LASIK and PRK reshape the cornea to correct how light reaches the retina, reducing or eliminating dependence on glasses and contact lenses. Both procedures use an excimer laser to make precise changes measured in microns, and both have been performed millions of times worldwide since receiving FDA approval in the late 1990s.
At Short Hills Ophthalmology, Dr. Farbowitz performs laser vision correction using the IntraLase femtosecond laser for flap creation and the VISX excimer laser for corneal reshaping. He evaluates every patient individually and recommends LASIK, PRK, or neither based on diagnostic findings rather than a one-size approach. Consultations are available at our Short Hills and Clifton offices.
Who Qualifies for Laser Eye Surgery
Not every patient is a candidate for laser eye surgery, and that screening process is one of the most important parts of a successful outcome. The evaluation looks at your eye health, prescription stability, corneal structure, and overall medical history to determine whether LASIK, PRK, or neither is appropriate.
- At least 18 years old with a stable prescription for one to two years
- Corneal thickness and curvature within safe treatment parameters
- No unmanaged dry eye, autoimmune conditions, or uncontrolled diabetes
- Refractive error within the approved treatment range for the procedure
- No pregnancy or nursing, which can temporarily shift prescription
Prescription and Age Considerations
LASIK and PRK each have effective treatment ranges for myopia, hyperopia, and astigmatism, though those ranges differ slightly depending on the procedure and the laser platform used. Your surgeon evaluates not just the prescription itself but how long it has been stable, since operating on a changing prescription leads to less predictable results.
Patients over 40 often develop presbyopia, the gradual loss of near-focus ability that makes reading glasses necessary. Laser vision correction can still be an option at this stage, sometimes using a monovision approach where one eye is corrected for distance and the other for near vision. For patients in their 50s and 60s, the consultation may also involve a discussion about early lens changes and whether a refractive lens procedure would be more appropriate than corneal surgery.
When PRK May Be the Better Fit
PRK is not a second-choice procedure. For certain patients, it is the recommended one.
Candidates with thinner corneas may not have enough tissue for the flap that LASIK requires. PRK works on the corneal surface without creating a flap, which preserves more stromal tissue. Patients in occupations or sports with a higher risk of eye trauma (military service, contact sports, first responders) sometimes choose PRK because there is no flap to displace after surgery. Prior corneal procedures may also make PRK the safer path.
During your consultation, corneal thickness measurements and topographic mapping determine which procedure gives you the best combination of safety and visual outcome.
Related reading: detailed candidacy factors.
How LASIK and PRK Correct Your Vision
Both LASIK and PRK reshape the cornea using an excimer laser to correct how light focuses on the retina. The clinical goal is the same: reducing or eliminating dependence on glasses or contact lenses. The difference between the two procedures is how the surgeon accesses the corneal tissue that needs reshaping.
The LASIK Procedure
LASIK begins with the creation of a thin corneal flap. The surgeon lifts this flap to expose the underlying stromal tissue, then applies the excimer laser to reshape the cornea according to a treatment plan mapped to your eye. After reshaping is complete, the flap is repositioned. It adheres naturally without stitches.
The procedure itself typically takes less than 10 minutes per eye. Wavefront-guided and topography-guided treatment options allow the laser to follow a customized map of your corneal surface rather than applying a uniform correction.
Most patients notice a significant improvement in vision within hours of surgery.
The PRK Procedure
PRK removes a thin layer of surface epithelium rather than creating a flap. The surgeon then applies the same excimer laser to reshape the cornea, using wavefront-guided or topography-guided mapping when appropriate.
Because the epithelium must regenerate on its own after surgery, initial recovery takes longer than LASIK. A bandage contact lens is placed on the eye to protect the surface during the first several days of healing.
The final visual outcomes for PRK and LASIK are comparable. The difference is in how you get there, not where you end up.
Your surgeon recommends the procedure that your diagnostic measurements support. Both approaches use the same excimer laser platform and deliver comparable long-term results.
Vision Conditions Treated by Laser Eye Surgery
Laser eye surgery addresses the refractive errors that cause your eye to focus light incorrectly. Rather than compensating with glasses or contacts, LASIK and PRK change the shape of the cornea so light reaches the retina where it should.
Myopia (Nearsightedness)
Myopia occurs when the eye is slightly longer than normal or the cornea curves too steeply. Light focuses in front of the retina instead of on it, making distant objects appear blurred while close-up vision stays clear. The excimer laser flattens the central cornea by a precise amount, shifting the focal point back onto the retina.
Myopia is the most commonly treated condition in laser vision correction and tends to produce highly predictable results within the approved treatment range.
Hyperopia (Farsightedness)
Hyperopia is the opposite structural pattern. The eye is slightly shorter or the cornea too flat, so light focuses behind the retina. Near objects are harder to see clearly, and with higher prescriptions, distance vision is affected as well. The laser steepens the central cornea to bring the focal point forward.
Hyperopic corrections require reshaping a wider zone of corneal tissue, which is one reason candidacy thresholds differ from myopia.
