LASEK

Several types of vision-correction eye surgery are available at our Brooklyn office. LASEK eye surgery, not to be confused with LASIK eye surgery, is a type of refractive eye surgery done to improve conditions such as nearsightedness, farsightedness, and astigmatism. This procedure is a combination of LASIK and PRK. During your consultation, your eye surgeon may recommend this procedure.

What is LASEK?

At first glance, you may have thought there’s a typo and we misspelled LASIK. Nope. LASEK is a similar laser eye surgery to correct refractive vision errors, but it’s different from LASIK.

Like the other types of laser refractive surgery (LASIK and PRK), LASEK uses an excimer laser to reshape the cornea. This allows light entering the eye to be properly focused onto the retina at the back of the eye. By correcting the refractive errors, LASEK allows the patient to see clearly without eyeglasses or contact lenses.

In LASEK, the outer layers of the cornea, called the epithelium, are kept in place, but are pushed aside to gain access to the cornea. They remain attached, unlike PRK where the epithelium is removed. The excimer laser then reshapes the cornea to correct the refractive errors. When this is complete, the epithelial tissue is repositioned on the surface of the eye. This protects the eye while it heals. We also place a special contact lens for three to four days to further protect the eye.

How is LASEK different from LASIK?

LASEK is considered to be a sister procedure to LASIK. They are both acronyms:

  • LASEK = Laser-Assisted Subepithelial Keratomileusis
  • LASIK = Laser-Assisted In-Situ Keratomileusis

The first difference between the two is how we reach the mid-layer of the cornea, the stroma, for reshaping with the laser. In LASEK, we push the epithelium off to the side of the cornea, but it remains attached. (This is the difference between LASEK and PRK, where the epithelium is removed and regrows during recovery.) Now we use the excimer laser to reshape the stroma. When this is complete, we replace the epithelium back over the cornea. A special contact lens is then placed on the eye and is worn for three to four days for added protection.

In LASIK, we gain access to the cornea is a different way. First, we use a femtosecond laser to create a corneal flap. The flap is lifted to gain access to the cornea and it is reshaped. Then the flap is placed back down and the procedure is complete.

Recovery is different between LASEK and LASIK. A LASEK patient recovers his or her functional vision one to two weeks after their surgery. There can also be more discomfort with LASEK, so patients use steroid eye drops for several weeks after their procedure. LASIK patients recover faster, regaining functional vision within 48 hours of their surgery. Discomfort only lasts a few hours, and steroid eye drops are used for the first week after surgery.

Otherwise, the end result of vastly improved vision is the same with both LASEK and LASIK.

Am I a candidate for LASEK?

Dr. Giyaur and our team at New York Laser Vision perform LASEK for patients who aren’t good candidates for LASIK. LASEK may be better for patients who have steep or very thin corneas, as this can make it difficult to make the corneal flap used in LASIK. If you have a high degree of myopia (farsightedness) this requires more tissue removal from the central cornea to correct the refractive error, so LASEK could be a better option. Also, if you have work or leisure activities that put your eyes at increased risk for injury LASEK is a better choice because it doesn’t involve the corneal flap that can dislodge during an injury.

What Happens During LASEK Eye Surgery?

LASEK eye surgery involves reshaping the cornea, which is the outermost portion of the eye. In this procedure, the surgeon uses an excimer laser to make very small changes to the cornea’s shape. These contouring changes enable light to enter the eye so that it focuses properly, creating clearer images. Many people no longer need eyeglasses or contact lenses after this procedure.

During LASEK eye surgery, the surgeon separates the corneal epithelium — the outer layer of tissue covering the cornea — from the layer underneath, moving it to the side but not removing or detaching it from the eye. After reshaping the cornea, the surgeon repositions the refracted tissue back onto the eye. This helps to speed healing.

The LASEK procedure differs from the PRK and LASIK procedures in a couple of ways. In LASEK eye surgery, the surgeon moves the very thin flap of corneal epithelium to the side of the cornea; in PRK eye surgery, the surgeon actually removes this tissue. Also, LASEK surgery involves the removal of significantly less tissue than the LASIK procedure.

Outcomes from LASEK eye surgery performed in our Brooklyn office are quite similar to those from PRK or LASIK, but the LASEK procedure may be a better fit for some people.

What Can You Expect During LASEK Eye Surgery?

LASEK has a very high success rate and a low level of complications. After visiting our office and having an examination, our team will work with you to determine if this procedure is right for your needs.

LASEK eye surgery is done as an outpatient procedure. During the surgery, a surgeon guides a pulsing laser over your corneal tissues to make changes to your eye. You will be awake during the procedure, but you will receive numbing medications so that you will not feel anything.

After the surgery, you’ll be able to go home after resting for a bit. We’ll tell you when you can start driving and getting back to your normal activities. Most people need to take about a week off from work while their vision improves.

Will I still need glasses or contact lenses after LASEK?

Most of our patients achieve 20/20 vision after these procedures. Some patients may only get as low as 20/40, but their correction is far less than it was originally.

What are the advantages of LASEK?

By not making a corneal flap, LASEK avoids the main potential complication of LASIK — possible problems with the flap healing. These are still rare, however, and can usually be addressed in a follow-up procedure if necessary.

Mainly LASEK is used for our New York Laser Vision patients who aren’t candidates for LASIK because they have naturally thin corneas or a high degree of farsightedness that would require removal of more corneal tissue, which could compromise the structural integrity of the eye.

Also, LASEK patients, because there is no corneal flap, have a slightly lower risk of developing dry eyes than LASIK patients.

What risks and complications are there with LASEK?

The basic side effects with LASEK are the same as those with LASIK and PRK. These include blurry vision, halos, and glare; possible over or undercorrection that may require another procedure; dry eyes; eye infection and irritation.

LASEK does not involve the possible complications involving the corneal flap of LASIK, but it has some potential problems exclusive to it. These involve the epithelium.

In some cases, the flap that keeps the epithelium connected to the cornea is not strong enough to be placed back over the eye at the completion of the laser reshaping, and it needs to be completely removed. This usually isn’t a risk unless you have very high myopia, in which case you’ll have a greater chance of having hazy vision.

Also, an alcohol solution is used during LASEK, and this causes tissue damage to the epithelial cells. This simply slows the healing process, but isn’t a long-term problem.

LASEK is a safe, effective alternative to LASIK for patients who are not good candidates for that laser procedure.

After my LASEK procedure when can I get back to my normal activities?

You’ll return home after your LASEK procedure at New York Laser Vision. You’ll have some mild to moderate discomfort for the first few days. You will keep your protective contact lens on your eye for four days while the surface epithelial cells heal and regenerate. We’ll also give you steroid eye drops and antibiotics that you’ll use for at least three weeks.

You’ll need to take about one week off of work after LASEK. Most normal activities can return at that point, as well, although we’ll give you a timeframe for strenuous exercise or physical work.

Can I have LASEK if I’ve had a corneal transplant or radial keratotomy?

If you’ve had a corneal transplant, LASEK can be used to correct refractive errors. For radial keratotomy (RK), LASEK could be an option, but not for sure. LASIK is not an option, as the corneal flap doesn’t work well with the cuts made in RK. We would need to examine your eyes to weigh your options. It could be best to wait for cataract surgery if you’re over 60 and have had RK.

Should You Consider LASEK Eye Surgery?

Many patients find that the LASEK procedure is an excellent way to improve their vision, so they do not have to worry about wearing glasses or contacts anymore. It is a safe procedure, but like any surgery, there are some risks. We will discuss these risks when you visit our office. It’s best to schedule a consultation to learn more about this procedure and others to determine which is right for your needs.

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