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LASIK Vs LASEK : Which one is better?

LASIK (laser-Assisted in situ keratomileusis) refers to creating a flap in the cornea with a microkeratome (a surgical device that is affixed to the eye by use of a vacuum ring. When secured, a very sharp blade cuts a layer of the cornea at a predetermined depth) and using a laser to reshape the underlying cornea.

LASEK (laser epithelial keratomileusis) on the other hand is a hybrid of photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK), the goal of LASEK is the preservation of the corneal epithelium. Rather than creating a flap with a microkeratome (as in LASIK) or scraping and removing the patient�s epithelium (as in PRK), LASEK treats the epithelium with alcohol to loosen and separate it from the stroma and it is then rolled back.

Both surgeries employ lasers to cut flaps in the cornea and rectify the shape. Main difference Between LASIK and LASEK is thickness of the flap which includes corneal stroma tissue in LASIK and only epithelial tissue in LASEK.

LASEK procedure is ideal for people who have corneas too thin for LASIK. The incision heals faster than the incision made for LASIK, though it takes longer for good vision to return.

A recent study by the University of Illinois at Chicago researchers report there were only minor differences in the results of both types of procedures. The slight differences in the visual and refractive results came out in favor of LASEK, though the researchers report these differences would not be obvious to a patient. Both procedures seem safe, effective, and predictable.
The findings are published in the current issue (Dec 2006) of American Journal of Ophthalmology.

The LASEK Procedure

In LASEK, the epithelium, or outer layer of the cornea, is cut not with the microkeratome cutting tool used in LASIK, but with a finer blade called a trephine. Then the surgeon covers the eye with an alcohol solution (perhaps one part alcohol and four parts sterile water) for around 30 seconds. The solution loosens the edges of the epithelium.

After sponging the alcohol solution from the eye, the surgeon uses a tiny hoe to lift the edge of the epithelial flap and gently fold it back out of the way. Then he or she uses an excimer laser, as in LASIK or PRK, to sculpt the corneal tissue underneath. Afterward, the epithelial flap is placed back on the eye with a kind of spatula.


Advantages of LASEK Laser Eye Surgery

LASEK surgery includes several advantages, including:

  • Complications associated with cutting and reattaching the flap in the cornea are avoided.

  • LASEK laser eye surgery causes dry eye less frequently than LASIK laser eye surgery.

Disadvantages of LASEK Laser Eye Surgery

Disadvantages of LASEK laser eye surgery include:

  • Longer visual recovery time compared to LASIK laser eye surgery. Many LASEK patients will not fully recover functional vision for 1 to 2 weeks while their eye heals, which is similar to the healing time experienced in PRK laser eye surgery. LASIK laser eye surgery patients often have good vision by the day after surgery.

  • LASEK laser eye surgery may cause more pain and discomfort than LASIK , but less pain than PRK laser eye surgery. Most LASEK laser eye surgery patients say the discomfort lasts about 2 days or less.

  • Patients need to wear a "bandage contact lens" for about 3 or 4 days after LASEK laser eye surgery to serve as a protective layer between your blinking eyelids and the treated eye surface, which is not necessary after LASIK.

  • Patients must use topical steroid drops for several weeks longer than that used after LASIK laser eye surgery.

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