Astigmatism
Astigmatism results from a cornea that curves unevenly, shaped more like a football than a basketball. Light splits into multiple focal points, producing blurred or doubled vision at any distance. Wavefront-guided and topography-guided laser treatments map the irregular surface in detail and apply a correction pattern specific to the shape of your cornea.
Many patients have astigmatism combined with myopia or hyperopia. Both conditions are addressed in the same treatment session.
Technology at Short Hills Ophthalmology
The laser platform a practice uses affects the precision, speed, and customization available during your procedure. Different platforms have different capabilities, and knowing what equipment your surgeon operates with is a reasonable part of your research.
IntraLase Femtosecond Laser (Flap Creation)
The first step in LASIK is creating a thin corneal flap. Dr. Farbowitz uses the IntraLase femtosecond laser for this step, a bladeless approach that replaced the manual microkeratome blade used in earlier generations of LASIK. The IntraLase delivers rapid pulses of infrared light to create a precise, uniform flap at a programmed depth and diameter.
Bladeless flap creation allows the surgeon to control flap thickness, hinge position, and diameter with a level of consistency that manual instruments cannot match. This precision is especially relevant for patients with thinner corneas, where preserving stromal tissue matters most.
The IntraLase laser is used only during the flap step. Once the flap is lifted, the excimer laser takes over for the vision correction itself.
VISX Excimer Laser (Corneal Reshaping)
The VISX excimer laser performs the actual vision correction. After the IntraLase creates the flap (in LASIK) or after the epithelium is removed (in PRK), the VISX applies ultraviolet light pulses to reshape the corneal tissue with sub-micron accuracy. Each pulse removes a fraction of a micron of tissue, and the treatment pattern is calculated from your pre-operative measurements.
The VISX platform includes an iris registration system that locks onto your eye's unique iris pattern and accounts for any rotational shift between your seated diagnostic measurements and your position during surgery. An active tracking system follows your eye movements in real time and pauses the laser if movement exceeds the tracking range.
The VISX supports CustomVue wavefront-guided treatments, which map higher-order aberrations beyond what a standard glasses prescription captures. This allows the laser to apply a correction shaped to your individual optical system rather than a uniform prescription-based pattern.
Wavefront-Guided and Topography-Guided Treatments
Standard laser correction applies a uniform prescription-based treatment. Wavefront-guided and topography-guided treatments go further by incorporating a detailed map of your individual corneal surface and optical system.
Wavefront-guided treatments measure how light travels through your entire eye, capturing higher-order aberrations that a glasses prescription does not account for. The laser then applies a correction shaped to your specific optical fingerprint.
Topography-guided treatments use a high-resolution map of the corneal surface itself. This approach is particularly relevant for patients with irregular astigmatism or corneal surface variations. It is also the basis for topography-guided PRK, which the practice performs for candidates whose eyes are better suited to surface ablation.
The choice between treatment profiles is clinical, not cosmetic. Your surgeon recommends the approach that your pre-operative measurements support.
The laser platform is one factor in surgical outcomes. Surgeon experience, patient selection, and pre-operative diagnostic accuracy are equally important. During your consultation, Dr. Farbowitz will explain how these elements work together for your specific case.
What to Expect Before, During, and After Surgery
Understanding the full timeline helps set realistic expectations. Laser eye surgery is a quick procedure, but the experience extends from your initial evaluation through several months of visual stabilization.
Pre-Operative Evaluation
Diagnostic Assessment
The consultation is a diagnostic appointment, not a sales conversation. Your surgeon measures corneal thickness, maps the corneal surface with topography, dilates your pupils to examine the internal structures of your eye, and verifies your refractive prescription. Tear film quality is also assessed, since untreated dry eye can affect both surgical outcomes and post-operative comfort.
Contact Lens Preparation
If you wear contact lenses, you will need to stop wearing them for a specified period before the evaluation so your cornea returns to its natural shape. Soft lenses typically require a few days to two weeks out; rigid or gas-permeable lenses may require longer.
Day of Surgery
At the Office
Plan for roughly two to three hours at the office, though the laser portion of either LASIK or PRK takes only minutes per eye. Numbing drops are applied so you feel pressure but not pain. You will be awake during the procedure and asked to focus on a fixed light while the laser works.
The Procedure
For LASIK patients, the flap is created first, then the excimer laser reshapes the cornea, and the flap is repositioned. For PRK patients, the surface epithelium is removed and the excimer laser is applied directly to the corneal surface. A bandage contact lens is placed on the eye after PRK to protect the surface during initial healing. You will need someone to drive you home.
Recovery Timelines
LASIK: Hours to Days
Vision improvement is often noticeable within hours. Most LASIK patients return to work and normal activities within one to two days. Common experiences during the first week include mild dryness, light sensitivity, and halos around lights at night. These typically diminish over the first several weeks.
PRK: Days to Weeks
The bandage contact lens stays on for approximately five to seven days while the epithelium regenerates. Vision is functional but noticeably hazy during this period, and most patients take several days off from work. Clarity improves progressively over the following weeks.
