LASEK Fact Sheet

Laser epithelial keratomileusis (LASEK) is a newer form of laser vision correction that Cole Eye Institute surgeons are now offering to some patients. LASEK combines many of the benefits of the two most commonly performed procedures - LASIK (laser assisted in-situ keratomileusis) and PRK (photorefractive keratectomy) - and can deliver excellent visual results in the right patients. The technique was invented several years ago by Massimo Camellin, M.D., an ophthalmologist in Italy.

All laser vision correction works by reshaping the cornea, or clear front part of the eye, so that light traveling through it is properly focused onto the retina (back of the eye). The cornea has five distinct layers. In LASEK, the top layer of cells, or epithelium, is treated with alcohol for about 30 seconds to detach it from the underlying tissue, then it is lifted or rolled back. The newly exposed tissue is treated with the same laser used in LASIK or PRK, then the top layer of cells is replaced.

This is in contrast to LASIK, in which a cutting device known as a microkeratome makes a flap in the stroma, exposing a deeper layer of the cornea, followed by the laser treatment and replacement of the flap. LASEK differs from PRK by preserving the top layer of cells, rather than scraping them away and waiting for them to grow back. This is supposed to facilitate healing of the cornea with less discomfort than PRK. LASEK avoids some of the complications that can be associated with LASIK, such as problems with the operation of the microkeratome, problems with the thickness and size of the flap, or difficulties reattaching the flap after treatment. LASEK appeals to some patients who do not like the idea of having their eye cut.

LASEK may also be better for patients who have steep or very thin corneas which make it difficult for the surgeon to make a proper LASIK flap. Also, since traumatic injury to the eye is more serious after LASIK than LASEK, patients who engage in professional or leisure activities that put their eyes at increased risk for injury (such as boxing) may be better suited for LASEK. LASEK also causes dry eye less frequently than LASIK does, so it appeals to patients who suffer from that condition.

On the negative side, however, LASEK patients generally have a longer visual recovery time than LASIK patients. Many LASEK patients will not fully recover functional vision for 1 to 2 weeks while their eye heals, which is similar to the healing time experienced in PRK. LASIK patients often have good vision by the day after surgery. Also, LASEK patients report experiencing more pain and discomfort than LASIK patients do, but less pain than PRK. Most LASEK patients report the discomfort lasts about 2 days or less. Patients need to wear a "bandage contact lens" for about 3 or 4 days after LASEK to serve as a protective layer between your blinking eyelids and the treated eye surface, which is not necessary after LASIK. They also must use topical steroid drops for several weeks longer than that used after LASIK.

LASIK is by far the most commonly performed laser vision correction procedure today, but LASEK is expected to become more widely performed as so-called customized treatments become available, because such personalization of laser vision correction results are more easily obtained with "surface" treatments such as PRK and LASEK.

Dr. Ronald R. Krueger, Medical Director of Refractive Surgery at the Cleveland Clinic Cole Eye Institute, co-organized the first international congress on LASEK surgery to further investigate and teach the benefits of LASEK.

Schedule a free consultation with our team of experts to see if one of these procedures is right for you. Call 216/445-8585 for an appointment.