LASEK vs LASIK

LASIK vs. LASEK: Which is Better for You?

LASIK and LASEK are laser eye surgeries that can correct vision problems. Both procedures reshape the cornea with excimer lasers. 

Additionally, both are highly successful at correcting refractive errors, including:

• Myopia (nearsightedness). With myopia, you have difficulty seeing distant objects clearly
• Hyperopia (farsightedness). With hyperopia, you have difficulty seeing close-up objects clearly
• Astigmatism. Astigmatism is distorted vision due to irregularities in the shape of the cornea or the lens

Though they share similarities, these procedures have distinct differences that are important to understand. This article covers everything you need to know to determine whether LASIK or LASEK is best for you.

What is LASIK?

LASIK stands for Laser-Assisted In Situ Keratomileusis. It is a laser eye surgery that permanently corrects your vision by reshaping your eye’s corneal tissue. 

The cornea is the part of your eye that helps to bend and focus light to create an image. However, it is not always perfectly shaped, which can cause refractive errors that impact your eyesight.

LASIK uses a femtosecond laser to cut a flap in the cornea and reshape the tissue. Then, the surgeon replaces the flap, and the tissue heals on its own. It takes only a few hours to a day to heal from LASIK. Most people have clear vision within hours after surgery.

What is LASEK?

LASEK, which stands for laser-assisted subepithelial keratectomy, is a modification of PRK. PRK has been around longer than LASIK, but both are still widely used today. LASEK combines the benefits of PRK and LASIK.

The procedure uses an excimer laser and an alcohol solution to loosen the cornea. Compared to LASIK, the cuts require less precision. However, LASEK is a more invasive procedure that involves a longer recovery period.

LASEK may be a better choice for people with thin corneas. This procedure doesn’t involve removing as much corneal tissue as LASIK.

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5 Main Differences Between LASEK and LASIK

Here are five key differences between LASEK and LASIK:

1. Surgery Complexity

LASIK is considered an easier surgery than LASEK, with less downtime and a quicker recovery. This is because LASIK is less invasive than LASEK.

2. Treatment Length

Both refractive surgery treatments can be done in one day — typically within a half hour. While the surgeries may sound long and painful, they are fairly quick and easy. Given today’s technology, they can be done immediately.

LASIK surgery may be quicker because it is typically less invasive. The surgery can be done in as little as 10 minutes on each eye.

3. Post-Operative Care

The recovery time for LASIK surgery tends to be quicker than for LASEK since the surgery does not involve as much cutting away. With both surgeries, you may feel discomfort for a month or more. But you should see clearly immediately after.

If any issues arise after either surgery, reach out to your healthcare provider immediately. Both surgeries are safe and effective, so you should not have any major issues after surgery, barring mild discomfort.

4. Candidacy

People who are not good candidates for LASIK (such as those with thin corneas) are generally considered for LASEK. It is essential to talk to your eye doctor to weigh your options and make an informed decision on which surgery is right for you.

5. Cost & Insurance Coverage

Insurance typically does not cover LASIK or LASEK eye surgery. It’s worth reaching out to your provider to ensure that your plan includes whichever surgery you choose.

Surgery costs can add up depending on the type of surgery you choose, where you have the surgery done, and how complicated your surgery is, including other factors. But vision insurance and some medical insurance may be able to help shave off some of the price.

How Does a LASIK Procedure Differ from LASEK?

The primary difference between LASIK and LASEK is how the procedure is performed.

What Happens During a LASIK Procedure?

LASIK surgery only takes about 10 minutes for each eye and causes little to no pain during the procedure.

Here's what to expect during LASIK surgery:

1. Your eyelids are held open with a tool so the eye surgeon can work. Then, your eye doctor places eye drops that contain a numbing agent in your eyes.
2. The surgeon uses a small blade or special laser to cut a thin flap in your cornea. This is the part that may cause some discomfort for the patient. Many people report feeling "a sensation of pressure" during this part of the surgery.
3. The excimer laser gently reshapes your cornea. It is guided by a computer that has a map of your eye preloaded into it.
4. After the excimer laser finishes, the surgeon smooths the corneal flap back into place.
5. If you are getting both eyes operated on, this process will immediately be repeated on the other eye.
6. Once finished, your eye surgeon, or a team member, will provide you with an eye shield and detailed instructions for recovery.

