Is LASEK Eye Surgery for You? (LASEK vs LASIK)



Vision correction patients will usually get just as good results from LASIK as LASEK, a recent study shows. Dec. Both types of surgeries use lasers to cut flaps in the cornea of the eye to correct its shape. LASEK (laser-assisted subepithelial keratectomy) cuts only the outside surface area of the cornea.

This process avoids some of the flap problems that can arrise with the deeper cut made by the LASIK (laser in situ keratomileusis) procedure. But the recovery time for LASEK takes a bit longer and there may be more pain after surgery.

So Which is Better For You... LASIK or LASEK?

To find out, a University of Illinois at Chicago researcher Dimitri Azar, MD, and colleagues compared 122 eyes treated with LASIK to 122 eyes treated with LASEK. "Both procedures seem safe, effective, and predictable," Azar says in a news release. Eyes treated with LASEK ended up with slightly better vision. But the difference was too small for patients to notice.

"We found that although there were some differences ... that favor the LASEK procedure, the differences were not clinically significant," Azar says.

The findings appear in the December 2006 issue of the American Journal of Ophthalmology.

How LASEK Eye Surgery is Done:

LASEK (laser epithelial keratomileusis) is a newer variation of the PRK procedure, where a laser is applied directly to the eye's outer surface. The laser corrects vision by reshaping the cornea of the eye.

To understand how LASEK surgery works, you first must know the fundamental differences between LASIK, LASEK, and PRK:

* With LASIK, a thin flap is cut across the surface of the eye's and then lifted to expose a flat surface. A laser beam of light is applied to the eye for reshaping. When the laser surgery is finished, the flap is replaced, which helps protect the eye for quicker healing.

* Unlike LASIK, the PRK procedure does not require the eye to be cut. Instead, a laser is applied directly to the eye's surface. The thin, outer layer of the eye (epithelium) is vaporized by the laser and it eventually grows back.

* In a LASEK procedure, the extremely thin epithelial layer is preserved by lifting it from the eye's surface before the laser is applied. Following the LASEK procedure, the epithelium layer is replaced on the eye's surface.

In LASIK, the thicker flap of eye is cut with a microkeratome cutting tool or a specially designed cutting laser. With the LASEK procedure, the ultra-thin flap is cut with a specially designed cutting tool known as a trephine.

The LASEK procedure is mostly used for people with corneas that are too steep or thin for LASIK surger, when it may be difficult to create a thicker flap as used in LASIK. The LASEK procedure was developed to reduce the chance of complications that can occur when the flap created during LASIK doesn't have the proper diameter or thickness for the procedure.

According to a survey among members of the American Society of Cataract and Refractive Surgery (ASCRS), the popularity of LASEK surgery is growing among refractive eye surgeons, as it is with epi-LASIK, which is another variation of the LASIK procedure. Unlike LASIK, the Epi-LASIK procedure uses a plastic cutting blade called an epithelial separator, which cuts & detaches part of the epithelial layer from the eye.

Unfortunately, patients who undergo the LASEK procedure generally tend to heal more slowly and result in more complaints of discomfort than with the LASIK procedure. For this reason, some surgeons prefer the PRK procedure instead of the LASEK or epi-LASEK procedure because they find no advantage in the latter two procedures.

In 2008, a study published in the Journal of Refractive Surgery indicated that people who underwent the PRK procedure tended to heal slightly quicker and with less pain than people who had a surgical technique called butterfly LASEK. The term "Butterfly" refers to the shape and type of the thin flap lifted in LASEK, which is believed to decrease pain and increase the healing time.

In 2007, a study published in the Journal of Cataract and Refractive Surgery concluded that the outcome of LASEK depends on the surgeon's experience. Therefore, one should always ask their eye sugeon how many procedures they have performed.

LASIK Doctors

We encourage you to research all LASIK Doctors in your area and review the profile of each LASIK or Laser eye surgeon you are considering to learn about his or her philosophy, education and treatment experience. 

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