PRK / Trans-PRK — the solution for thin corneas
PRK (photorefractive keratectomy) and its variant Trans-PRK (a no-touch technique, with no instrument contact with the cornea) are surface refractive surgery techniques that require no corneal flap. I reshape the surface of your cornea directly with an excimer laser after removing a thin surface layer (the epithelium), which then regenerates naturally. PRK is particularly suitable for thin corneas, combat-sport athletes, military personnel and occupations exposed to a risk of eye trauma.
What is PRK?
PRK — short for photorefractive keratectomy — is a laser surgery performed on the very surface of your cornea. Unlike LASIK, I do not create a flap: I first remove the thin surface cell layer (the epithelium), then reshape the cornea with an excimer laser. The epithelium then regenerates naturally within a few days.
Today, I mostly perform Trans-PRK: the laser itself carries out both steps (epithelium removal + reshaping), in an entirely no-touch manner. It is a gentle technique, with no instrument contact, that respects corneal biomechanics. Visual recovery takes longer (5 to 7 days for functional vision), but the long-term result is stable.
To reduce the risk of corneal haze (scar-related clouding), I routinely apply low-concentration mitomycin C (0.02%) during surgery, a measure that is now standard in modern PRK.
Trans-PRK — next-generation PRK. Trans-PRK is entirely no-touch: no instrument touches your eye. The excimer laser performs both the epithelium removal and the corneal reshaping in a single continuous step, making the procedure quick, reproducible and well tolerated.
Animated demonstration below ↓
Scroll through the steps of the procedure at your own pace.
Trans-PRK step by step
Click ▶ to start the animation, or go through the steps one by one at your own pace.
Interactive animation — for a larger view, open the diagram in full screen ↗
Who is PRK for?
PRK is particularly suitable when the cornea is thin or irregular, or when your activities expose you to a risk of direct eye trauma. Only a comprehensive assessment allows me to confirm that it fits your profile. For a first idea of the criteria I look at, you can read my article “Am I eligible for refractive surgery?”.
- You are over 18
- Your prescription is stable
- Myopia up to −6 diopters
- Low astigmatism
- Thin or irregular cornea (LASIK and SMILE contraindicated)
- You work in a high-risk occupation (military, firefighter, combat-sport athlete, pilot)
- High myopia above −6 D (a phakic lens is more suitable)
- Progressive keratoconus
- Uncontrolled dry eye disease
- Tendency to form keloid scars (risk of corneal haze)
- You are pregnant or breastfeeding
- You have an active, unstabilized autoimmune or inflammatory disease (lupus, rheumatoid arthritis, Sjögren's syndrome, scleroderma…)
- You have an active eye infection or inflammation
For high corrections, a phakic lens (ICL) is often an excellent alternative — we will discuss this together.
Advantages and points to consider
- No corneal flap → corneal biomechanics preserved, particularly suitable for occupations exposed to a risk of trauma
- Biomechanically preserved cornea — little induced weakening
- Possible on thin or slightly irregular corneas
- More than 35 years of scientific follow-up — the oldest of the modern laser techniques
- Approved and used by the armed forces and high-risk occupations
- Slower visual recovery than LASIK or SMILE (5 to 7 days)
- Significant pain during the first 2 days, requiring you to stay in the dark
- A bandage contact lens is worn for 2 to 3 days
- Later return to work (Day 5 to Day 7)
- Strict sun protection (sunglasses) for several months to prevent haze
- PRK does not prevent later presbyopia or cataract
PRK in pictures
This short animation illustrates the steps of PRK: removal of the epithelium and corneal reshaping with an excimer laser.
From your first assessment to visual freedom
Pre-operative assessment
At your first consultation, I carry out a comprehensive assessment: precise measurement of your prescription, corneal mapping (Anterion), measurement of corneal thickness and examination of the anterior segment. This allows me to confirm that PRK is the best option for you. A check-up with pupil-dilating drops (Skiacol) may be needed before surgery.
