LASEK
LASEK is a variation of PRK which is similar to LASIK in many ways, but avoids some of the problems associated with both. It is a great alternative for patients who are not good candidates for LASIK, and often preferred over traditional PRK.


/Vision-Eye Care News Articles/ - March 24, 2007 - PRK sculpts the eye from the outside, removing the epithelial layer entirely, risking corneal haze and requiring a longer recovery time and longer time to achieve full vision benefits than LASIK. Corneal haze often occurs as an immune response, because the eye interprets the surgery as trauma.

In LASIK a flap is created that allows all the work to be done inside of the eye and produces almost immediate results. The eye does not interpret LASIK surgery as trauma, so corneal haze does not occur. LASIK can result in flap complications and, because the nerves which trigger tearing are cut, it can cause dry eye. It is not appropriate for patients with thin or steep corneas, or patients who engage in activities which could cause the flap to dislodge, such as contact sports.

LASEK uses a very fine blade and an alcohol solution to lift the epithelium, so the work is done inside of the eye, like in LASIK, but a flap is not created. The nerves which cause tearing are not affected, so the risk of dry eye is not elevated.

The Procedure
You will be awake. Anesthetic drops are used to numb your eye. During the LASEK procedure a very fine blade, called a trephine, is used to cut the epithelium. Your eye is soaked in an alcohol solution for about 30 seconds to make it easier to lift. The solution is sponged off and the epithelium is gently lifted and folded back out of the way. The cornea is sculpted with an excimer laser, and the epithelium is carefully put back in place. You will wear a bandage contact lens for several days.

Achieving the full visual benefits of LASEK usually takes about four to seven days. This is much quicker than PRK which can take up to six months, but not as quick as LASIK which can produce almost instant results.

Epithelium loss
In some rare cases the epithelium is too weak to be replaced. When this occurs the PRK procedure is chosen. For most patients this does not cause long-term problems, but it does mean a longer wait for full visual benefits. Patients who choose LASEK because they are not good candidates for PRK may experience more serious complications, particularly corneal haze.

LASEK candidates
Good candidates for LASEK are those who meet the general criteria for any type of refractive surgery, but are not good candidates for LASIK or PRK for one or more reasons including:

· Large pupils
· Thin corneas
· Steep corneas
· Career or lifestyle which involves trauma to the head and face (contact sports, police, military, etc.)
· Dry eyes
· Certain disorders of the corneal surface
· Myopia too severe for safe PRK

LASEK is a relatively new procedure which combines old and new techniques. Risks associated with both PRK and LASIK are significantly reduced or eliminated altogether. Some of the benefits of LASIK are reduced or lost. LASEK makes refractive surgery a safe option for many who are not eligible for other procedures.

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