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Although the decreased thickness of the corneal flap during LASEK surgery makes vision correction surgery an option for patients with thin corneas or patients with steep corneas, there are some disadvantages to this procedure. Specifically LASEK surgery usually has a longer recovery period than LASIK. It is not unusual for LASEK patients to not have corrected vision for one to two weeks after the procedure, while LASIK patients may have corrected vision after only one day.
LASEK surgery patients also typically report more discomfort following the procedure than LASIK patients. However, this discomfort usually only lasts for one to two days. Other disadvantages to LASEK surgery involving the recovery period include the need to wear a specially-designed contact lens as a bandage for three to four days after the procedure and the need to use topical steroid drops for longer than required after LASIK surgery.
Patients who were previously determined to be less than ideal candidates for LASIK surgery may find the new LASEK procedure is a possibility for vision correction surgery. Laser epithelial keratomileusis, also known as LASEK, is a procedure which is used to treat astigmatism, nearsightedness and farsightedness. Patients who have steep corneas, as well as patients who have thin corneas are typically not ideal candidates for LASIK because the surgeon is unable to cut the corneal flap properly. However, LASEK employs a thinner cutting blade to make the corneal flap; therefore, surgeons can create the necessary flaps in these patients. Other patients, such as those who engage in leisure or career activities which put their eyes at risk, may also be better suited for LASEK because there is less of a potential for the flap to be disturbed after the procedure.
The LASEK recovery period is very similar to the recovery period following LASIK surgery with a few exceptions. Patients recovering from LASEK surgery can expect the flap created during the procedure to be fully healed after one day. However, they will likely have to wear a specially designed contact lens for four days following the procedure. This contact lens acts as a bandage during the recovery process.
The LASEK recovery process may have a brief period of discomfort following the procedure. This irritation usually only lasts for a day or two. Additionally, LASEK patients may not enjoy improved vision for approximately one week after the procedure. The patient will likely visit the surgeon for the first post-operative visit the day after the procedure. Additional visits usually occur one week after the procedure and three months after the procedure. These post-operative visits are critical because they enable the surgeon to evaluate the results of the surgery and determine whether or not there are complications which require emergency care.
There are a few preparations which patients should make before undergoing LASEK surgery. One of the most important preparations is meeting with the surgeon. This is important because it gives the patient the opportunity to learn more about the procedure, as well as the recovery process. Additionally, it will enable the surgeon to evaluate your eyes and obtain information, such as corneal thickness, refraction and pupil dilation.
Patients who wear rigid gas permeable contact lenses should also prepare for LASEK surgery by not wearing these lenses for three weeks before the surgery. This is important because it will help to ensure the shape of the eye is not modified at the time of the procedure.
Finally, LASEK surgery patients should arrive at the surgery center after eating a light meal, taking all required prescription medications and removing all eye makeup. In addition to these basic requirements, individual surgeons may have additional requirements for their patients. Following these instructions and arriving on time and properly prepared for the procedure is very important.
You trust your ophthalmologist, but when she suggests you have LASEK vs. LASIK, you're hesitant. You've always heard LASIK is the way to go.
Here's a vision tip: Ask your ophthalmologist why she thinks you're a better candidate for LASEK eye laser surgery rather than LASIK. She may tell you that:
* you have wide pupils
* you have thin corneas
* you have flat corneas
If your ophthalmologist gives these reasons, you are, indeed, a candidate for LASEK and probably don't need to seek a second opinion. You can check with another laser eye surgeon and have a thorough eye exam to see if you should have LASIK. If that doctor gives you the "flat corneas" answer, you'll probably end up having LASEK treatment.
Oh, there's another benefit: That post-operative haze you get with LASIK is reduced with LASEK eye surgery, especially if you need correction above 6.00 diopters. However, you'll still experience the usual visual effects and have to wear a contact lens bandage to hold the epithelium in place.
LASEK and LASIK; when you say them they sound very similar. However, there are many differences between these types of laser eye surgeries.
While both LASEK and LASIK involve numbing the cornea, repositioning of the flap and both use excimer laser treatments for the procedure, that is also where the similarities end.
With LASEK surgery, a medicinal alcohol is used during the procedure to treat the top layer of cornea cells for about 30 seconds. LASIK does not use a technique involving alcohol. LASEK uses a butterfly or superior hinge technique when making the flap and LASEK requires a soft contact lens as a bandage after surgery. LASIK requires no stitches or bandages for healing.
LASIK usually offers a generally less painful recovery LASEK and healing times vary between the two.
LASEK uses an alcohol solution on the cornea cells to destabilize them right before surgery. One disadvantage of LASEK is that the alcohol solution kills all of these cells on the cornea, which means they must be regenerated. This loss of cells may interfere with the patient's vision for a time after the procedure.
During the healing process, the cells that are dead will still need to be expelled from the area while the others that are in the process of healing will be allowed to live on. This process can take some time also. Therefore, with the use of the alcohol solution, LASEK often results in a longer time for vision to be restored, however, it is often with less complications when compared to other laser eye surgeries.
