No-Touch Laser (Trans-PRK / T-PRK)

Suitability assessment and planning with Dr. Nejmi Öztürk, ophthalmologist and eye surgeon, at HG Hospital in Kahramanmaraş, Türkiye — surface laser applied without touching the cornea

What is No-Touch laser?

No-Touch laser (Trans-PRK, T-PRK, transepithelial PRK) is a refractive laser (laser eye surgery) method in which the epithelium, the outermost cell layer of the cornea (the clear front layer of the eye), and the tissue beneath it are reshaped with the excimer laser in the same session. No instrument touches the surface of the cornea; no alcohol, brush or flap is used. The names “notouch”, “no-touch eye surgery” and “T-PRK” all describe the same method.

The method is the laser version of PRK, the oldest laser technique. In PRK, the epithelium is softened with dilute alcohol and removed by hand; in No-Touch, the laser does this step too. The procedure has two phases but is applied without interruption: the laser first removes the epithelium, then thins the tissue beneath it (the stroma) at the micron level to correct the prescription.

Unlike LASIK, no flap is created; therefore flap-related problems do not occur and the structural integrity of the cornea is preserved. The trade-off is a longer recovery and more noticeable discomfort in the first days. Myopia (nearsightedness, blurred distance vision), astigmatism (distorted vision) and, to a limited degree, hyperopia (farsightedness, difficulty seeing up close) can be corrected.

Who is No-Touch laser suitable for?

No-Touch is suitable for people aged 18 or over whose prescription has been stable for at least 1 year and who have a low-to-moderate refractive error; it stands out particularly in the following situations:

• Thin cornea: Because no tissue is used up for a flap, surface laser can be applied to some of the thin corneas that are not suitable for LASIK.
• Contact sports and risk of impact: In sports such as boxing, wrestling and football, and in occupations such as military service, police work and firefighting, the absence of a flap is an advantage.
• A tendency to dry eye: Because there is no flap incision, the corneal nerves are affected less; long-term dry-eye symptoms are usually milder.
• Superficial corneal irregularity or small scars: Combined with a topography-guided profile if needed.
• Some keratoconus patients: Limited surface laser combined with cross-linking is used in suitable cases to reduce irregularity (combined CXL-laser).
• People who do not want a flap and who are uneasy about an instrument touching the eye.

Who is it not suitable for?

• High prescriptions: with surface laser, the risk of corneal haze and regression increases as the prescription gets larger; in these patients SMILE, LASIK or ICL is considered.
• People whose vision needs to be clear the very next day; with No-Touch, clearing takes weeks.
• Progressive keratoconus (thinning and bulging of the cornea); it is considered only together with cross-linking and in selected cases.
• Pregnant and breastfeeding women, and people whose prescription has changed in the last year.
• Diseases that impair wound healing (uncontrolled diabetes, certain rheumatic and immune system diseases), an active eye infection, or a history of herpes (cold sore virus) inflammation in the eye.
• People in whom a cataract has begun, and people with advanced dry eye.

Examination and tests

The examination before No-Touch assesses the thickness and map of the cornea to determine whether surface laser is safe and which profile will be used; it usually takes 1–2 hours.

• Prescription measurement without and with drops (cycloplegic refraction).
• Corneal topography and tomography: maps of the front and back surfaces, screening for keratoconus, epithelial thickness map.
• Pachymetry: corneal thickness; the tissue that will remain after the laser is calculated.
• Pupillometry: pupil diameter in the dark.
• Tear tests, eye pressure measurement and a dilated retinal examination (with the pupil widened).

How is No-Touch laser performed?

No-Touch is done with anesthetic eye drops, takes about 5–10 minutes per eye, and you go home the same day. The steps are as follows:

1. The eye is numbed with anesthetic drops; there is no injection or general anesthesia. A small device is placed to keep the eyelids open, and you are asked to look at the target light.
2. In the first phase the excimer laser removes the epithelium; in the second phase it corrects the prescription. The two phases follow one another without interruption; the total laser time is usually 30–60 seconds. An eye-tracking system follows small movements.
3. For high prescriptions or eyes at risk of scarring, a medicine called mitomycin C is applied to the surface of the cornea for a few tens of seconds; the aim is to prevent corneal haze.
4. The eye is rinsed with cold saline, antibiotic drops are applied and a protective bandage contact lens is placed.
5. In most patients both eyes are treated in the same session. The discomfort felt varies from person to person; during the laser you may notice a faint smell and a clicking sound, but there is no feeling of pressure. Burning and stinging begin a few hours later.

What is recovery like after No-Touch laser?

After No-Touch, noticeable discomfort and blurred vision are normal for the first 3–5 days; once the epithelium has healed over, the bandage lens is removed and vision clears over the following weeks.

