Laser epithelial keratomileusis, or LASEK, is a newer form of laser vision correction that combines many of the benefits of the two most commonly performed procedures -- LASIK and PRK. It is used to treat astigmatism, nearsightedness or farsightedness. In LASEK, the epithelium, or outer layer of the cornea, is cut not with the microkeratome cutting tool used in LASIK, but with a finer blade called a trephine and a 20% alcohol solution.
Complications associated with cutting and reattaching the flap in the cornea as is done in LASIK are avoided.
LASEK causes dry eye less frequently than LASIK.
Longer visual recovery time compared to LASIK. Many LASEK patients will not fully recover functional vision for 1 to 2 weeks while their eye heals, which is similar to the healing time experienced in PRK. LASIK patients often have good vision by the day after surgery.
LASEK may cause more pain and discomfort than LASIK, but less pain than PRK. Most LASEK patients say the discomfort lasts about 2 days or less.
Patients need to wear a "bandage contact lens" for about 3 or 4 days after LASEK to serve as a protective layer between your blinking eyelids and the treated eye surface, which is not necessary after LASIK.
Patients must use topical steroid drops for several weeks longer than that used after LASIK.
LASEK shows side effects less frequently than is seen with PRK, however side effects may occur. These may include:
Sensation of having a foreign object in your eye (can last anywhere from 1 to 4 days)
Temporary reduced vision under poorly lit conditions (up to 12 months)
Dry eyes, requiring the use of moisturizing drops (up to 6 months)
Hazy or cloudy vision (should disappear within 6 to 9 months)
LASEK may be better for patients who have steep or very thin corneas, which make it difficult for the surgeon to make a proper LASIK flap. Since traumatic injury to the eye is more serious after LASIK than LASEK, patients who engage in professional or leisure activities that put their eyes at increased risk for injury (such as boxing) may be better suited for LASEK. LASEK IS better for people with dry eye syndrome because in avoiding a deeper flap, the corneal nerves responsible for the tearing reflex are not cut.
Before your surgery you will meet with a coordinator who will discuss with you what you should expect during and after the surgery. During this session your medical history will be evaluated and your eyes will be tested. Likely tests will include corneal thickness measuring, refraction, and pupil dilation. Once you have gone through your evaluation, you will meet the surgeon, who will answer any further questions you may have. Afterwards, you can schedule an appointment for the procedure.
If you wear rigid gas permeable contact lenses, you should not wear them starting three weeks before the date of your surgery. Other types of contact lenses shouldn’t be worn for at least three days prior to surgery. Be sure tobring your glasses so your prescription can be reviewed.
On the day of your surgery, eat a light meal before coming and take all of your prescribed medications. Do not wear eye makeup or have any bulky accessories in your hair that will interfere with positioning your head under the laser. If you are not feeling well that morning, call the doctor’s office to determine whether the procedure needs to be postponed.
LASEK is done under local anesthesia. During the procedure, the top layer of cells, or epithelium, is treated with alcohol for about 30 seconds to detach it from the underlying tissue. It is then lifted or rolled back so that the eye doctor can access the cornea tissue. The newly exposed tissue is treated with the same laser used in LASIK and PRK, and then the top layer of cells is replaced.
This is in contrast to LASIK, in which a cutting device makes a flap in the cornea. LASEK differs from PRK by preserving the top layer of cells, rather than scraping them away and waiting for them to grow back. This is believed to facilitate healing of the cornea with less discomfort than PRK.
After the LASEK procedure, expectations are similar to what can expect after LASIK. However, even though the flap created by LASEK heals in about a day, patient usually wear a special contact lens that acts as a bandage for up to four days after surgery. Patients also may experience irritation in their eye during the first day or two afterward. For patients who undergo the LASIK procedure, good vision is usually attained in a few days. For LASEK this may take as long as a week.
You will revisit the doctor for an evaluation the day after, as well as one week and three months after surgery.
If you have any questions after your surgery or if you experience pain, a sudden decrease in vision, red eye(s), or discharge from your eye(s), contact your eye doctor immediately.
