LASEK - Laser Eye Surgery Guide - Laser Eye Surgery Guide

LASEK is a laser vision correction procedure that is commonly described as a combination of LASIK and PRK. The technique involved incorporates a flap being created from the top layer of the cornea, known as the epithelium. This is done using a specially designed blade known as a trephine. The flap is required as it can then be moved out of the way to allow the laser to act on the cornea unobstructed.

The LASEK procedure is commonly recommended to those patients who already have a thin cornea but who desire laser eye surgery.

What actually is LASEK?

LASEK is the abbreviation used for 'Laser Epithelial Keratomilieusis'. The procedure performed is almost identical to PRK, although it differs because in LASEK the corneal epithelium is kept attached whereas in PRK, the epithelial flap is totally removed.

During the more traditional LASIK procedure, the risk of problems, such as damage to the corneal epithelium, were higher than desired. To resolve this issue, LASEK was introduced as an innovative version of PRK.

Although the chances of complications are lower after LASEK than LASIK, you should note that the recovery period is longer and has been known to cause noticeably more discomfort to the patient. For more information that may be helpful when considering the different types of laser eye treatment, you should book a consultation with a laser eye surgeon.

What are the features that define LASEK, PRK and LASIK?

The most widely known types of laser eye surgery are PRK, LASIK and LASEK, especially the latter two. It is easy to become confused when comparing the three procedures as they do share many common features. To ensure that you are committing yourself to a procedure that you are aware of, here is some key points that state key differences between the techniques.

Firstly, LASEK is laser eye surgery, which is performed using a special blade called a trephine. The trephine is employed by the surgeon to create the corneal epithelium flap, which is then manoeuvred out of the way to give the excimer laser access to the cornea for reshaping.

Secondly is LASIK. This form of laser eye surgery uses a microkeratome rather than a trephine. This microkeratome is also used to create the corneal flap, which similarly to LASEK is then moved out of the way to allow a special excimer laser to act efficiently.

Finally, PRK is different again. This laser eye surgery procedure was used prior to LASEK and LASIK. The most noticeable difference that can be seen in PRK is that a corneal flap is not created. Instead, a laser is employed by the surgeon to remove a layer of cells from the corneal epithelium. This has a similar effect to the trephine and microkeratome in that it creates an access route to the cornea for reshaping. The cornea reshaping is also done with an excimer, like in LASIK and LASEK.

You should be aware that these are not the only three options available to you if you wish to undergo laser eye surgery. As time goes by, more and more innovative and technological advanced procedures are being introduced. For example, Ultralase is one company that also offers procedures such as Wavefront LASIK. Laser treatments such as these are extremely quick and effective and are becoming increasingly popular.

Am I a suitable candidate for LASEK?

LASEK is considered suitable for those who have thin corneas already and so may not be able to undergo certain other corrective eye treatments. Alternatively, if you are often involved in playing contact sports such as American football then this treatment may also be good for you as it may leave your eye less vulnerable to damage post-surgery.

Career is another factor that can influence how suitable LASEK is for you. If you work in a field that involves vision, for example if you are a pilot, then LASEK could be a good option for you to increase your seeing power.

During your consultation, a detailed health and lifestyle analysis will be made to determine if you are a suitable candidate for LASEK. There are, however, some points that are compulsory if you wish to undergo the procedure. These points include being of the correct age (the minimum age is often 21), if you do not have any other eye problems as well as how realistic your expectations are in regards to the outcome of your LASEK procedure.

If you are considered unsuitable for LASEK then there are other options potentially available to you depending on the reasons behind your lack of suitability. These options will be explained by your surgeon, however one common alternative is an implantable contact lens (ICL). If you wish to find out more about the ICL or any other options you may be aware of, then please look through out 'Laser Eye Surgery FAQs' section.

