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LASEK
In the interest of long-term safety, we may recommend to patients with thinner corneas or irregularly shaped corneas, an advanced surface ablation procedure also known as PRK or LASEK. This procedure, which does not create a flap, can give us more cornea to work with enabling a more complete correction or a larger treatment zone diameter. The procedure involves removing the very thin surface layer of the cornea known as epithelium (usually about 50 microns thick) then reshaping the exposed cornea with a laser. The laser treatment is the same as in a LASIK procedure; the only difference is that the placement of the treatment is not as deep in the cornea as with LASEK, the risk of ectasia or instability is lowered. The vision outcome or percentage of patients achieving 20/20 or better vision, is the same as with LASIK in our experience and in published studies. When the procedure is completed, usually after 15-20 minutes, a thin soft contact lens without prescription is placed on each cornea to act as a clear bandage. The vision is immediately better upon standing up from laser, but will fluctuate for several days to several weeks until the surface healing is complete and stabilized. The soft contact lenses are left in place without removing them for 5 days. The contact lenses will minimize the postoperative discomfort, however, some mild pain can occur usually on the second or third day after surgery. We will prescribe a painkiller for you so that it is available to you in the event that you experience discomfort. Once we remove the contact lenses, usually after 5 days, the vision progressively stabilizes and improves. Patients are usually able to return to work after 3-5 days; however, there may be some blurriness that persists for 1-2 weeks further until the cornea is stabilized. Improvement of sharpness in vision is usually noted over a several week period. Antibiotic and nonsteroidal anti-inflammatory drops are used postoperatively for one week and topical steriod drops are used in a tapering dose for 3 months. Haze can develop in the cornea as it heals; however, with modern lasers and techniques, this is quite rare. In some cases, we will treat the cornea in the laser suite with a drop called Mitomycin-C to minimize the risk of haze in high risk cases.
The difference between LASIK and advanced surface ablation LASEK/PRK can be summarized as follows:
- Less intrusive surgical procedure.
- Slower recovery of vision with LASEK. Mild discomfort may occur in the first few days after LASEK.
- Eyedrops used in tapering dose for 3 months.
- Haze affecting vision can rarely occur necessitating re-treatment.
- Enhancement can be done after 6-12 month
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