Laser Epithelial Keratomileusis (LASEK): Cost & Effects

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What is LASEK? 

The LASEK procedure is suitable for anyone with a very thin or very steep cornea. 

This surgery is a slight variation of the LASIK and PRK procedures. 

In the LASIK procedure, the surgeon uses an instrument called microkeratome to create a thin flap which remains hinged on the eye, enabling him to lift this outside layer of the cornea. He then reshapes the cornea using an excimer laser. The flap is then re-positioned back on the cornea and acts as a natural bandage.
On the other hand, in the PRK procedure, the surgeon removes the entire upper layer of the cornea (epithelium) and then uses targeted laser or excimer laser to correct and reshape the cornea. After the surgery, a clear contact lens which acts as a bandage is placed over the eyes.

Am I eligible or an ideal candidate for LASEK?

LASEK surgery may be ideal for you if:

  • You are above 18 years of age, and have a very high degree of short-sightedness which requires the removal of more corneal tissue.
  • It is ideal for you if you have very thin corneas, suffer from dry eyes, are concerned about a corneal flap, or if you had eye surgeries such as PRK done earlier.
  • If you are a sportsperson, or are in any profession which puts you at high risk of eye injury and you lead a very active lifestyle,

It is not ideal for you if:

  • you suffer from eye diseases or retinal/optic nerve diseases such as keratoconus, cataracts, corneal disease, herpes simplex, herpes zoster, or from autoimmune diseases such as multiple sclerosis, rheumatoid arthritis, or Lupus, or conditions such as diabetes, arthritis, collagen vascular disease.  
  • you take steroids or immunosuppressants, or are prone to allergies or keloids.

Note: You need to have stable vision for a year before the date of the surgery. 

How is the LASEK procedure performed? 

In the LASEK procedure: 

  • The doctor administers local anesthesia to numb the eyes.

Please Note: An eyelid holder is used to hold your eyelid open to prevent blinking and restrict any eye movement. 

  • The surgeon then uses a fine blade called trephine to make a small cut on the epithelial layer.
  • He covers the epithelial layer with a small cone through which he pours an alcohol solution. The eye is then left for around 30 seconds.
  • This alcohol solution loosens the rim of the epithelium, making it easier for the doctor to carefully lift and fold back the epithelial flap, and reshape the exposed corneal tissue underneath, using an excimer laser.
  • After the reshaping the cornea, the doctor places the epithelial flap back on the cornea.
  • A contact lens is then placed in the eye, which acts as a bandage, allowing the rim of the epithelial flap to heal.

The same procedure is repeated with the other eye. 

LASEK is a great alternative for patients who are not able to undergo LASIK surgery due to extremely thin or irregularly shaped corneas. LASEK is also a good option for patients who are not comfortable with the flap in their eyes created during LASIK surgery. 

LASEK surgery is performed to treat myopia (nearsightedness), hyperopia (farsightedness) and astigmatism.

Are there any side effects of LASEK? 

Following the surgery you may experience: 

  • the sensation of having a foreign body in the eye for around 4 days
  • poor night vision or cloudy vision under dim conditions upto 9 months
  • more pain and discomfort compared to the other procedures
  • dry eyes which is a common side-effect for which the doctor will prescribe eye drops for use upto six months after the surgery

Other side effects may include: 

  • infections
  • seeing halos around objects
  • sensitivity to bright light
  • inflammation
  • undercorrection or overcorrection of eye power too may occur, which may require further surgery or dependence on contact lenses or eyeglasses for selected or all activities.
  • a more serious side-effect, which could occur after LASEK surgery is thinning of the cornea, over time. Corneal crosslinking treatment helps to arrest such conditions. In this procedure custom-made riboflavin drops saturate the cornea, which is then activated by ultraviolet light. According to studies, this increases the amount of collagen cross-linking in the cornea thus strengthening the cornea.

Some of these conditions may require medications and will gradually disappear as the eyes begin to heal. 

Are there any pre-surgery and post-surgery guidelines for LASEK? 

Prior to going for an evaluation by an ophthalmologist, it is recommended to stop using contact lenses for four weeks and switch to wearing glasses. Wearing contact lenses over a long period of time changes the shape of the cornea. The cornea then takes a long time to assume its natural shape.  It is similar to how a watch band leaves an imprint on the hand when worn for a long time. Therefore, an evaluation and surgery based on the cornea which has not assumed its natural shape can have negative implications. 

During the evaluation you need to discuss in depth with your doctor about whether you are a good candidate for LASEK surgery, what are the alternative surgeries you can opt for, what are the risks and complications involved, what can you expect after the surgery, and what are the pre and post surgery guidelines. 

The doctors usually advise LASEK surgery if you are not a suitable candidate for LASIK surgery. 

On the day of the surgery avoid applying any cream, lotion, or makeup on your face. 

You need to:

  • discontinue any cold or allergy medicines at least 4 days prior to the surgery. If you take any blood thinners you need to check with the doctor whether you need to stop taking them for sometime prior to the surgery.


  • to stop smoking and drinking alcohol 48 hours before and after the surgery.
  • you should not take insulin if you are a diabetic.
  • arrange for being driven home after the surgery.

Following the surgery you need to:

  •  take care not to rub your eyes. In fact, wearing an eye shield during sleep will be ideal so that you do not inadvertently rub your eyes.  
  •  avoid strenuous exercise, such as heavy lifting, or swimming, that could result in eye injury.
  • Wear sunglasses for a week after the surgery, even while indoors, is a must. Ideally, glasses should be worn for the first six months after the surgery to avoid UV rays and avoid haze formation.
  • avoid strong sunlight or glare for 4 weeks after the LASEK surgery to avoid haze formation if you are a sportsperson.
  • avoid applying any makeup or lotion on the face, and avoid any situation involving dirt for 7-10 days.
  • be careful not to get face wash or soap in your eyes while washing your face, or showering. In fact, you need to keep water and shampoo away from your eyes for at least 7 days after the surgery.
  • Avoid swimming and hot tubs for at least a month after the surgery.
  • You will need to apply eye drops in your eyes at regular intervals as prescribed by the doctor.