The entire LASEK surgery will only last seven to 10 minutes per eye. The healing process may take anywhere from from a few days to a few months. Please see you doctor if you are having problems healing from LASEK.
Is LASEK better than LASIK? LASEK was created as a surgery that would be safer than LASIK and reduce the problems associated with PRK. But does this make LASEK better or safer than LASIK?
The cons of LASEK are as follows: corneal cell loss, infection, debris that may get under the flap, side effects of oral analgesics and the chance of the epithelial not healing. The cons of LASIK are: complications with the flap, infection interface debris, and dry eyes.
The pros of LASEK are: fewer long term side effects, suitable for all people. The pros of LASIK are: less pain, and quicker vision recovery.
So, is LASEK better than LASIK? The answer strictly depends on the patient. It's best to always speak with your eye doctor or surgeon about which type of surgery is right for you.
Although LASEK surgery and LASIK surgery are very similar procedures which yield similar results, there are some advantages to LASEK. One of these advantages is the decreased potential for dry eye. Another advantage is the elimination of complications which stem from cutting and reattaching the flap in the cornea.
For some patients the most important advantage of LASEK surgery is the procedure can make vision correction surgery an option for patients who were considered poor candidates for LASIK. This includes patients with thin corneas and patients with steep corners. During LASEK the thickness of the flap cut in the cornea is significantly less than the thickness required during LASIK.
Does having LASEK mean that you will be at risk for having more complications?
LASEK was created to avoid the complications of other specific eye surgeries. However, there are still risks of complications, but this is typical with any type of medical procedure.
With LASEK, the biggest complaint is the pain. LASEK recovery does involve more pain and a longer recovery time. You may also develop halos, dry eyes or disrupted night vision. These problems typically right themselves in less than a year.
LASEK does not appear to offer a greater risk of complications when compared to other laser eye surgeries like PRK and LASIK. On the contrary, it actually has fewer long-term complications when compared with the other types of laser eye surgeries, such as LASIK or PRK.
As with every medical procedure, it is always best to get your doctor's opinion on the complications of LASEK.
As with any laser eye surgery, the right choice for you should be discussed with your doctor. However, there are certain people who may benefit from LASEK when compared to others.
If you are over 18 and your cornea has bends or irregularities in it, such as a corneal curve, then LASEK may be the choice for you. If your cornea is too flat or thin for LASIK, then LASEK may be your choice. If your cornea is too steep for LASIK, then LASEK may be the right procedure for you also.
If your ophthalmologist has determined that you are not a candidate for LASIK, discuss the possibility of LASEK.
One of the major problems of LASIK surgery that everyone dreads: corneal flaps. When the blade touches your cornea and the epithelium or the outer layer covering your cornea, you run the risk of having displaced flaps or flaps that are the wrong size. In fact, flap problems represent a large percentage of LASIK complications.
If you're debating LASEK vs. LASIK, know that LASEK laser eye surgery uses a trephine with a finer blade than the LASIK microkeratome in order to remove the epithelium from your cornea. After the excimer laser (the same laser used for LASIK) reshapes the cornea, your LASEK surgeon replaces the epithelium, so there are no corneal flaps. The epithelium heals and seals in about a day.
The downside of LASEK: Your vision takes longer to recover. But if you're concerned about corneal flaps, LASEK surgery will ease your mind, and put the light in your eye!
Although LASEK surgery has been shown to produce fewer side effects than other vision correction procedures, there may be some temporary side effects which may exist. Some of these side effects may include irritation, poor vision in dimly lit situations, dry eyes and hazy vision. However, it is important to note these side effects are usually temporary in nature and can often be managed.
An uncomfortable feeling of having a foreign object in the eye may exist for one to four days following LASEK surgery. Patients may also experience dry eyes for up to six months after the procedure, but this can be managed through the use of moisturizing drops. Hazy vision may also occur but it will typically clear up within six to nine months. Finally, LASEK surgery patients may experience poor vision in dimly lit situations for up to 12 months after the procedure, but this condition should improve over time.
If a LASIK surgeon has refused to perform LASIK on you because you have thin or flat corneas that are too thin to create the LASIK flap, LASEK eye surgery may be for you. Laser Epithelial Keratomileusis, or LASEK, is designed to correct corneal shape.
You may have resigned yourself to wearing glasses or contact lenses because you're not a candidate for the LASIK procedure. A LASEK vs. LASIK fact: LASEK surgery doesn't require the surgeon to cut the cornea with a microkeratome. LASEK ablates, or burns off, a small amount of tissue underneath the outer cornea or epithelium. The thin underneath cornea gets a remodel, becoming more spherical--you may not have as much cornea as a LASIK patient, but with LASEK, you can improve what you do have.
NOTE: If you have keratoconus, in which the cornea thins and becomes cone-shaped, you may not be a candidate for LASEK. And if you're a boxer with thin corneas, putting your eye at risk of injury, LASEK has fewer complications.