• Days 1–3: This is the period when stinging, burning, watering and light sensitivity are most intense; they usually peak at 24–72 hours. Pain-relieving drops and oral medication, a dimly lit room, sunglasses and cold compresses bring relief. Antibiotic and steroid (cortisone) drops are used as prescribed; do not rub your eyes.
• Days 3–5: The epithelium heals over; the bandage lens is removed at the check-up. Discomfort decreases quickly, while vision is still fluctuating and blurred.
• Weeks 1–2: Vision reaches a level sufficient for daily life; return to desk work is usually after 1–2 weeks. Do not wear eye make-up and keep water out of your eyes.
• Month 1: Vision is largely clear; stay away from swimming pools, the sea, hammams (Turkish baths) and saunas for 4 weeks. The steroid drops are continued for weeks, with the dose gradually reduced.
• Months 1–3: Final clarity and stability settle in. Sunglasses are worn for 3–6 months to reduce the risk of haze.

Check-ups are usually on day 1, on day 3–5 when the bandage lens is removed, at month 1 and at month 3. Because the day 1 and day 3–5 check-ups are done in Kahramanmaraş, patients coming from Elbistan and the surrounding districts may need to stay a few days or come twice; this plan is worked out together at the examination.

What are the risks and limitations of No-Touch laser?

Because there is no flap or incision, No-Touch is structurally a safe method; its risks mostly belong to the healing period of the surface.

• Discomfort in the first days: Symptoms are more noticeable than after LASIK and SMILE and last 3–5 days.
• Corneal haze: Can occur with high prescriptions and in eyes not protected from the sun; the risk is reduced with mitomycin C, steroid drops and sunglasses. In most cases it clears with time.
• Delayed epithelial healing: If the epithelium does not heal over within a few days, additional treatment is needed; dry eye and some systemic diseases can delay healing.
• Infection: Rare; the risk is slightly higher in the first days while the epithelium is open, so attention is paid to the drop schedule and hygiene.
• Regression: With high prescriptions, part of the prescription can return; additional correction can be done if the cornea is suitable.
• Steroid-related rise in eye pressure: Measured at the check-ups while the drops are being used; it is temporary.
• Night halos, glare, under- or over-correction: Can occur as with all laser methods; they fade within months in most patients.
• Limitations: Vision takes weeks to clear, it is not preferred for high prescriptions, and it does not prevent presbyopia (the need for reading glasses after 40).

No-Touch or SMILE, No-Touch or PRK?

No single method is superior to the others for every patient; the choice depends on corneal thickness, prescription, occupation and the time that can be set aside for recovery.

No-Touch and PRK differ solely in how the epithelium is removed; the laser correction and the recovery process are largely the same. Some studies have reported that the epithelium heals slightly faster with No-Touch; both methods remain valid.

Assessment and planning in Kahramanmaraş

Your suitability for No-Touch laser is assessed with the examination and measurements at HG Hospital in Kahramanmaraş, Türkiye; the method that suits you is planned together with Dr. Nejmi Öztürk. Dr. Öztürk is an ophthalmologist working in cataract and refractive surgery; he sees patients at HG Hospital (Üngüt Mevkii, Prof. Dr. Necmettin Erbakan Blv. No:209, 46050 Onikişubat / Kahramanmaraş).

HG Hospital is a private hospital contracted with the Turkish social security institution (SGK); patients with valid SGK coverage may use it, although a private-hospital co-payment may apply. Refractive laser surgery to reduce the need for glasses is, however, generally not covered by SGK, and most private health insurance policies also exclude it. Patients without SGK coverage, such as international patients and visitors from abroad, pay privately or through their private or travel health insurance; the hospital checks coverage before treatment. Fee information is given by the hospital after the examination, and insurance coverage is clarified at the consultation.

For patients coming from Elbistan, Afşin, Göksun, Ekinözü and Nurhak, the examination and measurements are planned so that they can be completed on the same day; the drive between Elbistan and Kahramanmaraş takes about 2 hours. Dr. Öztürk does not see patients in Elbistan; for travel, accommodation and check-up planning, see the patients from Elbistan and the surrounding area page.

Frequently asked questions

Sources

• Turkish Ophthalmological Society — todnet.org
• American Academy of Ophthalmology (AAO) — aao.org
• European Society of Cataract and Refractive Surgeons (ESCRS) — escrs.org
• National Eye Institute (NEI) — nei.nih.gov

Related pages

• Laser eye surgery — all methods
• PRK laser eye surgery
• SMILE laser eye surgery
• Combined CXL-laser for keratoconus

This page is for information only; diagnosis and treatment decisions are made after an examination. The results of any surgical or interventional procedure may vary from person to person. You are advised to obtain detailed advice from your physician before any procedure.

Dr. Nejmi Öztürk

Ophthalmologist and eye surgeon. Graduate of Erciyes University Faculty of Medicine; completed his residency at Ankara Atatürk Training and Research Hospital. With 21 years of experience in cataract and refractive surgery, strabismus, glaucoma, retina and oculoplastic surgery, he sees patients at HG Hospital in Kahramanmaraş, Türkiye. Biography and training

This content was prepared and medically reviewed by Dr. Nejmi Öztürk. Last updated: 28 September 2026 · Site editor and contact