Procedure
TransPRK, Surface Laser Eye Surgery
TransPRK is a procedure that permanently corrects myopia (nearsightedness), hyperopia (farsightedness) and astigmatism by reshaping the surface of the cornea with a laser. It is the least invasive refractive surgery technique. There is no cut and no flap, and nothing touches the eye. The laser works directly on the corneal surface, in a single sequence.
Dr Steven Nahaisi
Updated on 15 October 2026 · 30 min read
I offer it when LASIK is not the best option for your cornea, typically when it is too thin, or when you feel more comfortable with a procedure that involves no cut. Visual recovery is gradual. Allow 7 to 10 days to get back to your everyday independence, and 1 to 3 months for the result to stabilize.
TransPRK is performed with the Schwind Amaris 750S excimer laser, a reference machine in surface refractive surgery, at the Institut Laser Ophtalmologique Voltaire (Voltaire Laser Eye Institute), Paris 11th (11e arrondissement). Only one machine is used. TransPRK does not require a femtosecond laser, since there is no flap to create.
On this page, I explain what TransPRK is, its history, how the procedure goes, its indications and limits, recovery and risks. I also answer the real questions my patients ask me every week in consultation.
On this page12 sections
WHAT IS TRANSPRK?
TransPRK: definition and principle of the procedure
PRK stands for PhotoRefractive Keratectomy. As the name suggests, it means sculpting the cornea by photoablation for a refractive purpose, that is, to correct vision defects. TransPRK (for "TransEpithelial PhotoRefractive Keratectomy") is its modern version, performed entirely by laser and without contact with the eye.
It is a proven technique. Schwind's SmartSurfACE procedure, which I use at the Institut Voltaire, has been on the market since 2009 and has benefited from SmartPulse technology since 2015; it alone accounts for more than 900,000 procedures performed worldwide.
The principle of all laser refractive surgery is to reshape the cornea, the transparent tissue at the front of the eye that provides most of its optical power. What sets the techniques apart is the route used to reach the deep layer of the cornea, the stroma.
The cornea has three main layers. At its surface, the epithelium, the "skin" of the cornea, is a thin membrane that regenerates naturally after ablation. Deeper down, the stroma carries most of the optical power; it does not regenerate after ablation, and that is why the new corneal curvature holds over time. The innermost layer, the endothelium, is not involved in refractive surgery.
There are several ways to reshape the stroma. LASIK creates a corneal flap that is lifted to reach the stroma (learn more about LASIK). SMILE removes a thin lenticule of tissue from inside the cornea through a micro-incision (learn more about SMILE). TransPRK simply goes through the epithelium with the laser and then sculpts the underlying stroma, in a single continuous sequence, with no cut and no contact.
The TransPRK sequence, in one continuous step
The epithelium is first vaporized with the excimer laser over the treatment zone. This removal of the corneal "skin" takes a few seconds, with no contact at all, and it is painless.
The stroma is sculpted immediately afterward, in the same session, by the same laser. The correction profile is applied point by point according to a personalized aberrometry map (learn more about personalized treatment).
A bandage contact lens is placed at the end of the procedure on the surface of the eye. It protects the exposed area while the epithelium heals and eases the sensations of the first 48 hours.
The epithelium closes in 24 to 48 hours, then fully restratifies in 4 to 6 weeks. This natural, gradual epithelial healing is what explains the visual recovery time. It has no impact on the quality of the final result.
The history of PRK: from manual scraping to transepithelial laser
PRK is the very first refractive surgery ever performed with a laser. In the early 1980s, it was discovered that the ultraviolet light of the excimer laser could remove corneal tissue with micrometric precision, without damaging the cornea or its healing. The first procedures on the human eye followed in the second half of the 1980s, a few years before LASIK appeared.
The basic principle has not changed since: the laser sculpts the stroma to give it a new curvature. What has evolved is the way the epithelium is removed to reach the stroma. The machines have also become more precise and safer.
The first PRKs removed the epithelium mechanically, by scraping with a spatula or a rotating brush. A later generation used a diluted alcohol solution to loosen the epithelial layer before the laser pass. These approaches worked, but they lengthened the procedure, and the healing that followed was more painful. They are still practiced today in many laser centers in France that are not equipped with recent TransPRK technology.
Today's TransPRK eliminates this manual step. The laser itself removes the epithelium and then sculpts the stroma, in the same operative session and with no contact at all. This is the transepithelial "no-touch" approach: a single sequence, a single laser. This is the technique I perform at the Institut Voltaire. Feedback about the older PRK done by scraping or with alcohol, which was more uncomfortable, no longer applies.
