Excimer laser photorefractive keratectomy (PRK) has shown promising results in preliminary studies. However, even if long-term safety and efficacy are demonstrated, questions have been raised about its viability from a cost-effectiveness perspective. We analyzed the economic investment of elective excimer laser PRK both from the societal and individual perspectives. When the present value of likely expenses associated with excimer laser PRK and follow-up care are compared with those entailed in wearing soft contact lenses, PRK is roughly equivalent to daily wear soft contact lenses over a 10-year horizon and considerably less expensive than extended-wear soft contact lenses. When the analytic perspective is extended to 20 years, excimer laser PRK is a less expensive investment than both daily wear and extended-wear soft contact lenses.