Ashfield Eye Clinic, Ashfield, NSW

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How LASEK differs from LASIK

LASEK differs from LASIK in that LASEK is a far less invasive procedure.

LASEK involves the re-sculpting of the corneal surface to improve the focusing ability of the eye . . . whereas LASIK involves cutting a flap in the cornea. Thus, with LASEK, the laser is applied to the surface of the eye only.

Leading ophthalmologists have moved in this direction because it eliminates many of the risks associated with the cutting procedure involved in LASIK.

With LASEK, for example, there is less risk of a patient developing a condition known as “chronic dry eyes” and a consequent dependence upon lubricating drops. (The fact that it is not necessary to cut a flap means there is no disturbance of the nerves which trigger the tear glands.)

There is also no risk of a corneal flap becoming dislodged and damaged in sporting or other physical activities, as exists with LASIK. Further, LASEK eliminates any risk associated with the application of suction to the eye, which is a part of the LASIK procedure.

The new LASEK procedure also provides the surgeon with superior ability to treat people with thin corneas and helps him deal better with cases of astigmatism, as LASEK results in less biomechanical change in the eye. Thus, it minimises any potential instability, and there is no weakening of the structural integrity of the cornea.

The fact that LASEK does not disturb the architecture of the eye also allows the surgeon more scope for re-treatment, although the incidence of necessary second procedures is less than with LASIK.

Eliminating Confusion

There exists confusion with regard to the fact that LASEK is, technically speaking, a refinement of the original surgical technique known as “PRK” – a technique which was the forerunner of LASIK.

In fact, LASEK, Epi-LASIK, Advanced Surface Laser Treatment (ASL) are all synonyms for PRK.

Here is clarification on this important point:

LASEK is, in fact, a highly evolved form of PRK (Photorefractive Keratoplasty) i.e. BUT with considerable modifications that render it equal to or better than LASIK in terms of safety, efficacy, and ultimate result.

From the surgeon’s perspective, control and predictability are greatly improved, with better visual outcome in terms of quality of vision, sharpness and clarity of night vision (the pupil is larger at night, placing a higher reliance on the cornea’s periphery, which stays undisturbed in the less invasive LASEK technique).

Importantly, LASEK has been enabled by improvements in technology and incorporated into the Schwind ESIRIS Scanning Spot Laser – a highly sophisticated piece of German-engineered technology that only a proportion of ophthalmic surgeons have access to.

The Schwind’s laser beam has what is termed a Gaussean profile i.e. a bell-shaped curve to the end of the beam of energy it emits. This results in a smoother corneal surface.

Schwind perfected its technology in recognition, over the past few years, that this advanced form of PRK would become the procedure of choice for surgeons whose prime concern is safety and ultimate best outcome for the patient.

For the “impatient patient” there is one drawback with LASEK over the conventional LASEK procedure:

As is commonly promoted, with LASIK the healing process is usually complete within 24 hours. With LASEK, the vision typically becomes blurry and may remain that way for two to three days while the slower healing process of between three and four days takes place.

However, the less invasive nature of LASEK, its lesser incidence of risk, and its scope for superior long-term results, renders this more evolved procedure the only one Dr Barry Den will employ on a patient, when that patient’s condition allows this choice.