Ref.: Trokel SL. et al., "Excimer laser surgery of the cornea", Am J Ophthalmol, 1983 (founding work on corneal photoablation). Adib-Moghaddam S. et al., "Single-step transepithelial photorefractive keratectomy in myopia and astigmatism", J Cataract Refract Surg, 2016.
THE STEPS OF TRANSPRK
TransPRK step by step
To show concretely what happens during the procedure, I designed an interactive TransPRK simulator. It walks through the five stages of the surgery on a cross-section of the cornea: the normal eye, removal of the epithelium, the exposed stroma, laser reshaping, then healing. You move forward at your own pace, step by step.
Normal cornea
Cross-section of the anterior chamber. The cornea is covered by its epithelium, the thin outer layer visible just beneath the surface. In TransPRK, the entire treatment is done at the surface, with no flap creation.
TransPRK is a simple, quick procedure: everything is done in a single continuous sequence, under the same laser, with no change in the position of the operating bed between steps and no change of machine.
Step 1: positioning and anesthesia
The patient lies comfortably under the laser. Anesthesia is by eye drops only, with no general anesthesia and no injection. An anti-blink device keeps the eye open effortlessly. The eye cannot close during surgery. This is a common fear, but an unfounded one.
Step 2: removal of the epithelium with the excimer laser: about 20 seconds
The Schwind Amaris 750S first vaporizes the thin layer of epithelium over the treatment zone. The patient looks at a light and sometimes notices a particular smell, described as a burning smell. This smell comes from the interaction of the laser with the surrounding air: it has nothing to do with the cornea, which is neither heated nor burned. It is a normal physicochemical phenomenon of the laser.
The epithelium measures about 50 microns on average, but its thickness varies from one person to another. The Schwind platform, combined with our corneal OCT system, adapts the epithelial sculpting to each patient's actual thickness. Other platforms apply a standard epithelial ablation of about 50 microns, the same for everyone, whatever the profile.
Step 3: sculpting the stroma: 2.5 seconds per diopter
The same laser moves straight on to sculpting the stroma. Treatment time is very short, about 2.5 seconds per diopter treated. The patient simply looks at the light and feels nothing.
The laser incorporates the complete aberrometry map of the eye, measured just before the procedure, and applies the correction profile point by point. Ultra-fast eye-tracking follows the eye continuously: even with small involuntary movements, the treatment stays applied exactly where planned.
Step 4: application of mitomycin C: about 30 seconds
Mitomycin C is systematically applied to the surface of the stroma for about thirty seconds, then rinsed off. This drug modulates healing and prevents haze, the slight opacity that could occur after older PRKs, especially with high corrections. It is one of the advances that have made surface surgery as reliable as it is today.
Step 5: placing the bandage contact lens: about 10 seconds
The eye surface is rinsed with cold saline, then a soft bandage contact lens is placed on the surface of the eye. Like a contact lens, it protects the healing epithelium and eases the painful sensations of the first 48 hours.
The bandage contact lens stays in place until the epithelium has closed, between the 3rd and 5th day. It is removed at the first post-operative check-up.
Your time in the operating room is very short, about ten minutes for both eyes. Each step is explained as it happens, and some music is always playing to keep the atmosphere relaxed.
Summary of the steps and their duration
| Step | Tool | Approximate duration |
|---|---|---|
| Removal of the epithelium | Schwind Amaris 750S (excimer), customized | ≈ 20 seconds per eye |
| Sculpting the stroma | Schwind Amaris 750S (excimer), customized | ≈ 2.5 seconds per diopter |
| Application of mitomycin C (systematic) | Surface application | ≈ 30 seconds |
| Rinsing and placing the bandage contact lens | Manual step | ≈ 10 seconds |
THE LASER USED
Schwind Amaris 750S: a single laser, no contact
TransPRK uses only one machine: the Schwind Amaris 750S excimer laser, which performs both the removal of the epithelium and the sculpting of the stroma. No femtosecond laser is needed, since there is no flap to cut.
The operating room at the Institut Voltaire. For TransPRK, the Schwind Amaris 750S excimer laser (on the right in the photo) performs the entire procedure on its own: removal of the epithelium, then sculpting of the stroma, with no flap and no contact. The Zeiss Visumax 800 femtosecond laser (on the left), used to cut the flap in LASIK, is not involved here.
SmartSurfACE: Schwind's TransPRK
On the Schwind platform, TransPRK is called SmartSurfACE. It is Schwind's proprietary surface procedure: the Amaris laser removes the epithelium and corrects vision in a single step, with no suction, no flap, no blade and no alcohol. Hence the term "no-touch".
