LASEK (Laser Assisted Epithelial Keratomileusis) is a common alternative to LASIK surgery and can be used to treat all the common refractive errors including myopia (short sight), hyperopia (long sight) and astigmatism. It remains one of the safest forms of laser eye surgery.
What is LASEK?
LASEK is the a very popular form of elective vision correction surgery and can be used to treat myopia (short-sight), hyperopia (long-sight) and astigmatism.
The principle of LASEK involves using a special type of laser to precisely change the shape of your cornea — the dome-shaped transparent tissue at the front of your eye — to improve vision.
Normally, images are clearly focused on the retina in the back of your eye because the light rays are bent properly to contact the retinal surface. With short-sightedness (myopia), long-sightedness (hyperopia) or astigmatism, the light is bent incorrectly and it ends up being focused elsewhere, resulting in blurred vision. Traditionally, the blurred vision is corrected by bending (refracting) light rays with glasses or contact lenses. But reshaping the cornea itself also will provide the necessary refraction.
What are the benefits of LASEK?
- Quick, painless procedure, lasting less than 5 minutes per eye.
- Excellent results, with patients often seeing well within a few days.
- Clinically proven treatment – Research indicates that 97% of patients achieve their desired vision after LASEK treatment and complete satisfaction.
- No flap is created during surgery meaning it is suitable for patients with dry eyes, thin corneas or those who participate in contact sports.
- Surgery is very comfortable with minimal touch involved.
- No stitches required.
- Further adjustments can be made in the future to correct vision should the need arise.
How is it performed?
- Local anaesthetic eye drops are applied to both eyes.
- A solution of alcohol is used to gently separate the cells from the surface of the cornea.
- The cells are gently rolled aside.
- The excimer laser is then used to reshape the cornea. An average 3 diopter treatment needs less than 6 seconds of laser application.
- The surface cells are gently replaced and aligned back into its original position.
- A contact lens is placed on the surface to act as a bandage and no stitches are required.
What are the alternatives to LASEK?
- Refractive Lens Exchange
- Implantable Contact Lens
- Excimer laser was first invented in the 1970’s.
- Columbia University researcher Stephen Trowel first explored the idea of using it for vision correction.
- The laser used to reshape the cornea uses Ultra-Violet light.
- The first laser eye surgery was performed in 1987 with a technique called PRK on a 60 year old lady.
- Surgery involves excimer laser technology and wavefront
- Total surgery time is 3-5 minutes per eye
- Modern lasers can treat 3 D in less than 6 seconds of actual laser time
- One excimer laser pulse removes a quarter of a hundredth of a width of a human hair.
- It is estimated that over 32 million procedures have been performed worldwide.
- It is the safest form of laser eye surgery.
- Laser eye surgery involves surgery on the cornea and all our surgeons are dual trained in cornea and refractive surgery.
More Information about LASEK
For more information regarding this treatment as well as any frequently asked questions, please see below.
LASEK stands for Laser Assisted Epithelial Keratomileusis. It is the main alternative to LASIK.
Patients undergoing LASEK procedures often find that the healing process is slower than with LASIK and can result in more discomfort. The eyes may feel irritated during the first few days afterwards. Also, with LASEK compared with LASIK, it often takes longer to recover good vision; perhaps between four and seven days.
Our focus is to achieve complete satisfaction. All our patients are treated until discharge as part of the inclusive care plan. This includes 2 years of follow up and retreatments after your initial treatment. Although you may be discharged, all our patients remain under our care and positively encourage patients to get in touch should problems arise.
Our success has been dependent on personalised patient care and we believe this is paramount. All patients will see their surgeon at each visit as they are personally responsible for your care so you are safe in the knowledge that you are receiving the best possible standard of care.
Long-term results from laser eye surgery tend to be best in people who are carefully evaluated before surgery to ensure that they are good candidates for the procedure. During your consultation, the team led by your surgeon will ask about your medical and surgical history and undertake a comprehensive eye examination.
In the eye examination, your surgeon will evaluate your vision and look for signs of eye infections, inflammation, dry eyes, large eye pupils, high eye pressure and other eye-health conditions. They will also measure your cornea, noting the shape, contour, thickness and any irregularities. This helps them to assess whether you can undergo the procedure safely and evaluate which areas of your cornea need reshaping. They will calculate and determine the precise amount of tissue to remove from your cornea.
