Surface Laser (LASEK & PRK)


What is surface laser eye surgery?

Surface laser is the variety of procedures that work directly on the outer surface of the cornea. PRK is the acronym for Photo Refractive Keratectomy, the precursor to LASIK eye surgery. Like LASIK eye surgery, PRK uses an Excimer laser to reshape the cornea. However, PRK works directly on the outer surface of the cornea.

Another name for a similar procedure is LASEK or epi-LASIK.

Surface laser is safe and effective but has a very slow recovery and may leave patients with a tendency to recurrent erosion (pain in their eyes on waking in the morning).

At Custom Vision Clinic we now rarely perform surface laser eye surgery, because newer procedures offer similar benefits (like being able to treat those with thinner corneas or those who engage in contact sports and work). Keyhole laser eye surgery, where the laser reshapes the cornea without the need to make a flap, is called ReLEx SMILE ™.

This procedure has all the great benefits of LASIK (fast visual improvement and short recovery time) with the associated benefits of not cutting a flap in the cornea (no flap complications, less dry eye, improved comfort during the operation) and none of the downsides of surface laser eye surgery (more discomfort and shorter recovery time).

What surface laser treats

Who is suitable for surface laser eye surgery?

Ideal candidates for surface laser eye surgery include those patients who - for various reasons - are not suitable for LASIK.

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How does surface laser treatment work?

The vision correction treatment begins with anesthetic drops applied to numb your eye and prevent pain during the procedure. A lid speculum is placed in the eye to hold the lids apart for the procedure, eliminating possibility of blinking.

The surgeon will then gently remove the surface corneal cells (epithelium) and proceed with the laser aspect of the procedure. The laser is computer driven for accuracy and precision and it is programmed based on the patient’s refractive error such as nearsightedness, farsightedness, or astigmatism.

The eye correction surgery takes less than one minute for most patients. After the procedure a soft bandage contact lens is placed on the eye for three to five days until the epithelial layer regenerates.

Advantages and disadvantages of surface laser eye surgery

Advantages of surface laser eye surgery over other procedures

  • Uses less tissue*
  • Allows patients who are non-candidates with LASIK to have a laser refractive treatment
  • No flap created so no chance of a flap complication. Less than 1% chance of enhancement required*
  • The patient can resume all physical activities within 2 weeks*

*This is no longer an advantage when compared to ReLEx SMILE ™ laser eye surgery

Disadvantages to LASIK

  • Healing takes longer than LASIK (driving vision in 4 to 14 days)
  • Slight risk of haze (little risk with modern laser and adjunctive chemical therapy)
  • Delayed epithelial healing

Read more about laser eye surgery

Results at a glance

Laser procedures
Cataract procedures
Better than the national average of complication rates

My eyesight following the operation is brilliant and better than I thought possible, and this is all down to your excellent surgeon Mr James Ball and not to forget all the very dedicated people around him who make these operations possible.

Keith Garlick

Two of the best decisions I ever made in my life were firstly to have lens exchange and secondly to have Mr James Ball carry out my operation.

Patricia Walton

Within minutes I could tell there was a difference. But now, only a couple of months later, my sight is better than it was seven years ago! I can even read the really tiny print on the car sales ads! If you want that confidence you probably felt when you were younger, this is the ideal solution. Thanks to the treatment, I feel rejuvenated, independent and much younger!

John Hazelgreave

Many thanks for all your care and kindness. To me it appears a miracle that I can see so well. I feel very grateful. It is impossible to fully express my thanks.

Grace C.

May I offer grateful thanks for your expertise in operating on my eyes. It was intimated to me that you were the best, and from the results I am now enjoying, I am convinced that this is correct.

Jean D.

You are truly innovative. Thank you very much for curing the problems I have been having with my reading and near vision.

Sala M.

My work was becoming almost impossible. I had refractive lens exchange to both eyes with multifocal lens implants last July. I can now see better than 20/20 for distance and can read the tiniest print in newspapers - all without glasses! I have started reading for pleasure again, and I feel that my performance both at work and on the golf course has improved.


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You are truly innovative. Thank you very much for curing the problems I have been having with my reading and near vision.

Sala M.

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About our surgeons

Mr James Ball | Consultant Ophthalmic Surgeon

MA (Cantab) MB BChir FRCOphth CertLRS

I am a Consultant Ophthalmic Surgeon at Custom Vision Clinic, St James’s University Hospital, and Nuffield Hospital. My major interest is in refractive surgery and finding the best treatment suitable for each patient.

Mr Jack Gormley | Consultant Ophthalmic Surgeon

MB ChB (Hons) FRCOphth CertLRS

I am a Consultant Ophthalmic Surgeon at Custom Vision Clinic and York Teaching Hospital, where I lead the Corneal and Refractive service. I have completed over 2,000 surgical and laser eye procedures.