LASEK

LASEK is often described as a combination of the PRK and LASIK techniques and it is correct in that sense. It involves making a flap in the outer corneal layer (epithelium) using a special blade called a trephine. The epithelium is then lifted to one side.

The surgeon then uses a laser (excimer) to reshape the cornea.

LASEK is often advised for those patients with thin corneas.

What is ‘LASEK?

LASEK stands for LASer Epithelial Keratomilieusis and is very similar to PRK except for one thing: the outer layer of the cornea or epithelium is retained.

PRK removes the outer layer completely.

LASEK is a fairly new version of the PRK procedure and one that was developed to reduce the risks of complications from LASIK. These include problems with the epithelium flap created during surgery.

It does take longer to recover from this compared to LASIK and it can be more painful. Your surgeon will discuss the most suitable procedure for you.

What is the difference between LASEK, LASIK and PRK?

LASEK, LASIK and PRK are terms that you will often hear especially the first two. Many people do confuse LASEK with LASIK although they are separate procedures. It is easy to become confused by the medical terminology so here is a brief description of the differences between these three laser treatments:

a. LASEK: a form of laser eye surgery in which the surgeon uses a trephine to cut a flap in the outer layer of the cornea. He or she will then fold this flap back in order to reshape the cornea with an excimer laser.

b. LASIK: in this procedure the surgeon uses a special instrument called a microkeratome to make an incision in the epithelium. This incision takes the form of a flap which the surgeon then peels back. He or she can then reshape the middle layers of the cornea (stroma) using an excimer laser.

c. PRK: this was the forerunner of laser eye surgery. It differs from the other two procedures in that no flap is created in the epithelium. What happens instead is that the surgeon uses laser energy to ‘scrap away’ the cells of the epithelium to reveal the cornea underneath. The surgeon then uses an excimer laser to correct the refractive error.

Surgical treatments advance all the time and laser eye surgery is no exception. You will find that clinics such as Ultralase offer advanced forms of these treatments, which use up to the minute lasers such as Wavefront LASIK and Intralase.

Who should consider LASEK?

It is a good choice of procedure for people who have thin corneas and so may not be suitable for other types of laser vision surgery.

It is also recommended for people who engage in contact sports such as rugby: and for certain careers such as aviation.

As usual: if you are over 21, in good health, have no chronic or underlying eye problems and are realistic about the outcome of surgery then you will be considered for LASEK.

As with any procedure, the surgeon will talk to you about your lifestyle and expectations before taking measurements of your eye.

If I am not suitable for LASEK then is there an alternative?

Yes there is. You may feel disappointed at being refused LASEK but rest assured that there will be a sound medical reason for doing so.

The surgeon will be able to recommend a good alternative. One such alternative is an implantable contact lens or ICL. Visit our section titled ‘Laser Eye Surgery FAQS: ICL’ for more information.

What are the risks of LASEK?

All laser eye surgery comes with a small amount of risk. Complications are rare but they do happen and this is something you need to take into account when thinking about laser vision correction.

Complications include:

• Thinning of the cornea
• Slower recovery
• More pain and discomfort with LASEK than other laser treatments.
• Haze
• Glare
• Infection

These will be pointed out to you during your consultation. This is why it’s important to be aware of these before making any decision.

What are the benefits of LASEK?

Like all forms of laser eye treatment you will notice an improvement in the focusing power of your eyes. Your vision will be perfect (or near to) and this can mean no more glasses or contact lenses.

That is cited as the biggest benefit by the vast majority of patients.

If you are short-sighted then you will be able to see objects at a distance: if you are long-sighted then this means seeing objects close to. In both cases, objects will appear crisp and in focus.

So, no more glasses or contact lenses? Yes, but if you are in your forties or fifties then you will find that your eyesight changes as a result of the ageing process. The muscles of the eye do tend to harden and this becomes apparent when trying to read.

At present, research shows that the effects are permanent but further surgery may be required for older patients.

What should I ask the surgeon at the consultation?

The main ones to be asking include about his or her qualifications, number of years of experience, how many operations does he/she perform each week and the outcome of the surgery.

Our ‘General FAQS’ section contains a list of suggested questions that you can use during the consultation.

How much does LASEK cost?

The costs of LASEK do vary from clinic to clinic, which can depend on the type of treatment, surgeons’ fees and aftercare service.

If your LASEK involves a state of the art laser then this will push the price up. As a rough guide you can expect to pay the following:

• Standard LASEK = £995 per eye
• UltraLASEK (without Wavefront) = £1,395 per eye
• UltraLASEK Plus (with Wavefront) = £1,695 per eye

What is the LASEK procedure?

First of all you will be given local anaesthetic drops which will help to numb your eye.

The surgeon will then use a small cutting tool called a trephine to make a tiny incision in the outer layer of your cornea. He/she will then place a small cone over this layer (epithelium) into which he or she will pour an alcohol based solution.

This solution helps to dissolve some of the cells of this layer. This solution is left in the eye for around 30 seconds or so which helps to loosen the edges of the epithelium.

The surgeon will then lift an edge of the epithelium and peel it back. This reveals the inner layer of the cornea or the ‘stroma’. He/she will then use an excimer laser to correct the eye defect.

Once this is done the surgeon will then fold back the epithelium and apply a contact lens over the surface. Antibiotic eye drops are administered and a special plastic shield (similar to an eye patch) is placed over the eye.

How long do the effects of LASEK last for?

A10. The outcome of this surgery, like all laser eye treatments, depends on the skill and experience of the surgeon. So far, the effects have shown to be permanent although eyesight can change as a result of the ageing process.

If you are in your forties or older then please bear this in mind. You may require further surgery at some point in the future as a result of hardening of the eye muscles.

What does recovery from LASEK involve?

The recovery is very similar to that of PRK and LASIK, except that it does tend to take longer. It can be 3 to 7 days before you have good vision and you will experience pain and discomfort (irritation) during this time. You will be given painkillers in the form of anaesthetic eye drops to deal with this.

Try not to touch or rub your eye during this time. What can help is to wear the eye patch at night to remind yourself not to do so.

Arrange a week away from work after surgery to give yourself time to rest and for your eye to heal.

It will be a week before you are safe to drive.

An important part of this process is the aftercare service. You will be asked to attend an aftercare check up the day after surgery. This will be followed by regular check ups over the next few months.