SmartSurfACE combines transepithelial ablation with SmartPulse technology, which distributes the laser pulses so as to leave a smoother corneal bed. A more regular surface gives better-quality healing and a sharper visual recovery. This is the combination I use at the Institut Voltaire.
How the excimer laser works
The Schwind Amaris 750S works by photoablation: its ultraviolet light (193 nm) breaks the molecular bonds of the superficial layers of the cornea, which are vaporized instantly. The surrounding cornea stays cool.
Its main features in TransPRK:
- High repetition rate: a pulse frequency of 750 Hz, or about 2.5 seconds per diopter treated.
- Ultra-fast 6D eye-tracking: the tracker takes 1,050 measurements per second and compensates for eye movements in six dimensions, including involuntary microsaccades of the gaze. The laser cannot treat anywhere other than the planned spot. There is nothing to fear about possible movements during surgery.
- Iris recognition: the laser identifies unique landmarks on the iris and automatically compensates for cyclotorsion (the slight rotation of the eye between the sitting and lying positions). This is particularly important for astigmatism.
- Point-by-point aberrometry: the laser incorporates the aberrometry map of the eye, measured just before the procedure, and applies a personalized treatment profile. This is the key strength of the Schwind platform.
- Large optical zones: surface surgery uses less corneal tissue and, above all, better preserves the residual stromal bed. This saving makes it possible to use larger optical zones, which is useful in patients with large pupils.
- Dual energy level (AFLA): about 80% of the ablation is performed at high fluence for speed, the remaining 20% at lower fluence for finishing work, which smooths the corneal surface.
- Thermal control (ITEC): the distribution of pulses is managed to keep a safe surface temperature, without heating the surrounding corneal tissue.
Summary: the role of the laser
| Function | How | Result |
|---|---|---|
| Epithelial ablation | Customized transepithelial photoablation | Access to the stroma without contact |
| Refractive sculpting | Customized aberrometric profile | Lasting new corneal curvature |
| Intraoperative safety | Eye-tracking + iris recognition | Precision maintained despite movements |
Understanding aberrometry and customized treatment
WHO IS TRANSPRK FOR?
TransPRK: indications and candidacy criteria
TransPRK corrects the main refractive errors, within limits set both by corneal safety and by the healing time of the epithelium. The thresholds applied at the Institut Voltaire:
| Refractive error | Upper limit treatable with TransPRK |
|---|---|
| Myopia | ≈ -10 diopters |
| Hyperopia | ≈ +6 diopters |
| Astigmatism | ≈ -4 diopters |
| Presbyopia | Specific strategy, see the PresbyLASIK page |
These limits are indicative. The final decision depends on the precise characteristics of your cornea and your profile, assessed during the pre-operative assessment.
Situations where I favor TransPRK
Thin cornea. This is the most common indication. To operate safely, there must be enough healthy corneal thickness left under the treated area. When the cornea is too thin to allow this, TransPRK becomes the best choice: since it creates no flap, it preserves more thickness. The cornea stays stronger, and the risk of long-term deformation (ectasia) is greatly reduced.
A somewhat fragile corneal profile. Some corneas show subtle signs of fragility, without a formal contraindication to laser surgery. As a precaution, I then lean toward TransPRK. I systematically discuss these borderline cases with my two colleagues at the Institut Voltaire, Dr Rambaud and Dr Nicolau, during our weekly joint case reviews.
Risk of eye trauma. For patients who practice combat sports (boxing, MMA, martial arts), law enforcement officers or military personnel, the risk of a direct blow to the eye is high throughout life. In boxing, with gloves, a LASIK flap is not a problem, but for those who prefer to avoid this variable, TransPRK is particularly well suited: with no flap, there is no later risk of traumatic displacement. SMILE, which does not create a flap either, may also suit these profiles depending on the correction.
Apprehension about the cut. Some patients are particularly worried about the idea of a flap being created, or simply about their eye being touched during the operation. For them, TransPRK, a surface laser with no contact and no cut, is often more reassuring. I often say it: it is the technique best suited to anxious patients. It is something I address during the pre-operative interview, because we do not operate on eyes alone, we operate on patients. Their fears matter as much as the correction to be treated.
Certain enhancements on atypical corneas. Surface laser enhancement has a place in particular situations: atypical corneas, topography-guided treatments on a deformed cornea to correct high-order optical aberrations, or correction of old cuts made with a microkeratome (a flap technique that predates femtosecond lasers). These are specific indications, assessed case by case.
