Introduction to LASEK Laser Eye Surgery
Laser epithelial keratomileusis, or LASEK, combines benefits of the two most commonly performed procedures — LASIK and PRK. LASEK laser eye surgery is used to treat astigmatism, nearsightedness or farsightedness.
In LASEK laser eye surgery, 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 and a 20% alcohol solution.
What Are the Advantages of LASEK Laser Eye Surgery?
- Complications associated with cutting and reattaching the flap in the cornea are avoided.
- LASEK laser eye surgery causes dry eye less frequently than LASIK laser eye surgery.
What Are the Disadvantages of LASEK Laser Eye Surgery?
- Longer visual recovery time compared to LASIK laser eye surgery. Many LASEK patients will not fully recover functional vision for 1 to 2 weeks while their eye heals, which is similar to the healing time experienced in PRK laser eye surgery. LASIK laser eye surgery patients often have good vision by the day after surgery.
- LASEK laser eye surgery may cause more pain and discomfort than LASIK , but less pain than PRK laser eye surgery. Most LASEK laser eye surgery patients say the discomfort lasts about 2 days or less.
- Patients need to wear a "bandage contact lens" for about 3 or 4 days after LASEK laser eye surgery to serve as a protective layer between your blinking eyelids and the treated eye surface, which is not necessary after LASIK.
- Patients must use topical steroid drops for several weeks longer than that used after LASIK laser eye surgery.
What Are the Side Effects of LASEK Laser Eye Surgery?
LASEK laser eye surgery shows side effects less frequently than is seen with PRK, however side effects may occur. These may include:
- Sensation of having a foreign object in your eye (can
last anywhere from 1 to 4 days)
- Temporary reduced vision under poorly lit conditions
(up to 12 months)
- Dry eyes, requiring the use of moisturizing drops (up to 6 months)
- Hazy or cloudy vision (should disappear within 6 to 9 months)
How Do I Know if LASEK Laser Eye Surgery Is for Me?
LASEK laser eye surgery may be better for patients who have steep or very thin corneas, which make it difficult for the surgeon to make a proper LASIK flap. Since traumatic injury to the eye is more serious after LASIK than LASEK laser eye surgery, patients who engage in professional or leisure activities that put their eyes at increased risk for injury (such as boxing) may be better suited for LASEK. LASEK laser eye surgery is better for people with dry eye syndrome because in avoiding a deeper flap, the corneal nerves responsible for the tearing reflex are not cut.
How Do I Prepare for LASEK Laser Eye Surgery?
Before your LASEK laser eye surgery you will have met with a coordinator who will discuss what you should expect during and after the laser eye surgery. During this session your medical history will be evaluated and your eyes will be tested. Likely tests include measuring corneal thickness, refraction, and pupil dilation. Once you have gone through your evaluation, you will meet the surgeon, who will answer any further questions you may have. Afterwards, you can schedule an appointment for the procedure.
If you wear rigid gas permeable contact lenses, you should not wear them for three weeks before your surgery. Other types of contact lenses shouldn’t be worn for at least three days prior to surgery. Be sure to bring your eyeglasses to the surgeon so your prescription can be reviewed.
On the day of your LASEK laser eye surgery, eat a light meal before going to the doctor, and take all of your prescribed medications. Do not wear eye makeup or have any bulky accessories in your hair that will interfere with positioning your head under the laser. If you do not feel well that morning, call the doctor’s office to determine whether the procedure needs to be postponed.
What Happens During LASEK Laser Eye Surgery?
LASEK laser eye surgery is done under local anesthesia. During the procedure, the top layer of cells, or epithelium, is treated with alcohol for about 30 seconds to detach it from the underlying tissue. It is then lifted or rolled back so that the eye doctor can access the cornea tissue. The newly exposed tissue is treated with the same laser used in LASIK laser eye surgery and PRK. Then the top layer of cells is replaced.
This is in contrast to LASIK laser eye surgery, in which a cutting device makes a flap in the cornea. LASEK laser eye surgery differs from PRK by preserving the top layer of cells, rather than scraping them away and waiting for them to grow back. This is believed to facilitate healing of the cornea with less discomfort than PRK.
What Happens After LASEK Laser Eye Surgery?
After LASEK laser eye surgery, expectations are similar to what can expected after LASIK. However, even though the flap created by LASEK laser eye surgery heals in about a day, patient usually wear a special contact lens that acts as a bandage for up to four days after surgery. Patients also may experience irritation in their eye during the first day or two after LASEK laser eye surgery For patients who undergo the LASIK procedure, good vision is usually attained in a few days. For LASEK laser eye surgery this may take as long as a week.
You will revisit the doctor for an evaluation the day after LASEK laser eye surgery, as well as one week and three months after surgery.
When to Call the Doctor
If you have any questions after your LASEK laser eye surgery or if you experience pain, a sudden decrease in vision, red eye(s), or discharge from your eye(s), contact your eye doctor immediately.
Reviewed by the doctors at The Cleveland Clinic Cole Eye Institute.
Edited by Charlotte E. Grayson, MD, WebMD, October 2004.
Portions of this page © The Cleveland Clinic 2000-2005