If you wear contact lenses, which can change the shape of your cornea, you’ll need to completely stop wearing them and wear only your glasses for at least one week before your evaluation and surgery. The team will provide specific guidelines depending on your situation and how long you’ve been a contact lens wearer.
LASEK surgery is usually completed in 10 minutes or less. During the procedure, you lie on your back in a reclining chair. You may be given medicine to help you relax. After numbing drops are placed in your eye, an instrument is gently positioned to hold your eyelids open.
A special well is placed on your eye for the solution to stay in place for 30 seconds. The solution separates the surface epithelial cells from the stroma, and allows direct access to the structural collagen of the cornea to be reshaped with the excimer laser. With each pulse of the excimer laser beam, a tiny amount of corneal tissue is removed. After reshaping the cornea, the surface cells are gently positioned back into place. A bandage contact lens is then placed on the eye to protect the surface during the healing phase.
The vast majority of patients who need LASEK surgery in both eyes will have both eyes treated on the same day.
LASEK surgery is incredibly comfortable during the procedure. Most patients will only feel a gentle pressure at most.
As LASEK surgery involved treating the surface of the eye, the eye may be uncomfortable for the first 24-48 hours. This is entirely normal and any discomfort can be managed with drops and oral analgesia.
All patients will be given a set of eye drops that help vastly reduce the risk of infection and inflammation. These generally last for the first 4 weeks but some patients may require lubrication drops for the first few months.
Although you will be able to see immediately after surgery, your vision will improve over time. Whilst you should be legal to drive the next day, it may take between 4 and 12 weeks after your surgery before your eye heals and your vision stabilizes.
You’ll have a follow-up appointment with the team one to two days after surgery. They will check the flap in detail and look for any complications. Plan for other follow-up appointments during the first six months after surgery as your doctor recommends.
It might be a few weeks before you can start to use cosmetics around your eyes again. You might also have to wait several weeks before resuming strenuous contact sports or swimming.
Although complications are rare, it should not be forgotten that laser eye surgery is a surgical procedure. No procedure is risk-free but steps are taken throughout the process to reduce these risks to a minimum. Listed below are some of the risks with LASIK surgery,
- Dry eyes – It is estimated that 30% of patients will experience dry eyes after LASEK surgery, mainly during the night. In the vast majority of cases, these symptoms settle in the first few months but a very small proportion of patients may experience long-term issues with dry eye. Dry eyes can reduce the quality of your vision
- Halos, glare and double vision – After surgery you may have visual symptoms at night. You might notice glare, halos around bright lights or double vision. This generally lasts a few days to a few weeks. Even when a good visual result is measured under standard testing conditions, your vision in dim light (such as at dusk or in fog) may be reduced to a greater degree after the surgery than before the surgery.
- Reduction of best potential vision – Some patients lose lines of vision on the vision chart that cannot be corrected with glasses, contact lenses, or surgery as a result of treatment.
- You may be under treated or over treated – Although a very high proportion of patients achieve 20/20 vision without glasses or contacts, approximately 3-5% of patients may require additional treatment once the vision has stabilised. A very small proportion of patients may still need glasses or contact lenses after surgery. This may be true even if you only required a very weak prescription before surgery. If you used reading glasses before surgery, you may still need reading glasses after surgery.
- For some long-sighted patients, results may diminish with age – If you are long-sighted, the level of improved vision you experience after surgery may decrease with age. This can occur if your manifest refraction (a vision exam with lenses before dilating drops) is very different from your cycloplegic refraction (a vision exam with lenses after dilating drops).
Certain health conditions can increase the risks associated with LASEK surgery or make the outcome less predictable. Your surgeon may not recommend laser refractive surgery for you if you have certain conditions, including:
- Autoimmune disorders, such as rheumatoid arthritis
- A weakened immune system caused by immunosuppressive medications or HIV
- Persistent dry eyes
- Unstable vision due to medications, hormonal changes, pregnancy, breast-feeding or age
- Keratitis, uveitis, herpes simplex affecting the eye area, glaucoma, cataracts, eye injuries or lid disorders
LASEK is usually not advisable if you:
- Have an eye disease called keratoconus, or if you have a family history of it
- Have fairly good overall vision
- Have severe myopia
- Have very large pupils or thin corneas
- Have the onset of cataract
LaserVision was initially founded in Guildford, Surrey. Now with clinics in over 6 locations, we are able to treat the eye conditions of patients nationwide. This treatment is available at: