LASIK ou PKR : quelle différence ?

Les deux corrigent la vue au laser. Le LASIK crée un fin capot cornéen puis corrige en profondeur : la récupération visuelle est très rapide. La PKR (PRK) corrige en surface, sans capot : la récupération est plus progressive, mais elle est préférée pour certaines cornées fines ou à risque.

Peut-on opérer la presbytie ?

Oui, plusieurs stratégies existent (laser, correction en bascule, implants selon les cas). Le choix dépend de l'âge, de la correction et de l'état du cristallin. Un bilan permet de définir la solution la plus adaptée.

Qui peut être opéré ?

L'éligibilité dépend d'un bilan préopératoire complet : mesure de la correction (stable), topographie et épaisseur de la cornée, état de la surface oculaire. Ce bilan écarte notamment un kératocône débutant, contre-indication importante au LASIK.

Refractive surgery: LASIK, PRK and vision correction

Name: Chirurgie réfractive : LASIK et PKR
Creator: Pr Eric E. Gabison

Refractive surgery corrects nearsightedness, astigmatism, farsightedness and presbyopia to reduce or eliminate your dependence on glasses. It relies mainly on two laser techniques — LASIK and PRK — tailored to you after a thorough work-up. Here is what you need to know to understand your options.

LASIKPRKMyopiaAstigmatismPresbyopia

⬇ Download this fact sheet (PDF)

Which vision problems can be corrected?

Myopia — blurred distance vision.
Astigmatism — distorted vision at all distances.
Hyperopia — visual strain, fatigue, difficulty seeing up close.
Presbyopia — age-related decline in near vision, which can be managed with dedicated strategies.

LASIK

LASIK involves creating a thin corneal flap, then reshaping the cornea beneath it with an excimer laser. Its main advantage is very fast visual recovery, with little discomfort. It requires a cornea of suitable thickness and shape, which is checked during the pre-operative work-up.

PRK

PRK corrects the cornea's surface, without creating a flap. Recovery is somewhat slower and discomfort in the first few days more noticeable, but it is an excellent option for thin corneas, certain at-risk profiles, or particular lifestyles (contact sports, exposed professions).

How to choose? The role of the pre-operative work-up

There is no single "best" technique: the right choice depends on your eye. The work-up measures your correction (which must be stable), the topography and thickness of the cornea, and the condition of the ocular surface and retina. It notably rules out early keratoconus, an important contraindication to LASIK. This work-up is what determines the safest and most suitable technique.

And after age 50?

When presbyopia sets in and the lens starts to change, lens surgery with an implant can also correct vision. The strategy is discussed case by case according to age and the condition of the lens.

The techniques in detail

Each technique has its own indications, advantages and limits. Explore them in detail:

LASIKLaser correction with flap PRKSurface correction SMILEMini-incision, no flap Clear lens exchangeLens replacement Refractive cataract surgeryPremium implants

Which vision problem to correct?

Depending on your prescription, the solutions differ. Learn more about each condition:

MyopiaBlurred distance vision AstigmatismDistorted vision HyperopiaVisual strain, near vision PresbyopiaNear vision after age 45

Before you decide

All questions →

Want to depend less on your glasses?

A refractive work-up determines if — and how — you can be operated on.

Book an appointment

Are you a healthcare professional? To go further: the expert course "Corneal refractive surgery" — PRK, LASIK, lenticule extraction (SMILE/SILK), ablation limits (Munnerlyn, PTA), complications (DLK, PISK, CTK) and iatrogenic ectasia.

This page is for general information only and does not replace a medical consultation. The indication and technique are always individualized after a complete work-up. Pr Eric E. Gabison — cornea and refractive surgery, Fondation Adolphe de Rothschild, Paris.