The corneal criteria of the pre-operative assessment
Candidacy is not just a matter of corneal thickness. It depends on several parameters analyzed during the assessment:
- Total corneal thickness (pachymetry).
- Mean and maximum anterior corneal curvature (keratometry).
- Posterior corneal curvature, which helps screen for early keratoconus.
- Epithelial thickness and its distribution map.
- The residual stromal bed calculated after ablation.
- Eye habits: repeated rubbing, pressure on the eyes during sleep. These are risk factors to take into account.
The pre-operative assessment determines the most suitable technique. I always discuss these criteria with you and go through the test results in detail.
The pre-operative assessment: everything you need to know
Ref.: Randleman JB. et al., "Risk assessment for ectasia after corneal refractive surgery", Ophthalmology, 2008. Ambrósio R. Jr. et al., "Integration of Scheimpflug-based corneal tomography and biomechanical assessments", J Refract Surg, 2017.
WHEN TRANSPRK IS NOT THE BEST OPTION
Situations where I prefer another technique
TransPRK has two limits: the visual recovery time and surface healing. In certain situations, another technique is preferable.
Need for a fast recovery. If you cannot afford a week of reduced visual independence, and the characteristics of your cornea allow it, a technique with a faster recovery will be preferable.
Thick, regular cornea with no risk profile. When the corneal parameters comfortably allow another technique, TransPRK brings no decisive advantage and imposes a longer recovery.
Beyond the limits of the laser. For myopia above -10 diopters, or with a cornea that is not compatible with laser surgery (keratoconus, early ectasia), other options exist. The phakic implant (ICL, implantable collamer lens) is a lens placed inside the eye, behind the iris, that corrects high refractive errors without touching the cornea. When this option is best suited to your case, I refer you to a specialized colleague.
HOW THE PROCEDURE GOES
How TransPRK surgery goes at the Institut Voltaire
Here I describe the procedure itself. A separate page covers the practical side: appointment notice, prescription, anti-anxiety tablet, removing contact lenses, arriving at the clinic, changing into surgical attire, going home, first check-up.
Surgery day: preparation and practical details
Before the procedure
An anti-anxiety tablet is taken about an hour before the procedure. No fasting is needed. On arrival, after the paperwork and the last eye scans, the patient changes into sterile attire and is taken to the pre-induction room.
In the operating room, the patient lies under the laser. Anesthesia is by eye drops only, with no general anesthesia and no injection. An anti-blink device keeps the eye open effortlessly.
The laser pass
For each eye, the sequence is continuous: removal of the epithelium, then sculpting of the stroma, all in about thirty seconds per eye, a little more depending on the correction. The patient looks at a light and the laser does the rest, with no contact or pressure at all, and without any instrument being visible.
We then move on to the second eye. Your time in the operating room is very short: about ten minutes for both eyes. Each step is explained as it happens, in a relaxed atmosphere, with music.
The atmosphere of the operating suite at the Institut Voltaire: the pre-operative room (anesthetic eye drops and sterile attire), the procedure in progress (with music), and the post-operative room (rest, handing out protective glasses).
Iris recognition and eye-tracking: safety throughout the procedure
Before each procedure, two measurements are recorded for each eye: the complete aberrometry map (the exact correction profile), and a high-resolution photograph of the iris in its natural position, which includes cyclotorsion. These data are loaded into the laser, separately for the right eye and the left eye.
Just before each pass, the Schwind Amaris 750S performs an iris recognition test: it identifies the unique patterns of the iris and confirms that it is about to treat the right eye, with the right profile. This cross-check prevents any mix-up between the right eye and the left eye.
The benefit goes beyond identification: the laser adjusts the correction in real time according to the exact position of the iris throughout the procedure. Even if the eyes move slightly during sculpting, the correction stays applied exactly where it should be. The result is as precise as if the eye had stayed perfectly still.
The bandage contact lens
At the end of the treatment of each eye, the eye surface is rinsed with cold saline, then a soft bandage contact lens is placed. It protects the healing area of epithelium and speeds up the closure of the surface. It also eases the painful sensations of the first 48 hours.
Right after the procedure
Vision is relatively good in the hours following TransPRK, but it can be hard to keep your eyes open because of the discomfort. Vision starts to blur in the evening, as epithelial healing begins, then improves gradually day by day.
After a short rest in the recovery room, UV-protective glasses are provided for the trip home. The first check-up appointment is scheduled, and the instructions for the first days are explained again before you leave.
