LASIK vs LASEK: What is the difference?


What is LASEK?

LASEK eye surgery is a form of laser vision correction that is used to treat nearsightedness, farsightedness, and astigmatism.  Like LASIK and PRK – other types of laser vision correction – LASEK reshapes the surface of the eye – known as the cornea – using an excimer laser.  By reshaping the cornea, LASEK improves the focusing power of the eye, resulting in clearer vision without relying on glasses or contact lenses.  Generally speaking, LASEK is recommended for patients who would otherwise be good candidates for PRK. When comparing LASEK vs. LASIK make sure you clearly understand the difference.

LASIK vs. LASEK: Difference between LASIK and LASEK?

Not everyone is a candidate for LASIK. However, those who aren’t good candidates for LASIK may find LASEK is an option for their vision correction needs.  Generally speaking, all forms of laser vision correction have comparable results for those who are good candidates. 

The fundamental difference in how LASIK and LASEK are performed involves the preparation of the eye for the laser treatment.

During LASIK, a thin flap is created on the cornea using a microkeratome or a femtosecond laser surgical tool.  The laser vision correction treatment is applied to the cornea surface under the flap.  The flap is then placed back over the treated area.  The replaced flap serves as a natural bandage, keeping the eye comfortable during healing which provides excellent vision by the next day.

LASEK vs. PRK: Difference between PRK and LASEK?

During PRK, the surgeon first removes a thin outer layer of the cornea – a layer of cells known as the epithelium.  The epithelium may be removed with a mechanical device a spatula or with the aid of alcohol. The underlying corneal tissue is then reshaped with an excimer laser. A bandage contact lens is then placed and a new epithelial layer grows back within approximately five days.

How does LASEK Work?

LASEK procedure involves a little of both LASIK and PRK procedures.  Like PRK, in LASEK the layer of cells covering the cornea – known as the epithelium – is separated from the underlying tissue. But instead of completely removing and discarding this tissue, as in PRK, the LASEK surgeon eases the epithelium to one side of the cornea, keeping it attached to the eye.

The excimer laser vision treatment is applied to the exposed cornea and the epithelial tissue is repositioned back onto the surface of the eye.  Then a bandage contact lens is placed on the eye to keep the epithelium in place as it heals.

There is a version of LASEK called epi-LASIK or e-LASIK that doesn’t use alcohol to loosen the epithelium. In epi-LASEK, the surgeon only uses a blunt, plastic blade to separate the epithelium from the eye. This technique avoids the possibility of a reaction from the alcohol, which can damage epithelial cells.

LASEK can be a good option for those patients who have thin corneas, or extremely high prescriptions, which may make them a less-than-ideal candidate for LASIK.  However, LASEK typically involves more discomfort and a longer recovery time than LASIK.

How to prepare for the LASEK Surgery Procedure?

The preparation for laser vision correction is largely the same regardless of what technique is recommended. Follow these 4 steps when preparing for LASEK surgery:

1. Are you a good candidate for LASEK surgery?

First and foremost, your eye surgeon will conduct a thorough evaluation of your eye to make sure you are a good candidate for laser vision correction and discuss which procedure best suits your circumstances.

2. Stop wearing contacts for a few days prior to the surgery date

Second, you will likely be told to stop wearing your contacts for a few days before your surgery date.  This is to make sure the measurements of your eye needed for the surgery are as accurate as possible (contacts can change the shape of your cornea).

3. Know what to expect during the LASEK procedure

Third, you should know you will be awake for the procedure.  You may be given valium or other anti-anxiety medication to help you relax during the procedure.  Don’t worry, your eye surgeon will apply numbing drops to your eyes to keep you comfortable.

4. Have travel arrangements planned

Finally, be sure to arrange for someone to take you home after the procedure – you won’t be able to drive yourself. 

How long is LASEK Recovery?

One important difference between LASEK vs. LASIK is the recovery time.  With LASEK, you’ll need to take some time off work to allow your eyes to heal, typically about a week.  As with all laser vision correction procedures, there will be a regime of medicated drops prescribed to help keep you comfortable and support the healing process during recovery.

LASIK, PRK, and LASEK all have high success rates and similar vision outcomes.  Because the choice of a procedure comes down to a patient’s specific vision and anatomy, after a thorough eye exam, your eye surgeon will advise you on the best type of laser eye surgery for your individual needs and requirements.

Published October 28, 2021
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