Preparation
If you wear contact lenses, you will need to stop wearing them 1 to 2 weeks beforehand (soft lenses) or 3 to 4 weeks beforehand (rigid lenses); a longer period may be needed for rigid lenses worn extensively. I give you a detailed quote, the informed consent form and the prescriptions for your post-operative eye drops and pain relievers.
The day of surgery
The procedure takes about 10 minutes for both eyes, as an outpatient, under anesthetic eye drops. At the end of the procedure, I place a bandage contact lens to protect the cornea while it heals. You go home 30 minutes later, with someone accompanying you.
Post-operative follow-up
I see you again at Day 3 (removal of the bandage lens), Month 1 and Month 3. You will use anti-inflammatory and lubricating eye drops for several weeks. Sun protection is crucial during the first months to prevent corneal haze.
What happens after PRK?
PRK requires more patience during initial healing, but long-term refractive stability is comparable to that of LASIK and SMILE. Here is what to expect.
The day of surgery
You wear a clear bandage contact lens. Discomfort, pain, watery eyes and light sensitivity are normal. Pain relievers are prescribed if needed. Complete rest: no screens, no reading. A darkened room is recommended.
Epithelial healing phase
Discomfort may be more pronounced (foreign-body sensation, watery eyes, light sensitivity). Vision remains blurry. This is normal — the epithelium is regenerating under the bandage lens.
Removal of the bandage lens
I see you in consultation and remove the bandage lens. Discomfort decreases quickly. Vision starts to clear but still fluctuates.
Back to work
You can resume screen work with frequent breaks. Vision keeps improving day by day. Sunglasses are mandatory outdoors.
Light exercise
You can resume brisk walking and cycling. Avoid swimming and sports with a risk of splashes or projectiles.
Stabilization check-up
I check healing and the quality of your vision. You may return to contact sports and pool swimming.
Final result
Your vision is fully stabilized. Strict sun protection must be maintained for at least 6 months to prevent corneal haze.
Comparison of techniques
Each technique has its own indications and limitations. Here is a brief comparison to guide you — the final decision rests on your personalized assessment.
| LASIK | SMILE | PRK | Phakic lens (ICL/IPCL) | |
|---|---|---|---|---|
| Action on the cornea | Flap + reshaping | Lenticule extraction | Surface (no flap) | None |
| Visual recovery | 24 h | 24–48 h | 5–7 days | 24–48 h |
| Myopia up to | −10 D | −10 D | −6 D | −30 D ¹ |
| Hyperopia up to | +5 D | +5 D | +4 D | +15 D ¹ |
| Astigmatism | Yes | Yes | Possible | Yes |
| Thin cornea | Contraindicated | Contraindicated | Possible | Ideal |
| Contact sports | After 4 weeks | After 2 weeks | After 2 weeks | After 3–4 weeks |
| Reversible | No | No | No | Yes |
| Anesthesia | Eye drops | Eye drops | Eye drops | General or local |
¹ Corrections beyond −18 D (myopia) or +10 D (hyperopia) require the IPCL (Care Group). The EVO Visian ICL (STAAR) covers myopia up to −18 D and hyperopia up to +10 D.
PRK / Trans-PRK fees
PRK / Trans-PRK: €2,600 for both eyes — this all-inclusive fee covers the procedure, post-operative check-ups and any enhancement needed within the year. For your information: these are unregulated fees, not reimbursed by the French national health insurance (Assurance Maladie); some complementary health insurance plans (mutuelles) contribute, depending on your policy. A detailed quote is always provided before any decision, and payment in installments may be offered — ask about it during your consultation.
PRK FAQ
Your PRK assessment starts here
A comprehensive assessment allows me to check your eligibility, choose the best technique with you (LASIK, SMILE, PRK or ICL) and answer all your questions.
Explore the alternatives
If this technique is not right for you, other options may be perfectly suitable.