February 6, 2023

Is LASEK Safe?

LASEK is corrective eye surgery that uses a laser to reshape your cornea.

But as with any surgery, it’s only natural to be concerned about the safety of the surgery. 

Let’s look at the risks, possible long and short-term side effects, safety features, and technologies of LASEK surgery.

Is LASEK Safe?

LASEK (Laser-Assisted Subepithelial Keratectomy modification) is considered one of the safest elective surgeries. 

When you consider undergoing any surgery, assessing the risks associated with the procedure is natural. It is wise to weigh the risks and costs based on your unique situation to see if you are the correct candidate for this operation.

LASEK can correct short-sightedness (myopia), long-sightedness (hyperopia), and asymmetry in the shape of the cornea (astigmatism). It can also benefit patients who need reading glasses.

Like other laser eye surgery techniques, LASEK reshapes the cornea and allows light to refract (focus) correctly on the retina.

LASEK and PRK are classed as surface laser treatments; you can consider them the same procedure. The results and healing are essentially the same.

Is LASEK safer than LASIK?

LASEK (also known as PRK) is an alternative to LASIK. LASEK is considered a safe and effective corrective laser eye surgery that allows more patients to benefit from laser eye surgery, either through choice or when not suitable for LASIK.

LASEK brings increased safety compared to LASIK for patients with thin corneas or if suspected of having some potential weakness in the strength of the cornea. For these patients, it is essential to maximise the strength of the cornea after treatment. 

Surface laser approaches, such as LASEK and PRK, leave a more significant proportion of untouched cornea afterwards, which is better for those with thinner or weaker eyes.

Short-term side effects of LASEK

Some patients experience minor side effects after surgery, but most will disappear within a few weeks or months.

During LASEK, the surgeon brushes the top layer of the lens to the side. Instead of discarding it, however, they keep it attached at one corner to be replaced at the end of the surgery. You should expect healing to take about a week to regenerate the epithelial cells.

You can read our article comparing LASEK and PRK to learn more about the differences between the two procedures.

During the first week, you can expect the following side effects:

  • Pain or discomfort, especially during the first 48-72 hours
  • Blurred vision
  • Watering eyes
  • Red eyes
  • Foreign body sensation

Side effects of the surgery in the following few weeks include dry eyes, glare, halos around bright lights, and some degree of blur. However, most side effects are short-lived, and LASEK is considered generally safe.

Most of these effects resolved during the first few months. The final vision result is measured around 4-6 months after treatment. By this stage, most dryness, blurring and glare have resolved.

Although the recovery time is longer than that of LASIK, it is still short enough to warrant surgery if you are interested in correcting your prescription permanently. 

Like any surgery, there are risks, and for a select few, there may be complications. To avoid experiencing difficulties, taking precautions and doing thorough research before deciding to have LASEK eye surgery is beneficial.

What Are The Risks Of LASEK?

It’s common for patients to experience some side effects during the recovery period after their surgery; however, these typically resolve without further intervention by 4-6 months after treatment when the eyes have healed fully.

Most complications and side effects experienced following LASEK surgery are short-term. However, for some, there are longer-term implications. 

In rare cases, some patients have no option but to undergo another operation, continue wearing spectacles or contact lenses, or use eye drops long-term.

Some of the side effects you may experience after LASEK eye surgery are:

  • Dry eyes, burning, or itching: This is a common side effect after having LASEK surgery. 20-40% of patients experience this to some degree. Dry eyes are at their worst around one to three months after surgery. Within six to twelve months, the symptoms have typically subsided. For a rare few, the symptoms persist indefinitely.
  • Glare or halos: Another common side effect after LASEK surgery. 20% of patients experience this side effect during the first 1-3 months. You may have sensitivity to bright lights and some trouble seeing in dim light or fog. This side effect lasts indefinitely for a very small number of patients, with the risk linked to the size of the prescription treated.
  • Under-correction: When this happens, the cornea absorbs too little energy, which removes less tissue. Undercorrection is usually easy to rectify with an enhancement procedure. Most surgeons wait at least three months, sometimes six, before offering an enhancement to allow the initial healing to complete.
  • Over-correction: When this happens, the cornea absorbs too much energy, which removes more tissue. Overcorrection is usually straightforward to rectify with an enhancement procedure.
  • Infection: Infections are rare with laser eye surgery. The incidence is one in 7,000 procedures for LASEK (or PRK) and one in 20,000 for LASIK. The rate is higher with LASEK than LASIK because of the more extended period for the skin layer to heal.
  • Corneal flap complications: Unlike LASIK eye surgery, there is no corneal flap and hence no flap complications.
  • Astigmatism: With any form of refractive surgery, some astigmatism can remain as the eye heals. Transient astigmatism is often seen after PRK and LASEK, lasting 1-3 months, which resolves naturally. If astigmatism persists, your surgeon may recommend laser enhancement surgery.
  • Vision loss or changes: This issue is rare and seldom occurs. Those who experience this complication may experience a worsening of their visual abilities.
  • Vision regression: The effect of the surgery may reduce over time. Often regression is based on the underlying prescription getting worse, meaning the short-sight is progressing after treatment while the laser result is stable. True regression of the laser effect can occur and is more common with high prescriptions.  Typically, only part of the initial benefit is lost. Enhancement surgery may be possible once the prescription is stable.
  • Slow healing time: A portion of the cornea is brushed aside or removed during the surgery, which can cause complications. Excess tearing, infection, pain on waking and slow regrowth during healing can cause issues. The process will take longer than after LASIK surgery. The regeneration of epithelial cells should take up to a week.

You should contact your doctor immediately if you experience discharge from your eyes, extreme pain, or sudden vision loss.

Increase Your Chances Of Success

Although LASEK has some risks, like with all surgery, this corrective eye surgery is highly successful, with excellent vision results.

To ensure you have a good chance of being among those who enjoy a positive experience with LASEK, follow a few essential guidelines before and after your LASIK surgery.

First, ensure that you are a good candidate for LASEK. 

Many people do not fit the criteria for this particular surgery, and some clinics may treat patients who aren’t optimal candidates. Choose your clinic carefully to ensure you are in the best hands.

If your eye doctor recommends you do not have LASEK, take their advice seriously. Get a second and third opinion, but be cautious.

At Focus, we perform many eye tests before recommending you for treatment, as well as before the treatment itself.

Several conditions should rule you out of having LASEK altogether, including:

  • Very dry eyes. This condition will prolong your healing time, and the treatment may worsen the dryness.
  • Some autoimmune disorders or diseases.
  • Diabetes – diabetic patients have worse healing and can do poorly with LASEK or PRK. LASIK eye surgery is preferred.
  • Rheumatoid arthritis, lupus, glaucoma, cataracts.

The Technology

The technology used during a LASEK procedure is highly advanced. Since laser eye therapy became popular in the late nineties, surgeons have been refining techniques and improving their methods and the tools needed to make them seamless.

LASEK technology has evolved as excimer lasers have improved. The technology is essentially perfected, so we have seen laser offerings plateau at a very high level. 

Most LASEK patients can expect 20/20 vision or better for short-sighted treatments, including astigmatism, with extremely low complication rates. 

During a LASEK surgery, your surgeon first uses an alcohol solution to loosen and detach the surface cells of the corneal epithelium. 

Depending on your surgeon’s particular method, your epithelial skin layer is brushed to the side, leaving it attached partly like a hinge. The alcohol solution is safe, although it does cause damage to the top layer of your eye’s cells, which will regrow after around a week.

An excimer laser (a cool, ultraviolet beam) removes tiny pieces of your cornea tissue by a process akin to evaporation. It reshapes the surface and lets your eye focus clearly by refracting light correctly. The laser is the same as used in a LASIK procedure.

Once your cornea has been sufficiently reshaped, your epithelium is replaced, and a medical contact lens is placed over it to assist the healing process. 

The laser used during the process is designed to detect any movement. Since you remain awake during the LASEK surgery, the laser machine will stop should you cough, sneeze or need to move for any urgent reason. It will only resume the procedure once you are still once more.

Modern lasers used in LASEK also rotate the treatment pattern to correct for any eye rotation, improving astigmatism correction.

The Bottom Line

LASEK is one of the safest procedures for suitable candidates, but there are risks, as with all surgery.

Some side effects can persist for some time after surgery, but for most patients, they are minor and last for a short while, leaving them with 20/20 vision. 

If you’re considering LASEK, book your free telephone consultation with a member of the Focus Clinics team. They’ll be happy to discuss your suitability and potential risks and put your mind at ease.


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