LASEK, or Laser-Assisted Subepithelial Keratectomy, is a vision correction procedure that uses a laser to reshape the cornea. This surgery is a popular alternative to relying on corrective lenses such as glasses or contact lenses for daily life. The primary goal of LASEK is to correct common refractive errors, which include myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. By altering the curvature of the cornea, the procedure allows light to focus more precisely on the retina, resulting in clear, uncorrected vision.
The Mechanism of LASEK Surgery
The LASEK procedure is classified as a surface ablation technique because the laser treatment occurs on the outer layers of the cornea. Unlike other procedures that cut a deeper flap into the tissue, LASEK begins with the application of a diluted alcohol solution to the eye’s surface. This alcohol serves to gently loosen the adhesion of the corneal epithelium, which is the outermost layer of cells.
The surgeon then uses a specialized instrument to carefully push this thin epithelial layer aside. Exposing the underlying corneal tissue, called the stroma, allows the excimer laser to be applied. The laser precisely removes microscopic amounts of stroma to correct the refractive error, sculpting the cornea into a new, ideal shape. Once the laser ablation is complete, the epithelial sheet is repositioned back over the treated area, acting as a natural protective covering.
Why LASEK is Chosen Over LASIK or PRK
LASEK is often recommended for patients who do not qualify for the more common LASIK procedure due to specific anatomical factors. A primary reason for choosing LASEK is that it is the preferred option for individuals with corneas that are naturally thinner than average. Because LASEK only involves lifting the very thin epithelial layer, it preserves more of the deeper stromal tissue compared to LASIK, which requires cutting a flap that includes both epithelial and stromal tissue.
The absence of a permanent, deep stromal flap also makes LASEK advantageous for those with high-impact or occupational risk factors. Patients involved in contact sports, military service, or law enforcement may be better suited for LASEK, as it completely eliminates the potential for flap-related complications or displacement from severe trauma. Structurally, LASEK’s method of treatment avoids the creation of a deep incision, which minimizes the risk of certain complications and preserves the overall biomechanical integrity of the cornea.
The Post-Operative Healing Timeline
The initial healing process following LASEK involves a period of greater discomfort compared to LASIK, since the epithelial layer must fully regenerate and reattach. Immediately following the procedure, a protective bandage contact lens is placed over the eye to shield the repositioned epithelial cells and aid in the healing process. This lens typically remains in place for three to seven days until the surface cells have sufficiently repaired themselves.
Patients should expect moderate pain, a gritty sensation, and light sensitivity during the first 48 to 72 hours as the epithelium heals. Surgeons typically prescribe pain medication and anti-inflammatory eye drops to manage this initial discomfort. While the protective lens is removed within the first week, vision may remain blurry and fluctuate for several weeks as the corneal surface smooths out. Full visual stabilization and the final outcome of the procedure can take between three and six months.
Screening Requirements for Candidates
Determining suitability for LASEK involves a thorough examination of a patient’s overall eye health and medical history. Candidates must be at least 18 years old to ensure that their eyes have reached full maturity, and the prescription must have remained stable for a minimum of one year prior to the surgery. Active eye conditions, such as severe dry eye syndrome, infections, or uncontrolled autoimmune diseases, typically require resolution before the procedure can be performed.
The primary clinical requirement for LASEK is the existence of a refractive error that falls within a treatable range. Unlike LASIK, which requires a thicker cornea for flap creation, LASEK is often the recommended choice precisely because it can be safely performed on corneas with lower-than-average thickness.