LASEK - LASEK Treatment

LASEK

What is LASEK?
LASEK is a relatively new surgery that utilizes a trephine to create an epithelial flap (as opposed to a deeper stromal flap with LASIK) and an alcohol solution to preserve the epithelial cells. Once the epithelial flap is created and lifted, the treatment proceeds as for traditional PRK, with light smoothing at its conclusion. Then, the epithelial flap is repositioned with a small spatula. LASEK preserves approximately 160 microns more corneal tissue, on average, than a typical LASIK procedure.

Refractive eye surgeries continue to advance, and more options are becoming available to patients with vision problems that have kept them from corrective surgery in the past. Combining some of the advantages of two other refractive surgeries, PRK and LASIK, LASEK can be used to correct nearsightedness, farsightedness, and astigmatism. LASEK is able to correct vision in patients with corneas that are too flat or too steep for LASIK, and can offer less post-operative pain and a shorter recovery time than PRK.

How is LASEK done?

As with all refractive surgeries, contact use must be discontinued several weeks prior to surgery. This allows your cornea to return to its original shape. Before beginning surgery a local anesthetic will be administered. 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. The eye is then soaked in a 20% alcohol solution (perhaps one part alcohol and four parts sterile water) for about 30 seconds. The solution loosens the edges of the epithelium. Aftersponging the alcohol solution from the eye, the surgeon uses a tiny hoe to lift the edge of the epithelial flap and gently fold it back out of the way. Then the surgeon uses an excimer laser, as in LASIK or PRK, to sculpt the corneal tissue underneath. Afterward, the epithelial flap is placed back on the eye with a kind of spatula.

LASEK Technology

LASEK has developed in recent years as a variation of the existing PRK procedure. The laser and technology are the same as with that procedure, but with LASEK a trephine blade is used to remove the top layer of the cornea.

Recovery and Post Op Expectations

If you are considering LASIK, but your doctor says you need LASEK instead, ask why. It's not for everyone, but many surgeons who perform LASEK consider it a better option for some patients who will probably not do very well with LASIK.

In many ways, what you can expect from LASEK is similar to what you can expect from LASIK, but there are some differences. The flap edge heals in about a day, though patients usually wear a bandage contact lens for around four days. You may feel eye irritation during the first day or two afterward. Also, the time it takes to recover good vision is often longer Û up to seven to fourteen days. A haloing effect can sometimes be experienced longer, but usually goes after a while. Of course, it varies from one person to the next.

Patients usually need to take eye drops for up to two months following the procedure, and should refrain from contact sports and swimming.

Complications

LASEK has no associated flap complications, one of the biggest concerns with LASIK. It also offers a quicker nerve regeneration time. On the down side, more pain is experienced and the recovery time is longer. Other complications include dry eyes, haloed or blurred vision and poor night vision, all of which regress in a year or less. About 2-5% of patients require an additional treatment to enhance the visual outcome.

Am I A Candidate?

When choosing refractive surgery, you and your doctor should weigh the positive and negative aspects of each procedure to decide which one is right for you. If your cornea is too thin, you will probably not be a candidate for LASIK, and LASEK or PRK might be a viable options. Some doctors use LASEK as the preferred procedure, but, because the recovery time is longer than in LASIK, it is important to have enough time set aside for the recovery process.