Potential risks of LASEK

As with every other surgical procedure, LASEK does carry some small risks and complications that you should be aware of before undergoing the procedure. The chances of complications occurring and very low but there are still worth considering. During your consultation, your surgeon will list, in detail, all the potential risks that may affect you but to supply some idea, below is a list of some possible complications:

• Longer recovery time than other laser eye methods
• A higher amount of pain and/or discomfort than with some of the other vision correction techniques
• Your cornea may become even thinner
• Haze or glare can affect your vision
• You may gain an eye infection

Benefits associated with LASEK

The primary and most sought after benefit of LASEK is that your vision should drastically improve as their ability to focus increases. It is possible that you will come out with 20/20 (perfect) vision, and if not it will probably be almost perfect, which results in you losing your requirement for contact lenses or glasses that may have previously inconvenienced your everyday life.

If you undergo LASEK to correct short-sightedness then you should notice that after recovery you are now able to seen far away objects. Alternatively, if you are long-sighted then the result should allow your close vision to improve dramatically.

You should note that while the results of LASEK are permanent, everyone's eyesight deteriorates with age, especially when they reach middle age. This is often most obvious when trying to read as the muscles in your eye lose elasticity and so focussing is more difficult. Therefore, if you wish to also correct this natural problem, then you will have to undergo further laser eye surgery.

You LASEK consultation

Before entering a consultation with your surgeon you should compile a list of questions that you deem important to ask. As each question is answered you can then tick it off your list. These questions may include asking about the surgeon's qualifications and experience as well as the realistic outcome that you should expect. For further ideas about questions you may wish to consider, please view of 'General FAQs' section.

At the end of your consultation your surgeon will be able to provide you with a quote as to how much your LASEK procedure will cost. This price is usually per eye and varies depending on the clinic. This is generally because of the surgeon's experience, technology used and location of the clinic. However, below is listed some rough prices, which should give you a general idea as to what you can expect:

• To undergo a standard LASEK procedure, the cost is often approximately £995 per eye.
• If you choose UltraLASEK without Wavefront then you can expect to pay something in the region of £1395 per eye.
• For UltraLASEK with Wavefront, the price is usually more at around £1695 per eye.

The LASEK procedure

Before making any surgical incisions, you will first have your eye held open by a specialised clip to prevent you from blinking. Once this clip is in position, the surgeon will apply some eye drops, which work to numb the eyeball so your procedure is as comfortable and painless as possible.

Once your eye is numb, your surgeon will employ the use of a specialised blade known as a trephine. This trephine is used to create a small cut in the top layer of the cornea, called the epithelium. This epithelial layer is subsequently covered with a small cone. An alcohol-based solution is then poured into this this cone and left for approximately 30 seconds. This is done to dissolve some of the cells of the epithelial layer and make the edges of the epithelium looser.

The next step carried out involves your surgeon carefully lifting and peeling back a flap of the epithelium to allow the laser to gain access. This laser is known as an excimer laser and is used to reshape the middle of the cornea to correct the refractive error of your eye.

Once this has been completed, your surgeon will gently reposition the flap of corneal epithelium. This is then covered by a temporary, protective contact lens or bandage and antibiotic eye drops are applied to prevent infection.

How long will the results of LASEK last?

Usually, the results of LASEK are permanent, however it has been suggested that the actual length of time the results last are dependent on the surgeon's skill and experience. Over time everyone's eyesight tends to get worse and this cannot be prevented by LASEK however, it can be employed to try and improve eyesight later in life.

Recovery after your LASEK procedure

Like with LASIK and PRK, the recovery period is relatively simple and hassle-free. However, with LASEK the recovery time is often longer at up to 7 days before the better vision can be experienced, compared to the 4 days with LASIK and PRK. It is likely that during this week, you will experience a level of discomfort and/or pain although this can be managed with painkillers and prescribed eye drops.

During the recovery period, please avoid touching your eyes or rubbing them as this can cause damage as well as potentially leading to infection. To try and prevent inadvertent touching overnight, you may wish to consider wearing an eye patch.

It is also advisable that you take a few days off work to relax and allow your eyes time to recover and heal. During this time you should also avoid driving as your vision and judgment may be affected and it could be dangerous for yourself and other road users.

A key factor during the recovery process is the check up appointments at the clinic. These appointments are often referred to as an aftercare package and are used to monitor the progress of your recovery and eyesight. The first check up will be the day after your surgery and subsequent appointments should be attended within the months following.