LASEK eye surgery is a variation of PRK to fix myopia (nearsightedness), hyperopia (farsightedness) and astigmatism. LASEK integrates specific approaches from both LASIK and PRK.
LASIK remains the most popular laser eye surgery, but for people who are not appropriate LASIK candidates, PRK or LASEK might be better choices and produce equivalent outcomes to LASIK.
What Is LASEK?
Like other types of laser refractive surgery, LASEK works by improving the cornea using an excimer laser, allowing light entering the eye to be appropriately focused onto the retina for clearer vision without spectacles or contact lenses.
The essential difference in how LASIK, PRK and LASEK are carried out issues how the eye is prepared for the laser treatment:
- During LASIK, a thin circular “flap” is produced on the eye’s surface using a microkeratome or a femtosecond laser surgical tool. The surgeon then folds back the hinged flap to access the stroma and reshape the corneal tissue using an excimer laser.
The flap is then gone back to its original position and serves as a natural plaster, keeping the eye comfy as it recovers. The flap adheres firmly without stitches, and healing takes place relatively rapidly.
- During PRK, instead of creating a corneal flap as in LASIK, the surgeon completely gets rid of the very thin outer layer of the cornea (epithelium, which resembles a clear “skin layer” covering the cornea), using an alcohol solution, a “buffing” device or a blunt surgical instrument. The underlying corneal stroma is then improved with an excimer laser. A new epithelial layer grows back within 5 days.
- The LASEK procedure involves a little of both LASIK and PRK. Like in PRK, the corneal epithelium is separated from the underlying stromal layer. But instead of totally removing and discarding this tissue, as in PRK, the LASEK surgeon pushes an ultra-thin “flap” of epithelium off to one side of the cornea, where it stays attached to the eye (like the thicker flap of corneal tissue produced during LASIK surgery).
After the laser treatment is completed, the epithelial tissue is repositioned on the surface area of the eye to cover the lasered stroma, and a plaster contact lens is put on the eye to keep the epithelium in place as it recovers.
Another laser eye surgery, called epi-LASIK or e-LASIK, is extremely just like LASEK. But rather of using alcohol to loosen the epithelium like in LASEK, in epi-LASEK the surgeon usually uses a blunt, plastic blade to separate the epithelial sheet from the eye. This avoids the possibility of a reaction from the alcohol, which can kill epithelial cells.
LASIK, PRK and LASEK all have high success rates and comparable vision outcomes. One is not always better than the other in the long term, however vision has the tendency to be more hazy in the first week with LASEK than with LASIK and PRK.
After an extensive eye examination, your eye surgeon will advise you on the best type of laser eye surgery for your private requirements and requirements.
LASEK vs. LASIK
The hinged flap made in LASEK surgery is developed in the epithelial layer of the eye and is much thinner than the corneal flap developed in LASIK (which contains both epithelial and deeper stromal tissues).
This is of particular value if you have a naturally thin cornea that makes you a less-than-ideal LASIK prospect.
The LASEK strategy avoids any corneal flap-related LASIK complications and minimizes the possibility of eliminating excessive cornea with the excimer laser and compromising the structural stability of the eye. By preventing a much deeper flap, there also is a little less risk of developing dry eyes after LASEK eye surgery.
LASEK likewise might be a much better option if you have a high degree of myopia (which needs more tissue elimination from the main cornea to remedy the refractive mistake), or if your occupation or hobbies puts you at high risk of an eye injury and dislodging the corneal flap created in LASIK surgery.
It’s essential to keep in mind, however, that LASEK generally includes more discomfort and a longer recovery time compared with LASIK surgery.
LASEK vs. PRK
LASEK is very much like PRK. Both include lifting the incredibly thin epithelium to access the much deeper corneal tissues, rather of developing a thicker corneal flap as in LASIK surgery.
The crucial distinction between LASEK and PRK is that LASEK protects and after that changes the epithelial layer whereas in PRK the epithelium is totally removed and discarded and a new epithelial layer grows back over the next couple of days following surgery.