For TransPRK, I recommend going home with someone: the first hours are sometimes uncomfortable (sensitivity to light, watery eyes, foreign body sensation). If no one can accompany you, going home by taxi or ride-hailing service is perfectly possible. Driving is not possible in the hours following the procedure.
RECOVERY AFTER TRANSPRK
Visual recovery and instructions after TransPRK
Recovery after TransPRK is gradual and follows a fairly well-defined sequence, described below to give you realistic benchmarks.
The first 48 to 72 hours
This period corresponds to the initial healing of the epithelium. The bandage contact lens protects the area, but sensations are still present: foreign body sensation, watery eyes, sensitivity to light, sometimes real pain, especially during the first two days. Most patients describe moderate to marked discomfort, managed with painkillers, rest with the eyes closed, and regular use of artificial tears.
I always prescribe what you need to get through this period. Sensations vary from one person to another, from a little stinging to more pronounced discomfort, and this cannot always be predicted. It is the only truly uncomfortable moment of the whole process.
From day 3
Intense pain or discomfort has gone. Patients are able to get around: this is when the first post-operative check-up takes place and the bandage contact lens is removed.
Vision is still blurry at this stage, usually around 2 to 3/10 (about 20/100 to 20/70). This is not enough to drive or go back to work, but enough to get around, go out and live at a slower pace.
The end of the first week
Around day 5 to 7, the epithelium has closed and the unpleasant sensations have clearly faded. Vision becomes clearer, without yet reaching the final result: expect about 70% of your visual acuity at this stage. It is a rather "cottony" blur, different from the usual blur of nearsighted people, linked to the ongoing epithelial healing.
From the second to the sixth week
Vision keeps improving, often with fluctuations from one day to the next or from one eye to the other. This is the "fluctuating phase": the epithelium reorganizes over the sculpted stroma and the cornea finds its optical balance.
At 1 month, most patients have recovered vision close to the final result. High corrections can take longer, sometimes 6 weeks to 3 months to stabilize completely.
The final result
It is assessed between 1 and 3 months after surgery. The vast majority of patients achieve uncorrected distance vision that lets them go about their daily lives without glasses or contact lenses for the treated defect.
Instructions for the first week
- Extended sun protection. Sun exposure is not recommended for the 6 months following TransPRK, because it can interfere with surface healing and promote a slight opacity (haze). There is no strict ban on going outside: well-tinted sunglasses are enough, and wraparound glasses or ski goggles in case of strong exposure (skiing, beach).
- No shower directly on the face while the bandage contact lens is in place. Use a damp washcloth around the eyes instead.
- No eye makeup for at least one week.
- Bathing without putting your head underwater is possible after about one week; swimming from 2 weeks.
- Steam room and sauna: not before two weeks.
Unlike LASIK, there is no strict ban on touching your eyes after TransPRK: with no flap, nothing can shift. It is still better to avoid rubbing during healing, so as not to irritate the epithelium while it is closing.
Returning to activities
Allow about one week before returning to work in most cases. Driving usually becomes possible at the end of the first week, once the epithelium has closed and vision is clear enough.
Non-contact sports can resume as soon as you feel ready, on average around day 4 to 5. Swimming should be avoided for 2 weeks. Sports with a risk of a direct blow to the eye can resume at three weeks. In the long term, there is no risk of flap displacement, whatever the intensity of the sport.
If you work in a high-risk environment (dust, chemicals), a sick note (time off work) can be prescribed case by case, typically for one week.
Post-operative eye drops
Treatment with eye drops lasts about 3 weeks, starting after the first post-operative nap, about 6 hours after the procedure:
- Antibiotic-corticosteroid eye drops: tapering protocol over about 20 days.
- Preservative-free artificial tears (such as Vismed or Hyabak): 4 to 6 times a day for at least one month, then as needed.
- Painkillers for the first 48 hours.
To put in the drops: in front of a mirror, gently pull the lower eyelid down (by pulling on the cheek rather than the eyelid). One drop placed in the pocket this creates under the eye is enough.
The first check-up
The first check-up takes place around day 3 after the procedure, at my office in Paris 19th (19e arrondissement), rue Archereau. It is a short check-up: checking epithelial healing and the absence of inflammation, and removing the bandage contact lens. Further check-ups are then scheduled at 1 month, then at 3 and 6 months depending on the situation.
Temporary effects in the first weeks
Several normal, temporary phenomena may appear:
- Dry eye, common but temporary, relieved by artificial tears.
- Halos around lights and increased sensitivity to light in low light: a temporary increase peaking around the 2nd month, then gradual regression.
