASIK requires more than comparing recovery times or complication statistics. Your individual eye health should guide the decision.

At Precision Eye Care, Dr. Maria Soledad Romero provides personalized ophthalmic care focused on each patient’s needs. Her extensive clinical experience helps patients understand their options and make informed decisions about their eye health.

The practice serves patients in Baltimore and surrounding communities, including Hampden, Gilford, Roland Park, Homeland, and Towson.

Whether you are exploring laser vision correction or experiencing dry eye symptoms, a professional assessment can help determine the most appropriate next steps.

Schedule an Appointment With Dr. Romero

Are you considering vision correction or concerned about dry eye disease?

Schedule an appointment with Dr. Romero at Precision Eye Care in Baltimore. During your consultation, discuss your visual goals, eye health, and concerns about postoperative recovery.

A personalized evaluation can help you understand which options may be appropriate for your eyes.

Request your appointment today

 

Source: https://www.aao.org/education/editors-choice/prk-appears-to-carry-higher-risk-of-early-dry-eye-