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Lasik Or Lasek - Which Laser Eye Surgery Procedure Is Right For Me?

Mar 25, 2008
What is the difference in the two main laser eye surgery procedures?

There are basically two laser refractive procedures to correct myopia (short sight), hyperopia (long sight) and astigmatism: 1) LASIK and 2) LASEK. [You might also have come across the PRK laser procedure. You can consider LASEK and PRK as basically the same procedure for most discussions - they are both forms of 'surface' laser eye surgery with pretty much identical results].

LASIK is a two stage procedure. Firstly a superficial flap is created in the top part of the cornea (the clear window at the front of the eye). The vision correction laser is then used to reshape the inner part of the cornea and so eliminate the need for glasses. The first flap creation stage used to be carried out with a mechanical blade device, but modern clinics are now using a special so called 'femtosecond' laser to prepare the flap in a safer and more accurate way. There will be grittiness for 3-4 hours only and vision is usually fairly clear within several hours.

In the LASEK procedure, there is no structural flap made as in the LASIK method. In LASEK, the surface skin cells are brushed to the side, the laser applied to correct the vision, and the cells brushed back into place. A contact lens is then placed on the eye. This procedure is painful for the first 2-3 days and vision recovery takes 4-7 days.

Both LASIK and LASEK procedures are very safe and will give you the same final results. It can be quite confusing if you are thinking about laser vision correction and want to know which procedure would be best for you. While both LASIK and LASEK can give you excellent vision in a safe and reliable way, some surgeons prefer one or the other, or may indeed only offer one type anyway!

How is the prospective patient supposed to decide?

What happens in practice is that patients are greatly influenced by what their particular clinician says, and understandably so. It is always worth seeking a second opinion and comparing the findings and comments of each centre. This shouldn't threaten any clinic worth its salt. Some patients feel more confident with one person or another, based on perhaps only "chemistry", but it is very important to know the difference in the techniques.

About 90% of all laser eye surgery treatments are done with the LASIK method. The lack of pain and the very rapid vision recovery are very appealing to most patients.

There are some patients who are not suitable for the LASIK method, usually due to anatomical factors in the eyes and may be eligible though for a LASEK surface laser technique.

It is worth noting that with the arrival of femtosecond lasers, such as the Ziemer LDV system, that some patients who were previously pushed into the LASEK group due to e.g. thin corneas, can now still have dual laser blade free LASIK. This is because the femtosecond lasers can create a very thin predictable flap and so preserve corneal strength.

LASIK and LASEK are both very effective procedures and can be used to treat myopia (short sight), myopia myopia(long sight), astigmatism (irregular corneal shape).

However, for reading vision problems, please be aware that many clinics do not have the correct technology required to correct these vision problems, including higher levels of long sight.
About the Author
Dr. David Allamby is medical director at FOCUS Laser Vision, a specialist laser eye surgery clinic in London, UK. You can find more information on laser eye surgery at Dr. Allamby's LASIK blog.
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