LASIK & LASEK - which procedure is best for me?
What is the difference in the two procedures?
There are basically two laser refractive procedures to correct myopia (short sight), hyperopia (long sight) and astigmatism: 1) LASIK and 2) LASEK. Both procedures are very safe and will give you the same final results.
It can be quite confusing if you are thinking about laser vision correction and want to know which procedure would be best for you. While both LASIK and LASEK can give you excellent vision in a safe and reliable way, some surgeons prefer one or the other, or may indeed only offer one type anyway!
How is the prospective patient supposed to decide?!
What happens in practice is that patients are greatly influenced by what their particular clinician says, and understandably so. It is always worth seeking a second opinion and comparing the findings and comments of each centre. This shouldn’t threaten any clinic worth its salt. Some patients feel more confident with one person or another, based on perhaps only "chemistry", but it is very important to know the difference in the techniques.
LASIK and LASEK are both very effective procedures and, using the technology available at FOCUS Laser Vision, can be used to treat myopia (short sight), myopia myopia(long sight), astigmatism (irregular corneal shape) and reading vision problems.
Please note that most clinics do not have the correct technology required to correct reading vision problems and higher levels of long sight. FOCUS Laser Vision does.
1) LASIK involves applying the laser treatment below the surface of the cornea, the clear window at the front of the eye, achieved by creating a very thin layer of the surface skin and supporting tissue below it, folding to one side, applying the treatment and then replacing the thin layer, which re-adheres in place. The surface is intact again after only several hours
LASIK Advantages:
- Quick healing (driving vision the next day in most cases)
- Re-treatments are easier
- Generally back to work or school within 48 hours
- Generally able to drive a car within 24 hours
LASIK Disadvantages:
- Uses more tissue
- Can have flap complications (occurrences are now extremely rare with all-laser technique using the Ziemer LDV Z-LASIK technique to create the surface layer)
2) In LASEK, only the surface skin cells (very thin surface layer) are removed, without their supporting tissue, as in the LASIK procedure. The skin has no structural integrity and grows back within 3-4 days.
After the surface skin is folded back, the laser gently removes the prescription, as is done with LASIK procedure, the skin layer is returned and then a contact lens is placed on the cornea for 3 to 4 days to allow the epithelium to heal and keep the cornea comfortable (it protects the eye). For high prescriptions, the doctor may use a special medicine at this point to prevent haze – a thin whitish layer that can affect vision.
LASEK Advantages:
- Uses less tissue, so the cornea is slightly stronger afterwards
- Allows patients who are non-candidates with LASIK, e.g. thinner corneas, to have a laser refractive treatment
- No flap created so there is no chance of flap complications
- Less than 1% chance of re-treatment
- Can resume all physical activates within 2 weeks
LASEK Disadvantages:
- Healing takes longer than LASIK (driving vision in 4 to 14 days
- Slight risk of haze (little risk with modern laser and adjunctive medical therapy)
- Delayed epithelial healing
What are some of the reasons for doing LASEK?
- Scarring on the cornea that impairs vision - can be removed with LASEK but will remain in the LASIK flap (the scar is not removed with LASIK).
- In corneas that are too thin for LASIK, PRK is an option.
- The patient has a preference for LASEK
- Certain occupations or hobbies, such as:
- Boxing
- Martial Arts etc
- Any sport, where contact with the eye is a concern. One doesn't want a flap that can be moved or injured.
We do approximately 20% of our patients with LASEK and find that the end result of the two procedures to be excellent.