LASEK Eye Surgery: How It Works
By Liz Segre; reviewed by Dr. Vance Thompson
LASEK (laser epithelial keratomileusis) is a relatively new procedure that is technically a variation of
PRK. Also called epithelial LASIK or E-LASIK, LASEK is used
mostly for people with corneas that are too thin or too flat
for LASIK. It was developed to reduce the chance of complications that occur when the flap created during
LASIK is not the ideal thickness or diameter.
The LASEK Procedure
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. Then the surgeon covers the eye with an alcohol solution
(perhaps one part alcohol and four parts sterile water) for around 30 seconds. The solution loosens the edges of the epithelium.
After sponging 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 he or she 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.
After LASEK
In many ways, what you can expect from LASEK is similar to what you can expect from LASIK, but there are some differences.
According to doctors who perform LASEK, 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 up to four to seven days. Of course, it varies from one person to the next.
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. Also, LASEK in some studies has been associated
with faster recovery of sensation or nerve function in the eye's surface (cornea) compared with LASIK.
[Page updated March 2007]
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