What Happens During a LASEK Procedure?

Different techniques can be used for this procedure, but the general steps of LASEK surgery include:

1. Topical anesthesia is placed directly on your eye to make it numb.
2. The epithelium (top layer of cells on your cornea) is treated with alcohol for about 30 seconds.
3. The epithelium is detached from the underlying tissue and rolled back to provide the surgeon access to the corneal tissue.
4. The same type of laser that is used in LASIK treats the cornea to correct your vision.
5. The top layer of cells is put back in place.
6. The wound is typically treated with topical steroids and antibiotics, and a soft contact lens is placed over your eye to protect it.

After 3 to 4 days, the soft contact lens can be removed once the eye is healed.

LASIK vs. LASEK: Success Rates

LASEK and LASIK are both highly successful types of laser eye surgery. More than 90% of people who get either procedure achieve 20/40 vision or better after surgery.

The effects of both last forever. This is because the surgeon reshapes your cornea, physically removing the imperfections at the root of your refractive error.

However, because your vision changes throughout life, you may develop other refractive errors down the line. You may still need to wear glasses or contact lenses after laser eye surgery, but this is not a result of regression following the procedure.

Pros and Cons of LASIK and LASEK

LASIK and LASEK achieve the same effect, but each procedure has different benefits and disadvantages.

Benefits of LASIK

LASIK is a permanent treatment for myopia, hyperopia, and astigmatism. Additionally, clear vision can help relieve other symptoms, such as headaches, that come with blurred vision.

Other pros of LASIK include:

• Fast healing time of 24 hours or less
• Minimally invasive eye surgery
• Improves vision to 20/40 or better
• Discomfort is mild and resolves quickly
• Reduced risk of complications, such as hazy vision

Common Side Effects of LASIK 

Side effects and risks involved with LASIK include:

• Dry eye (common)
• Higher risk of corneal flap complications
• The flap can dislodge if you experience head or eye trauma before fully healed

Benefits of LASEK

The biggest benefit of LASEK, like LASIK, is a permanent vision solution. It is a minimally invasive, quick, and safe surgery to fix your eyesight immediately.

Other pros of LASEK include:

• Safe alternative to LASIK for people with thin corneas
• No risk of corneal flap complications
• Dry eye side effect is less common than LASIK

Common Side Effects of LASEK

LASEK's side effects include:

• Dry eyes
• Nighttime glare
• Halos in the dark
• Discomfort

Compared to LASIK, the cons of LASEK include:

• Longer recovery process of three to five days
• Vision may take longer to clear
• Pain and discomfort can last a few days or more
• Risk of hazy vision due to a compromised corneal structure

LASIK vs. LASEK vs. PRK

Both LASIK and LASEK create flaps in the cornea. However, a LASEK flap is much thinner and only involves the epithelial layer of tissue. 

During PRK surgery, the entire outer layer of the cornea (surface epithelial cells) is removed. After PRK, the eye heals and grows a new epithelial layer.

Which Surgery Is Best for You?

PRK, LASIK, and LASEK surgery are all great options for vision correction. The best surgery will depend on:

• Your corneal thickness
• Your eye health
• Your general health
• Your lifestyle
• Your age

Laser eye surgery is a permanent solution that corrects your vision. LASIK, LASEK, and PRK are ideal compared to reading glasses and contact lenses.

Laser eye surgery is not for everyone. For example, you should not get eye surgery to correct your vision if you are under 18. There’s a chance that your eyes are still developing, which means your vision can change with time.

The best age to get eye surgery is between 20 and 40. This is after you have had a stable prescription for at least two years.

Schedule a consultation with a qualified eye surgeon to determine which surgery is best for you. They will ask about your medical history, take a corneal topography, and make a recommendation based on your eye and general health status.

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