How long will it take to recover from a LASEK procedure? 

You might require to take time off work for at least 7-10 days following the surgery, to allow your eye to heal. 

The initial vision recovery period which is 24 hours for LASIK surgery can be upto 7 days for a LASEK surgery. 

Complete recovery from LASEK surgery can take anywhere between 6 to 9 months. 

Note: LASEK surgery requires a longer recovery time when compared to LASIK surgery. 

What is the cost of LASEK surgery in India? 

The cost of LASEK surgery in India varies from Rs. 45,000 to Rs, 1,00,000. 

Are the results of LASEK surgery permanent? 

The results of LASEK surgery are longstanding. There may be risks of overcorrection or undercorrection involved, in which cases additional surgeries may be advised by the doctor or alternatively glasses or contact lenses may be prescribed in cases of minor vision correction.

LASEK surgery, however, does not prevent the natural loss of vision which occurs due to aging. 

More Topics on Opthalmology Procedures

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References

1. Sakimoto T, Rosenblatt M, Azar D. Laser eye surgery for refractive errors [Internet]. 2018 [cited 6 April 2018]. Available from: https://www.sciencedirect.com/science/article/pii/S0140673606682755

2. Renato Ambrósio , Steven E. Wilson , LASIK vs LASEK vs PRK: Advantages and indications [Internet]. 2018 [cited 6 April 2018]. Available from: https://www.tandfonline.com/doi/abs/10.1076/soph.18.1.2.14074

3. Taneri S, Zieske J, Azar D. Evolution, techniques, clinical outcomes, and pathophysiology of LASEK: review of the literature [Internet]. 2018 [cited 6 April 2018]. Available from: http://www.surveyophthalmol.com/article/s0039-6257(04)00135-3/abstract

Would you like to consult a doctor for Laser Epithelial Keratomileusis (LASEK) ?

Questions answered by trusted doctors

Verified User
I have undergone Lasek treatment 6 months ago,age 26. sight has been reduced from -1.75 to -0.5 &-0.75 but not reduced completely as assured by my doctor.What can be done to reduce sight completely.
Dr. Arjun Kumar Singh
Ophthalmologist/ Eye Surgeon, Patna
I will not advise you to go resugery
Dr. Vaibhev Mittal
Ophthalmologist/ Eye Surgeon, Sangrur
Hello

This power is too small to go for resurgery

Dr. Aditya Sharma
Ophthalmologist/ Eye Surgeon, Chandigarh
See this happens lasik gives u independence and notfreedom. Although since the no. Is small enhancement can be done but i wud advise u to. Not go for anything. This small residual wont hinder in ur day to day activity
Dr. A K Goel
Ophthalmologist/ Eye Surgeon, Moradabad
Please consult your operating surgeon.
Verified User
Is lasek eye surgery not detactable to pass medical exam. how much time it take to recover completely.
Dr. Ajay J Panchal
Ophthalmologist/ Eye Surgeon, Ahmedabad
swiming is not advisable up to months..otherwise recover 4-7 days.
Many medical fitness accept lasek /lasik operated eye . It mostly not detectable after healing of epithelium after approx 10-15 days
Dr. Vaibhev Mittal
Ophthalmologist/ Eye Surgeon, Sangrur
Hello

It usually takes 1 week for recovery

Lasik can be detected under slit lamp

Without slit lamp,it is very difficult to say if Lasik is done or not

Verified User
Pls explain what is LASEK and LASIK My doctor has adviced me for decreasing dependency of specs and to relive white corneal scar
Dr. Vaibhev Mittal
Ophthalmologist/ Eye Surgeon, Sangrur
hello It is very difficult to comment without actually examining your eyes kindly send me reports of your eyes so that i can review the reports and guide you
Dr. Pranav Dave
Ophthalmologist/ Eye Surgeon, Surat
Lasek is laser assisted  sub epithelial keratomileusis. It is advised when corneal thickness is marginally enough for the surgery where lasik might be risky. But recovery in lasek is slightly delayed than lasik. Discomfort may also be more.
Dr. Shahnawaz Kazi
Ophthalmologist/ Eye Surgeon, Mumbai
Aa you have a scar lasek can take care of both the number and the scar.
Ask health queries and get free answers from doctors in 24 hrs

Did you know?

Difference between LASIK and LASEK

The primary difference between LASIK and LASEK lies in how the corneal tissue that is to be reshaped is accessed. In LASIK, a cutting instrument called a microkeratome is used to create a flap in the outermost layer of the cornea, called the epithelium. 
While performing LASEK, an alcohol solution is used to loosen the epithelial cells while an ultra-fine blade called a trephine is used to make a much smaller flap than in LASIK. Patients with thin corneas therefore are ideal candidates for LASEK.

Recovery from LASEK surgery takes longer compared to LASIK surgery

Recovering from a LASEK surgery takes longer than LASIK surgery (four to seven days versus one to three days). Patients who undergo LASEK surgery may also experience greater discomfort than LASIK patients. However, there is a greatly reduced risk of flap complications with LASEK and the results of LASEK surgery can justify the temporary discomfort.

Advantages of LASEK surgery

The advantages of LASEK surgery include no complications associated with creating and reattaching the flap in the cornea as is done in LASIK, and less complaints of dry eyes again compared to a LASIK surgery.

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