LASIK Alternatives: LASEK and PRK
Sometimes referred to as epithelial LASIK, epi-LASEK, or E-LASIK, LASEK was developed primarily for patients with corneas that are thin or irregularly shaped. LASEK is generally considered a better and safer choice for patients with dry eyes or an active lifestyle, but can be used for anyone considering laser vision correction.
In LASEK, surgeons do not create a corneal flap such as in LASIK. Instead, the very thin, outer layer of corneal tissue, called the epithelium, is lifted up and pushed to the side of the cornea. Next, the laser is then applied to the eye to sculpt the cornea. The thin epithelial flap is then carefully put back in place. A clear bandage contact lens is then placed on the eye for comfort and to allow the epithelial layer to heal quickly. This contact lens is worn 24 hours a day for about 4 to 7 days before it is removed.
LASEK eliminates flap complications! Epithelial cells are the fastest reproducing cells in the human body. If there is any problem with the creation of the very thin epithelial flap the tissue can fully re-heal. LASEK also preserves the structural integrity of the cornea because the tissue treated, or removed, is closer to the surface of the cornea. In LASIK, the tissue is treated much deeper in the cornea. Also, by eliminating the cutting of a corneal flap, the corneal nerves that run through the cornea are not severed. This helps maintain the eye’s communication with the tear gland to reduce the risk of dryness. These are just a few of the reasons that your doctor may recommend LASEK.
LASEK patients usually experience a little more discomfort after the procedure and the visual recovery is slower than LASIK. Most patients who have LASEK will report a mild to moderate amount of ocular discomfort that consists of stinging and burning for 1 to 2 days. They will usually have vision that is good enough to drive in 3-7 days, but it may take weeks to reach the final outcome.
The advantages of LASEK over PRK are diminished pain, a shorter recovery, and a lower risk of infection.
PRK (“surface ablation”)
If your corneas are too thin to create the corneal flap needed for LASIK, PRK may be an option for you. PRK is often called “bladeless LASIK” or “surface ablation” because PRK applies the laser vision correction treatment to the top surface of the cornea, while LASIK applies the laser in the center of the cornea after the creation and lifting of a portion of the cornea. It is considered the safer procedure for patients who have an active lifestyle or work in professions with debris in the air. Because PRK does not require the creation of a corneal flap, all potential flap complications are eliminated.
PRK can be used to treat myopia (near-sightedness), hyperopia (farsightedness) and astigmatism. In PRK, the epithelium, or surface corneal cells, are first gently removed. The laser treatment is then applied to the eye. Afterwards a clear contact lens is placed on the eye by the surgeon to act like a bandage during the healing process. The patient wears the contact lens for the first 3-4 days after surgery or until the epithelium layer has completely regenerated. The lens will be removed by the doctor at a post-operative visit.
Discomfort with PRK can be moderate, but medications are used to help this. Visual recovery usually takes several days or longer.