- Fluctuating vision. Recovery is not linear; everything settles over a few weeks.
- Eye strain on screens, with headaches at the end of the day, which fades within a few weeks.
These are part of the normal recovery and do not indicate any fault with the laser. The cornea gradually stabilizes over 1 to 3 months.
Visual recovery over 30 days: TransPRK (blue curve) and LASIK (orange curve). After TransPRK, while the epithelium heals, the improvement is more gradual. Independence returns in 7 to 10 days, then vision keeps sharpening over several weeks. LASIK, for its part, recovers most of the vision in 24 to 48 hours. The curve is never perfectly linear; vision fluctuates from one day to the next before settling. Despite these different paces, the final result at 3 months is equivalent between the two techniques. (Curve taken from the explanatory booklet.)
RISKS AND COMPLICATIONS
TransPRK: the risks explained
TransPRK is a well-established surgery, with a very high satisfaction rate and good biomechanical safety. Like any procedure, it carries possible side effects and complications, rare but worth knowing about so you can decide with full awareness.
Discomfort during the first 48 to 72 hours
Epithelial healing causes real discomfort for two to three days: foreign body sensation, sensitivity to light, sometimes real pain, especially during the first two days. This is a normal, expected part of recovery. The bandage contact lens, painkillers and rest are enough to get through it.
Dry eye
In surface surgery, dryness is generally moderate and temporary, well controlled with artificial tears. In the rare more pronounced cases, I have a whole range of treatments to manage it: stronger artificial tears, lubricating gels at night, and sometimes doxycycline tablets in specific situations (particularly skin-related conditions).
Halos and night vision
Halos around lights, a slight decrease in night vision and glare may appear in the first weeks, peaking around the 2nd month. This is temporary and gradually fades in almost all patients. At 6 months to 1 year, night vision is generally better than before the procedure.
Corneal haze
This is a very slight, temporary opacity of the cornea that could appear after older PRKs, especially with high corrections. It has become rare today, thanks to the systematic intraoperative application of mitomycin C and to the quality of the lasers used. When haze does develop, it is generally asymptomatic and regresses spontaneously or with local treatment. The best prevention is still to protect your eyes well from the sun for the 6 months following the procedure.
Imperfect result and enhancement
Epithelial healing involves a degree of unpredictability. The result may not be perfect, or part of the correction may be missing, especially with high corrections. In that case, a surface laser enhancement may be offered after complete stabilization (not before 6 months after surgery), and it generally achieves the target result.
The enhancement is included in the initial fee during the first year. After that, it is offered at a preferential rate up to 5 years after surgery.
Serious complications
Infection, delayed healing, and a lasting decrease in visual quality are exceptional events that I have never had to manage in practice. They occur mainly when pre- and post-operative safety criteria have not been strictly followed. As with any surgery, zero risk does not exist. It is to minimize these risks that I carry out a complete assessment beforehand and that I am very selective about candidacy criteria.
TransPRK does not touch the optic nerve, the retina or the internal structures of the eye: it does not cause blindness in the usual sense of the word. Like any surgery, it can in exceptional cases lead to a decrease in visual quality, a loss of lines of corrected acuity, significant dryness or bothersome light phenomena. These situations remain rare, and the purpose of the pre-operative assessment is to reduce them as much as possible.
DURABILITY, ENHANCEMENT AND FOLLOW-UP
The TransPRK result over time
A lasting result
The correction applied by the laser is lasting. The corneal stroma does not regenerate after ablation, and that is why the new curvature holds over time. You will never go back to your original refractive error.
A slight regression is theoretically possible over 5 to 10 years, on the order of 0.25 or 0.50 diopter, linked to a very slight re-thickening of the epithelium over the sculpted stroma. It remains minimal, and if it bothered you, a laser enhancement is possible in most cases.
The natural evolution of the eye remains independent
TransPRK corrects the cornea, but changes neither the length of the eye nor the crystalline lens. The natural evolution of vision continues from the day of the procedure. Two phenomena may occur with age, independently of the surgery:
- Presbyopia, which appears around age 40-45 in everyone. If it bothers you, strategies exist (PresbyLASIK, blended vision (monovision), etc.). I will discuss it with you when the time comes.
- Cataract, which typically appears after age 60-65. It is treated with specific lens surgery, independent of TransPRK. Having had laser surgery does not complicate cataract surgery.
Post-operative follow-up
Follow-up is included in the fee, with no limit on consultations. You can contact me at any time by message and come in for a consultation as often as needed. I remain available. The relationship I build with each patient does not end on surgery day.
