Should I Get LASEK?

Laser eye surgery has transformed the lives of millions who wish to be free from glasses or contacts. However, procedures like LASIK may not be the best option for everyone, especially those with thin corneas.

That’s where LASEK (Laser-Assisted Sub-Epithelial Keratomileusis) comes in. Let’s discuss what it’s all about.

What Is Laser Epithelial Keratomileusis (LASEK)?

Your cornea is like a multi-layered window—it consists of different layers that work together to focus light. LASEK focuses on reshaping the middle layer to correct vision issues.

Just like in LASIK, a precisely controlled excimer laser reshapes the cornea to correct your specific vision error. However, instead of cutting a thick flap, a diluted alcohol solution is applied to loosen your cornea’s thin, outermost layer (the epithelium).

This thin, loosened sheet of cells is gently rolled to the side, exposing the underlying corneal tissue. The epithelial sheet will then be carefully repositioned, and a bandage contact lens will be placed to aid healing over the next few days.

Why Choose LASEK? 

If you’ve been told you’re not a candidate for LASIK due to thin corneas, LASEK could be an excellent solution. Since it preserves more corneal tissue, it’s safer for people who are naturally more prone to corneal weakness.

LASEK also allows more people to experience the benefits of laser vision correction. However, like any procedure, it has its drawbacks.

For instance, most people find the first few days after LASEK more uncomfortable than those after LASIK, as the epithelial layer regenerates. And since LASEK is slightly more technically demanding than LASIK, an experienced surgeon makes a big difference in your outcome.

The LASEK Procedure: From Preparation to Recovery

LASEK can feel like a big step, so let’s break down what to expect, from your first consultation to getting back to the activities you love.

Step 1: Is LASEK Right for Me? 

The first step is meeting with a skilled eye surgeon for a thorough evaluation. They’ll check your:

• Overall eye health. This ensures there aren’t other problems that could affect your outcome.
• Corneal thickness. Precise measurements confirm that LASEK is a safe option.
• Degree of vision error. This determines the amount of laser correction needed.

This is also your chance to address any worries. Ask about the surgeon’s experience, expected outcomes, and anything else on your mind. A good surgeon will take the time to explain everything clearly and address your concerns.

Step 2: The LASEK Surgery

The surgery itself is usually outpatient and relatively quick. Here’s the basic flow:

• Numbing the eye. Drops ensure you won’t feel any pain.
• Loosening the epithelium. A special alcohol solution prepares the surface layer of your cornea for the laser.
• Laser reshaping. The surgeon uses the laser to reshape the cornea based on your unique prescription, improving your vision focus.
• The epithelium as a bandage. The surface layer is repositioned to promote healing.

Step 3: Your Recovery Journey

This is what you can expect during the following weeks after your surgery:

• Initial healing. Expect a few days of discomfort (think tearing, light sensitivity) while the epithelium grows back. Your surgeon may give you specific care instructions and medication for this.
• Follow-up visits. Checkups are key to monitoring healing and managing any side effects.
• Vision improves over time: While initial improvement might be noticeable, full results can take several weeks or even months. Be patient!

Tips for a Smooth LASEK Recovery

After your surgery, it’s best to plan for a few days of rest from work and screen-heavy activities for optimal healing.

Your surgeon’s aftercare plan is there for a reason. Use prescribed drops and avoid any actions that might irritate your eyes.

Protection is also essential. Sunglasses help outdoors, and your surgeon might recommend avoiding swimming or other water-related activities for a period of time.

How to Choose a Surgeon

Choosing the right surgeon is as important as the procedure itself. Here’s what to look for:

• LASEK experience. Don’t just focus on the number of laser surgeries your surgeon has done; specifically, how many LASEK procedures they’ve performed and how often they perform LASEK currently.
• Technique. Some surgeons have developed variations on LASEK to improve comfort or results. Ask how their approach differs from ‘standard’ LASEK and why they recommend it.
• Technology. Wavefront guidance and newer lasers increase precision. Find out what your surgeon uses and how it can benefit your case.
• Consultation proper. Did they take time to explain things clearly, and listen to your concerns? Did you feel rushed? Trust your gut⁠—your eye health deserves a great communicator and a compassionate care provider.
• Second opinion. Even if you like a surgeon, getting another opinion provides reassurance and may offer insights that help you decide confidently.

Benefits, Risks, and Outcomes of LASEK

Let’s dive into the pros, cons, and what you can realistically expect:

What are the Benefits of LASEK?

LASEK doesn’t create a thick flap, which is crucial if you have less corneal tissue to work with. This reduces the risk of compromising the cornea’s strength during the procedure.

Despite this difference, LASEK boasts a high success rate in correcting various refractive errors. Most people experience significant vision improvement.

Additionally, LASEK also allows many people who aren’t candidates for LASIK to still benefit from laser vision correction.

Potential Risks and Complications of LASEK

It’s important to consider several factors when considering LASEK eye surgery. For instance, the recovery process can be slower than with LASIK since the initial healing of the epithelial layer might take several days.

Temporary discomfort and dry eyes following the procedure are normal⁠—your doctor will provide methods to manage this. 

Like any surgery, there is a small risk of infection or haze developing. However, this is generally treatable with diligent aftercare and regular follow-up appointments.

What Results Can You Expect from LASEK?

Most people notice some vision improvement quickly, but it can take several weeks or even months for their eyesight to stabilize fully. The goal of LASEK is improved vision—for most people, this means freedom from glasses or contacts for most daily activities.

Remember that the decision is very personal. A comprehensive consultation with an experienced LASEK surgeon is crucial. It will clarify whether it’s a good option for your specific situation, as well as address any anxieties you have.

Advances in LASEK Technology and Research

LASEK isn’t just sitting still⁠—researchers and surgeons are always finding ways to fine-tune it. Today’s excimer lasers are more precise than ever, allowing for better results and a greater chance of achieving your vision goals.

Wavefront-guided LASEK also creates a ‘fingerprint’ of your vision errors for a custom treatment. This can even improve things like night vision, which a standard LASEK procedure wouldn’t address.

Researchers are also seeking better ways to understand and support how the epithelium heals. Refinements in pain management might make the days after LASEK even easier.

Making LASEK More Accessible

Since LASEK is safer for thin corneas, these research advances are allowing more people to experience the benefits of laser vision correction.

While LASEK and similar procedures aren’t always covered by insurance, efforts are being made to improve accessibility and reduce out-of-pocket costs.

Is LASIK the Right Procedure for Me?

If freedom from glasses or contacts is your goal, and you have thin corneas, it’s definitely worth deeper exploration. Here’s what you need to carefully consider:

• Your corneas. Your eye doctor will measure your corneal thickness and assess its overall health. This will determine whether LASEK is safe for you. 
• Risk tolerance. Thin corneas increase the chance (though it’s still small) of a complication called ectasia, where the cornea weakens further after surgery. You need to be comfortable with that slight risk.
• Longer road to recovery. Be prepared for LASEK healing to take longer than LASIK. Are you okay with a few days of discomfort and a slower return to your best vision?
• Expected results. LASEK is excellent but not magic. Have realistic expectations about how much your vision will likely improve and what visual limitations may remain.

No one can rush you into this. Take your time, research, and remember⁠—it’s perfectly fine to decide LASEK isn’t for you. There might be other options, or you might simply stick with glasses or contacts and enjoy what they offer.