Initially, numerous surgeons thought that by protecting the epithelium LASEK would have a quicker recovery time than PRK. In practice, nevertheless, numerous surgeons have actually found that the replaced epithelial layer in LASEK often takes longer to heal compared with the development of a new epithelial layer after PRK.
As such, PRK stays the most popular of the “surface ablation” techniques (PRK, LASEK and epi-LASIK).
Description of LASEK Eye Surgery Procedure
Before. Your eye surgeon will perform a thorough eye exam and general medical examination to see if you are an appropriate prospect for LASEK eye surgery. Many eye surgeons will suggest LASEK only if you are not fit to LASIK eye surgery.
If you wear contact lenses, your doctor usually will advise you to stop using them for a period of time before taking measurements for laser eye surgery as contacts can alter the natural shape of your cornea.
As you will not be able to own yourself home from the surgery, you’ll have to organize someone to drive you. You’ll also have to arrange time off work– around a week in common cases – as your eyes recover and your vision begins to enhance.
During. Numbing anesthetic drops are first used to your eye. Then your surgeon makes a circular cut in the corneal epithelium using a fine blade (trephine). The trephine leaves a little arc-shaped area of the circle uncut, so the epithelial “flap” that’s created stays connected to the eye. A diluted alcohol solution is placed over the eye for approximately 30 seconds, which loosens the edges of the epithelium and allows the surgeon to carefully press the loosened flap of epithelium to the side.
The excimer laser is then positioned over the eye to improve the corneal stroma and remedy your vision. After the laser treatment is finished, the epithelial flap is rearranged on the eye.
A special contact lens that functions as a protective bandage is then put over your eye.
LASEK eye surgery is carried out on a walk-in, walk-out basis, and ought to take about 15 minutes per eye. You are awake for the procedure and should not feel any pain, but your surgeon may provide you a mild sedative to assist you relax.
After. You can return home after a short duration of rest following LASEK surgery. The majority of people report moderate to moderate pain in the first few days after LASEK.
You will need to keep the “plaster” contact lens on your eye for roughly 4 days while the surface epithelial cells heal and regenerate. Your doctor likewise will prescribe topical steroids and antibiotics for a minimum of 3 weeks to help healing and reduce the risk of infection.
Usually, visual recovery after LASEK (and epi-LASIK) is substantially slower than after LASIK and frequently slower than the recovery after PRK. Initial visual recovery can use up to a week with LASEK (rather than 24 hours in normal LASIK cases) and final results can be seen anywhere from a few weeks to several months.
LASEK and PRK outcomes are similar to LASIK outcomes. Most people attain 20/20 vision after laser eye surgery, and nearly all achieve 20/40 visual skill or better. Depending upon your degree of refractive error, you may still have to use glasses or contact lenses, however the prescription will be substantially lower.
Like LASIK and PRK, LASEK eye surgery is not necessarily a solution for presbyopia, a naturally taking place age-related loss of near vision. Your doctor will be able to advise whether you’re an appropriate prospect for presbyopia surgery instead.
LASEK Risks and Complications
LASEK and PRK complications are similar to LASIK complications. Side effects can include vision disturbances such as:
- Blurry vision, halos and glare
- Significant overcorrection, undercorrection or regression which might need additional surgery or dependence on glasses or contact lenses for some or all activities
- Dry eyes
- Eye infection and inflammation
While LASEK prevents the corneal flap-related risks of LASIK, there are some complications unique to LASEK surgery.
In some cases, the thin epithelial flap developed during LASEK is not strong enough to be changed over the cured area and will be gotten rid of completely as it would have remained in PRK. Normally, this does not present a risk, but if you have an extremely high prescription for myopia you might have a greater probability of experiencing hazy vision.
The alcohol solution used during LASEK causes tissue damage to epithelial cells that slows the recovery procedure instantly after surgery. Recovery after epi-LASIK generally is faster due to the fact that no alcohol is used to produce the epithelial sheet.
LASEK eye surgery offers a safe and reliable alternative to LASIK however usually is performed only if you are not a good candidate for LASIK eye surgery, owing to the faster visual recovery and minimal discomfort related to LASIK.
An experienced eye doctor will have the ability to recommend you when LASEK is the best vision correction surgery for your individual requirements.