The History and How LASEK Surgery Works
Laser-assisted subepithelial keratectomy or LASEK started in the year 1996. It is like bringing some aspects of LASIK and PRK surgery together to correct astigmatism, farsightedness, and nearsightedness. It attempts to decrease the chances of associated complications to LASIK while at the same time, produce less discomfort than that of PRK. Italian ophthalmologist Dr. Massimo Camellin is highly regarded for introducing the term LASEK, developing the original procedure, and thereafter popularizing the surgical technique.
Yes, LASIK is still the most popular laser eye surgery today but for patients who are not suitable to PRK, LASEK may serve as a better option. Such is the case for a patient with a high degree of myopia who requires more tissue removal from the cornea upon surgery or for someone whose line of work puts him at a high risk of eye injury, therefore has a higher likelihood of dislodging the corneal flap created in LASIK surgery.
LASEK works by creating a very thin corneal flap. This epithelial detachment is made with an alcohol diluted solution of 18 to 20 percent (%). Afterward, the reshaping of the cornea begins by using an excimer laser to allow light rays to enter the eye structure and precisely strike the retina at the back. After the laser treatment is done, the corneal flap is repositioned on the surface of the eye to fully cover the stromal layer that was hit by the laser. Later on, a bandage contact lens is placed on the eye to hold the corneal flap in place.
SEKAL microchirurgia Camellin. “LASEK by Massimo Camellin – Animation” Online video clip. YouTube. YouTube, June 8, 2014. Web. June 8, 2014.
Now, the corneal flap that is made in LASEK eye surgery is much thinner than in LASIK. In LASIK, the flap contains both epithelial and deeper stromal tissues. Since LASEK removes a thinner surface layer with an alcohol solution, it stays away from corneal flap-related complications. This means fewer problems leading to dry eyes and infection after surgery. It also minimizes the chances of removing excessive corneal layer with the laser and thereby affecting the eye’s structural integrity.
During PRK, either with an alcohol solution or a surgical instrument, the surgeon completely removes and discards the corneal epithelium that is all entirely different from LASEK. Then, the underlying corneal stroma is reshaped with an excimer laser and the new corneal epithelium is allowed to grow back in about five days. Again, the flap of corneal epithelium is retained in LASEK so it decreases the risk of infection, overall recovery time, and discomfort compared to PRK.
Potential Advantages Of LASEK Refractive Eye Surgery
Year by year, a large number of patients undergo eye surgeries to correct different refractive errors. Undeniably, LASIK and PRK have become the popular surgical procedures because of their safety and effectiveness but this does not take away some of their disadvantages. With PRK, post-operative pain and slow visual recovery are some of the common difficulties. Similarly, LASIK deals with flap-related complications.
On the other hand, LASEK surgery has its own advantages:
- less likely to develop dry eyes,
- avoidance of corneal flap complications,
- no incomplete flap and flap dislocation and wrinkles,
- prevention of flap infection and epithelial ingrowth.
Possible Disadvantages and Common Side Effects
- longer visual recovery time compared to LASIK
- short-term hazy or cloudy vision
- more pain and discomfort than LASIK but possibly less pain than PRK
- temporarily reduced vision in poorly lit conditions
- sensation of having a foreign object in the eye (possibly in one to five days)
Your eye doctor will discuss the possible risks before the surgery so that you fully understand the procedure and that any of your concerns will be addressed. The judgment and guidance of the eye surgeon, together with the patient, can weigh the risks and rewards of the surgery.