Full Stabilization: Three to Six Months
Both procedures reach final visual stability within three to six months as the cornea settles into its new shape. Follow-up appointments are scheduled to track your healing and measure your visual acuity at each stage. Your surgeon prescribes medicated drops tailored to your procedure and healing timeline.
Risks and Safety
Laser eye surgery has one of the highest patient satisfaction rates of any elective surgical procedure, but it carries risks that any informed candidate should understand before making a decision.
Dry Eye After Surgery: The most frequently reported side effect is dry eye, which occurs in a significant percentage of LASIK patients during the first few months after surgery. For most, this resolves with lubricating drops and time. If you already experience dry eye symptoms, your surgeon will evaluate the severity during your consultation and may recommend treatment before scheduling surgery.
Halos, glare, and starbursts around lights at night are common in the early recovery period, particularly for patients with larger pupils or higher prescriptions. These visual disturbances usually diminish as the cornea heals, though a small percentage of patients report some degree of persistent nighttime symptoms.
Under-correction and over-correction can occur. Some patients require a secondary procedure (an enhancement) to fine-tune the result after the cornea has stabilized. Your surgeon will discuss enhancement rates and timing during your consultation.
Serious complications are rare. Flap-related issues in LASIK (incomplete flap, flap displacement, epithelial ingrowth) occur in a very small fraction of cases and are typically manageable when addressed promptly. Infection risk exists for any surgical procedure and is minimized through sterile technique and post-operative drop protocols.
PRK avoids flap-related complications entirely, which is one clinical reason it is preferred for certain candidates. PRK does carry a small risk of corneal haze during healing, which is managed with mitomycin-C application during surgery and steroid drops during recovery.
The best protection against complications is thorough pre-operative screening. Patients who are poor candidates face higher risk. A practice that turns away borderline cases is prioritizing outcomes over volume.
Laser Eye Surgery Cost, Insurance, and Financing
LASIK and PRK are elective procedures, and most vision and medical insurance plans do not cover them. Understanding the cost structure before your consultation removes one layer of uncertainty from the decision.
Pricing for laser eye surgery is typically quoted per eye. The total reflects the surgeon's fee, facility and laser technology costs, pre-operative diagnostic testing, and post-operative follow-up visits. Some practices bundle all of these into a single price; others itemize them separately. When comparing quotes, confirm what is included so you are evaluating the same scope.
Costs vary based on the procedure performed, the laser treatment profile used (standard vs. wavefront-guided vs. topography-guided), and whether an enhancement policy is included in the original fee. A lower advertised price that excludes follow-up care or charges separately for an enhancement is not necessarily a better value.
Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA) can be applied toward laser vision correction. If your employer offers either, this is one of the most tax-efficient ways to pay for the procedure. Planning your surgery around your benefits enrollment period can make a meaningful difference in out-of-pocket cost.
Financing plans through third-party providers allow patients to spread the cost over monthly payments. Short Hills Ophthalmology can discuss available financing arrangements during your consultation.
For a full overview of accepted insurance plans, FSA/HSA details, and financing options, visit our insurance and financing page.
Your Surgeon and Practice
Dr. Michael Farbowitz is a board-certified ophthalmologist who has performed refractive surgery for over two decades. He was among the first surgeons in New Jersey to offer femtosecond laser-assisted cataract surgery and has continued to adopt advanced laser platforms as they have gained FDA clearance.
Dr. Farbowitz performs both LASIK and PRK and determines which procedure to recommend based on each patient's diagnostic results rather than defaulting to one approach. His surgical volume across both procedures gives him direct experience with the full range of candidacy profiles, corneal anatomies, and refractive targets.
Short Hills Ophthalmology coordinates all pre-operative testing, surgery scheduling, and post-operative care to make the process as convenient as possible. Our staff handles insurance questions and can explain costs for any procedure you may be considering.
Laser Eye Surgery in Short Hills, New Jersey
Our Short Hills office serves patients throughout Essex County and the surrounding communities. Located in the heart of Short Hills, we provide convenient access to laser vision consultations, pre-operative diagnostics, and post-operative care for residents of Millburn, Summit, Springfield, Livingston, Maplewood, and South Orange.
Many patients appreciate having a local practice with access to the same advanced laser technology found at major medical centers. Dr. Farbowitz performs refractive surgery at nearby outpatient surgical facilities, keeping travel time minimal for the procedure itself.
Short Hills Office
574 Springfield Avenue
Short Hills, NJ 07078
Laser Eye Surgery in Clifton, New Jersey
Our Clifton office extends our laser vision correction services to Passaic County and surrounding areas. Patients from Clifton, Passaic, Paterson, Wayne, Montclair, and Bloomfield benefit from easy access to refractive surgery consultations without traveling to New York or distant specialty centers.
The Clifton location offers the same thorough consultations, advanced diagnostic equipment, and personalized care as our Short Hills office. Patients can choose whichever location is most convenient for their appointments.
Clifton Office
777 Passaic Avenue
Clifton, NJ 07012
Schedule a Laser Eye Surgery Consultation
Your evaluation determines which procedure fits your eyes, what results to expect, and whether laser vision correction is the right choice for your situation. The consultation is a diagnostic appointment with no obligation to proceed.
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