Laser Epithelial Keratomileusis (LASEK) is a relatively new procedure it is another variation of LASIK. Also called epithelial LASIK or E-LASIK, it involves cutting an ultra-thin layer of epithelium lining the front of the cornea.

The tissue then is moistened with diluted alcohol and moved aside for laser treatment. (In PRK, the epithelium is completely removed and not replaced for laser treatment.) Like the corneal flap created in LASIK, the epithelial flap in LASEK is replaced to serve as a type of “bandage” to promote healing.

LASEK is considered more appropriate as a laser vision correction procedure for patients who might have unusually thin corneas or other eye abnormalities.

It was developed to reduce the chance of complications that occur when the flap created during LASIK is not the ideal thickness or diameter.

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.

In many ways, what you can expect from LASEK is similar to what you can expect from LASIK, but there are some differences. According to doctors who perform LASEK, the flap edge heals in about a day, though patients usually wear a bandage contact lens for around four days. You may feel eye irritation during the first day or two afterward. Also, the time it takes to recover good vision is often longer — up to four to seven days. Of course, it varies from one person to the next.

If you are considering LASIK, but your doctor says you need LASEK instead, ask why. It's not for everyone, but many surgeons who perform LASEK consider it a better option for some patients who will probably not do very well with LASIK.

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