People with flat corneas, who are prone to farsightedness or hyperopia, can have the thin inner cornea tissue reshaped and rounded through LASEK surgery
LASEK eye surgery may require more healing time than LASIK, but if you have thin corneas, LASEK is better than struggling with your eyeglasses and contacts!
You'd like to be back on the golf course immediately after having LASEK laser eye surgery, but don't load those clubs just yet. Any procedure needs recovery time. Besides, you don't want to miss the ball when you've improved your swing.
One of the considerations in LASEK vs. LASIK is the longer healing time.
With LASEK treatment, you'll see full visual results in three weeks to six months as opposed to one to six weeks after LASIK. The upside: You can listen to those golf motivational tapes. With LASIK, you can see results within 24 hours as opposed to a week with LASEK. Also, with LASEK, you'll have to wear a contact lens bandage, and take steroid drops for several weeks longer than LASIK.
You don't even get to practice your game during the two to three sick days you'll take from work after LASEK eye surgery--with LASIK, you can be back on the golf course the next day – just ask Tiger Woods.
If you have thin corneas, or don't like the complications of the microkeratome laser (though LASEK surgery has its own complications), clear vision trumps the extra time away from the driving range.
It's important to note that LASEK, like LASIK, employs an excimer laser to ablate or burn off the cornea beneath the epithelium. LASEK has an advantage when your eye surgeon uses LASIK Wavefront or eye-mapping lasers and spot-tracking lasers (.8 to 2 mm diameter) that can better treat astigmatism. Wavefront guided lasers, in particular, give a more detailed picture of your corneal problems than traditional refractive surgery.
While eye-mapping lasers improve LASIK results overall, if you have thin corneas, your LASEK eye surgeon will work with all 250 microns of cornea underneath the epithelium, giving you, with your thin corneas, better results than you might have achieved with LASIK, especially if you have monovision and you're opposed to a microkeratome laser. However, thin corneas may be an issue because Wavefront mapping may reveal the need to remove more tissue than is safe for LASIK treatment. Consult your surgeon, especially if your surgeon has recommended LASEK eye surgery over LASIK.
Confused about LASEK vs. LASIK vs. PRK? PRK belongs in its own category--although all three procedures use an excimer laser to resculpt the cornea. Here's the skinny on LASEK:
1) You have a complete eye exam with diagnostic technology that gathers information about your vision and eye geography.
2) Nurses and an ophthalmologist apply a sterile drape to protect your eyes.
3) You get numbed with a sedative, and your eyes get numbed with eye drops.
4) A special instrument loosens the epithelium around the surgery area.
5) The epithelium is pushed to the side.
6) You look at a target light while a laser reshapes your cornea without disturbing the tissue.
7) A minute or two later, the laser eye surgeon smoothes the epithelium back into place and applies a contact lens bandage.
In LASIK, the ophthalmologist creates a hinged flap in the cornea. After the procedure, your eyes are examined with a slit lamp microscope, since there is an incision in your eye.
Does LASEK seem less complicated than LASIK now? They both carry risks and benefits. The one thing that won't cause you confusion: being able to read the paper without glasses.
You have healthy eyes but you need glasses, and you've developed an astigmatism--it's genetic, after all. In astigmatism, your cornea is shaped like a football. Your vision gets blurry because there's no single focus in the eye. Do you resign yourself to being four-eyes for the rest of your life?
Not necessarily. LASEK eye surgery can treat your astigmatism without the complications of LASIK. In the LASEK vs. LASIK debate, both reshape your cornea from a football shape to the normal basketball shape. The blurriness lifts, but with LASEK, your eye tissue is disturbed less, although there's a slight chance of scarring. Also, if you have wide pupils, you're probably a better candidate for LASEK eye laser surgery than LASIK.
So put away those glasses...and if your mom doesn't have cataracts or glaucoma but does have flat or thin corneas, you might encourage her to have LASEK and put away her glasses too.
You want to get rid of glasses because it doesn't fit with your lifestyle. Maybe you're a commercial pilot and have developed thin corneas as well as myopia. Can you have LASEK to save your career?
All aviation professionals would argue that, LASEK vs. LASIK debates aside, you need to fully heal before you can fly. Also, if you're hoping for 20/20 vision, aim higher: Pilots need 20/16 or 20/10 vision. Fortunately, with custom LASIK, LASEK and the new Wavefront-guided lasers, you have a good chance of achieving 20/16 or even 20/10 vision.
Some LASEK eye surgery patients, or pilots who have had PRK, complain of reduced vision in low light conditions. Still, if you hope to pilot an F-16, you're better off having LASEK eye surgery than LASIK, since Uncle Sam won't allow LASIK patients to fly--the exception is Wavefront LASIK.
Remember, healing takes longer with LASEK and PRK than LASIK. The military and the airlines won't let you fly until you've been fully healed, so you may just have to watch "Top Gun" while your eyes are healing for several months--you have to submit an FAA form after three months. For more information, contact your recruiter or the FAA, www.faa.gov.
|Sheri Ann Richerson|