Any enhancement is included during the first year. After that, up to 5 years, it is offered at a preferential rate.
FEES AND COVERAGE
How much does TransPRK surgery cost in Paris
TransPRK fee: €2,800 for both eyes (€1,400 per eye). A fixed fee, the same whatever the correction to be treated, whether myopia, hyperopia or astigmatism.
What the fee includes
- The procedure, using the Schwind Amaris 750S laser.
- The bandage contact lens placed at the end of the procedure.
- Clinic fees at the Institut Voltaire.
- Complete post-operative follow-up, with no limit on consultations.
- Any enhancement during the first year.
- Prescriptions for post-operative medication.
The pre-operative consultation
The pre-operative consultation is charged at the standard rate set by French national health insurance. Arrangements differ depending on the location:
- Paris 10th and 19th offices: nothing to pay upfront (direct billing).
- Institut Voltaire (Paris 11th): €50 paid upfront, including a €30 fee supplement (above the standard rate). Your complementary health insurance reimburses at least €20, and often the full amount depending on your plan.
Payment
Payment is made on surgery day, at the front desk, before the procedure. Accepted methods: bank card, check, bank transfer or direct debit. Payment in 4 installments is possible, by check or direct debit.
Complementary health insurance does not pay the clinic directly: you are the one reimbursed on presentation of the invoice. If your complementary health insurance covers a significant amount, we can defer a corresponding payment and only cash it once you have received your reimbursement.
Detailed fees, quotes and complementary insurance reimbursements
Frequently asked questions
Your questions about TransPRK surgery
Does TransPRK hurt?
The procedure itself is painless, with anesthetic eye drops, no contact, and a laser that lasts only a few seconds. It is the surface healing afterward that is uncomfortable, for 48 to 72 hours: foreign body sensation, sensitivity to light, sometimes real pain, especially during the first two days. I always prescribe painkillers (step 1 or step 2), sometimes an anti-anxiety medication, along with rest with the eyes closed and artificial tears. The bandage contact lens eases the sensations. Most patients describe a difficult stretch of 2 to 3 days, followed by a clear improvement.
How long does TransPRK surgery take?
About ten minutes for both eyes. The laser pass itself lasts only a few seconds per eye. The rest of the time is spent on positioning, explanations and placing the bandage contact lens.
What is the difference between TransPRK and the older PRK?
Classic PRK removed the epithelium manually, by scraping or with an alcohol solution, which made the procedure more uncomfortable and the healing more painful. TransPRK, entirely laser-based and contact-free, vaporizes the epithelium in a few seconds and then moves straight on to sculpting the stroma, in the same session. The results are identical, but the experience is much more comfortable. Feedback about the older PRK no longer applies to modern TransPRK.
When can I go back to work after TransPRK?
Allow about one week in most cases. If needed, I prescribe a sick note covering this period. Going back before the end of the first week is generally frustrating: vision is still blurry and fluctuating, and eye strain is marked.
When can I use screens again after TransPRK?
Screens are not forbidden. Looking at a screen does not harm healing or vision. It is the patients themselves who find themselves very limited during the first 48 to 72 hours because of the discomfort, then by blurry near vision during the first 10 days. So everyone goes by their own discomfort and needs.
When can I drive after TransPRK?
Generally at the end of the first week, once the epithelium has closed and vision is clear enough.
When can I return to sports after TransPRK?
Non-contact sports: as soon as you feel ready, on average around day 4 to 5. Swimming: from 2 weeks. Sports with a risk of a direct blow to the eye (combat sports, ball sports): at three weeks. In the long term, there is no risk of flap displacement, whatever the intensity of the sport.
When can I fly after TransPRK?
In theory, you could travel the very next day. Flying poses no particular problem. I still advise waiting 3 to 4 days, because the trip can be uncomfortable due to the discomfort. Remember to bring your artificial tears: air conditioning in the cabin is drying.
Can I go out in the sun after TransPRK?
Sun exposure is not recommended for the 6 months following TransPRK. Surface healing is sensitive to it, as UV exposure can promote a slight opacity (haze) or delay stabilization. There is no strict ban on going outside: if you will be exposed (skiing, beach), bring well-tinted sunglasses. There is no reason to stay indoors outside of situations of strong exposure.
Can I wear makeup after TransPRK?
No eye makeup for at least one week, to avoid any contact or particles on the healing area. Makeup on the rest of the face is possible from the next day.
Can I go to the swimming pool, steam room or sauna after TransPRK?
For swimming, I advise waiting 2 weeks. Simple bathing without putting your head underwater, however, is allowed after one week. Steam room and sauna: not before two weeks.
