LASEK Laser Eye Surgery

    Introduction to LASEK Eye Surgery

LASEK is an acronym for laser epithelial keratomileusis.

It is one of the newer variations of PRK where the laser energy is applied directly to shape the outer surface of the eye in order to correct one’s vision.

In the LASEK method of laser eye surgery, the epithelial layer is retained by cutting a flap which is lifted prior to the application of the laser energy. When the reshaping operation is completed by the laser, the epithelium is folded back onto the eye surface.

The main difference between PRK and LASEK laser eye surgery is that the PRK procedure removes the epithelium layer completely, it subsequently grows back over time, whilst the LASEK procedure the epithelial layer is preserved.

The primary difference between the LASIK and LASEK procedures is the cutting tool used to create the epithelial flap. In LASIK, a microkeratome cutting tool or a special laser is used whilst in the LASEK procedure, a tool called a trephine is used.

In LASEK surgery only a very thin epithelial flap is cut, it can therefore be used to treat corneas that are too thin for LASIK.

    Suitable candidates for LASEK eye surgery

You would probably be a good candidate for LASEK surgery if your  cornea is considered to be too thin or too steep for the LASIK procedure.

The LASEK procedure can reduce the possible complications that may arise with the thickness of the flaps cut in the LASIK method. If the thickness of your cornea is not ideal for LASIK procedure then the LASEK method may be a suitable alternative for you.

However, people who have the LASEK procedure tend to heal slower than those who go through the LASIK procedure. Moreover, the people who go through LASEK procedures usually have more complaints.

Due to these results, doctors usually prefer performing PRK over LASEK.
 

    The LASEK Laser Surgery procedure

During a LASEK procedure, a local anaesthesia will be applied to the eye.

The outer layer of corneal cells (the epithelium) is cut using hand-held surgical tool called a trephine.

The trephine has a cylinder-shaped blade that forms the outline of the flap. A gap in the arc of the blade allows for the hinge of the flap.

A dilute alcohol solution is applied for the eye for about 30 seconds, and then is sponged off. (The alcohol solution loosens and helps "float" the epithelium.)

The epithelium is gently lifted from the eye and folded back so that there will be room to operate on the corneal tissue underneath.

An Excimer laser, similar to those used in LASIK and PRK, is used to reshape the underlying cornea (called the stroma).

The thin epithelial flap is put back in its original position.

To keep the epithelium securely in place, a bandage contact lens is applied.

Three or four days later (after the epithelium has  reattached to the eye), the bandage contact lens is removed.

    After the LASEK procedure

Recovery after LASEK surgery tend to be slower than after LASIK. The flap heals after a day but the bandages are required for a further three to for days in order to protect the eye from infection and irritants.

Your eye may be irritable for the first forty eight hours after LASEK surgery and it takes longer for your vision to return to normal than if you had undertaken a similar LASIK procedure.

Your vision should completely recover in about a week.

Following your procedure you will be given eye drops and ointment to help the healing process. You may also be given painkillers and sleeping tablets to ensure you sleep well over the first few days and until the eye heals properly.

Having the LASEK procedure is also generally more painful than a similar LASIK procedure and the discomfort may last for a week or so.

You will need to have a friend or relative with you when you are discharged to help you home after the procedure.

    Bandage Lens

Bandage lenses are soft disposable clear contact lenses which are placed over the treated eye(s) to improve vision after the procedure and to protect the eye whilst it heals. They will be removed by the surgeon after a few days.

    Possible Side Effects

LASEK surgery has very few side effects and complications are rare. Reduced night vision is the most common side effect. Any side effects tend to reduce gradually during the healing process and only rarely persist.

As with LASIK, PRK and other types of refractive surgery, there are risks and possible complications associated with LASEK. Potential complications include:

Dry eyes.
Vision problems, such as poor night vision, glare, halos and haze.
Incomplete or inaccurate vision correction.
Infection following surgery.

There may be a slightly greater risk of eye infection, scarring, glare and unpredictable healing of the cornea after LASEK compared to LASIK. But serious complications following LASEK are rare.