Can I rub my eyes after TransPRK?
Unlike LASIK, there is no strict ban on touching your eyes after TransPRK: with no flap, nothing can shift. It is still better to avoid rubbing during healing, so as not to irritate the epithelium. In the long term, I recommend that all my patients limit chronic eye rubbing, which can weaken the cornea. This is general eye-care advice, independent of the surgery.
How much time off work should I plan after TransPRK?
One week in general.
Do I need a letter from another ophthalmologist before consulting for TransPRK?
No. No referral letter or prescription is needed. You can book an appointment directly on Doctolib or by phone.
My surgeon suggested TransPRK rather than LASIK: why?
Several reasons can lead to favoring TransPRK: a cornea too thin for LASIK to be done safely, subtle signs of corneal fragility, an activity with a risk of eye trauma (combat sports, law enforcement, military), or marked apprehension about the idea of a cut. In these cases, TransPRK is the most suitable technique, and the result at 3 months is equivalent. We always discuss it together in consultation, after the assessment.
Can TransPRK be done for high myopia?
Yes, up to about -10 diopters. TransPRK is even sometimes the technique of choice for high myopia with thin corneas, because it better preserves corneal thickness. Recovery is simply a little longer than for moderate corrections.
TransPRK or LASIK: what is the difference?
LASIK uses a flap; TransPRK is a surface treatment, with no flap and no contact. LASIK offers a faster recovery (24-48 hours versus 7-10 days for TransPRK). TransPRK better preserves the corneal structure and provides greater biomechanical safety. The result at 3 months is equivalent. The choice depends on your cornea and your profile.
TransPRK or SMILE: what is the difference?
SMILE is performed entirely with the femtosecond laser: a small disc of corneal tissue (lenticule) is cut inside the cornea and removed through a micro-incision. SMILE and TransPRK share the absence of a flap, but SMILE offers a faster recovery. On the other hand, it is less suited to high corrections and to astigmatism, and it does not correct hyperopia. The choice between techniques is made case by case.
Is the TransPRK result permanent?
The correction is lasting: the cornea keeps the new shape the laser gave it. A slight regression is possible over 5-10 years (0.25 to 0.50 diopter), but it remains minimal. The natural evolution of the eye with age (presbyopia after 40-45, cataract after 60-65) occurs independently of the surgery.
Can I have TransPRK during pregnancy?
Pregnancy is a period we avoid as a precaution: hormonal fluctuations can temporarily change the refraction. Breastfeeding, on the other hand, is not an obstacle. The assessment is made case by case, and there is no need to wait until you have had all your children: surgery can be done between two pregnancies or before.
From what age can you have TransPRK?
From age 18, provided the correction has stabilized, which is generally the case between 18 and 24. There is no upper limit: if the cornea allows it, TransPRK is still possible at 50, 60 or 65. At these ages, presbyopia and screening for an early cataract need to be factored into the surgical strategy.
BOOK AN APPOINTMENT
Ready to consider TransPRK?
The first step is simple: a consultation to review your eyes, your prescription and the options available to you. There is no commitment and no pressure, just a complete assessment and a frank discussion.
I see patients at three locations in Paris:
- Institut Laser Ophtalmologique Voltaire, 5 rue La Vacquerie, 75011 Paris (Wednesday afternoons). Metro Voltaire (9), Philippe Auguste (2).
- Cabinet Ophtavie, 37 rue Archereau, 75019 Paris (Monday afternoons). Metro Crimée (7).
- Centre Santé Plus, 12 rue du Faubourg Saint-Martin, 75010 Paris (Thursday afternoons). Metro Strasbourg-Saint-Denis (4, 8, 9).
TransPRK surgery takes place on Friday mornings at the Institut Voltaire, sometimes on Wednesday afternoons.
Book an appointment on Doctolib
Phone and WhatsApp: 01 84 80 28 04 · Email: nahaisi@laservisionparis.com · Doctolib messaging
Download the explanatory booklet (PDF)
"I don't operate on eyes, I operate on patients."
Dr Steven Nahaisi, ophthalmic surgeon in Paris, LASIK and refractive surgery specialist.
Author: Dr Steven Nahaisi, ophthalmic surgeon, specialist in laser refractive surgery, Institut Laser Ophtalmologique Voltaire, Paris 11th.
Your surgeon
Dr Steven Nahaisi
Ophthalmic surgeon dedicated exclusively to laser refractive surgery. He operates at the Institut Laser Ophtalmologique Voltaire and consults in three Paris offices. Consultations in English.
