What is LASEK?
LASEK (Laser-Assisted Sub-Epithelial Keratectomy) is one of a number of laser eye treatments currently available for the correction of visual problems such as far-and near-sightedness and astigmatism. Around 10 % of laser eye surgery patients will opt for a LASEK procedure.
- Successful LASEK can reduce or completely eliminate the need for glasses or contact lenses.
- Suitable for even the very short-sighted.
- Suitable for those with thin corneas.
- LASEK is known as a NO-KNIFE procedure as no incision to the eye is necessary.
- The nature of the procedure is often recommended for those whose profession or hobby puts them at greater risk of eye injury – rugby players, swimmers, builders, welders or those in the military.
How does LASEK work
With most laser treatments a thin flap of corneal tissue (the protective tissue that covers the eye) needs to be cut to allow the laser clear access to the eye. This is then peeled back while the laser surgery is underway and sealed back in place afterwards.
However, LASEK does not cut a flap in the cornea. Instead, the tissue is smoothed back using a weak alcohol solution that loosens it, allowing it to be moved temporarily to one side. An excimer laser is then used to precisely re-shape the cornea.
- Step 1: A small blunt instrument called a trephine is used to make a shallow circular cut on the outer layer of the epithelium.
- Step 2: A weak alcohol solution is then applied to the eye. This loosens the corneal tissue (epithelium).
- Step 3: The corneal tissue (epithelium) is then moved to one side before the laser surgery is carried out.
- Step 4: A cool beam from the laser is used to reshape the cornea.
- Step 5: The epithelial flap is then folded back in place.
- Step 6: Finally a ‘bandage’ contact lens is put on to hold the tissue in place until it has fully rebonded with the surface of the eye.
The LASEK procedure
Before LASEK: The eyelids are kept apart using a speculum to prevent blinking and, immediately prior to the procedure, anaesthetic drops will be applied to numb the surface of the eye. If you are nervous, a mild sedative might also be prescribed.
During LASEK: You shouldn’t feel any pain during the procedure, which takes around 15 minutes per eye. It will take your vision a little time to adjust so you will not be permitted to drive; make sure you arrange for alternative transport home.
After LASEK: You are likely to experience some mild discomfort for a few days after the procedure for which you will be advised to take over the counter painkillers. You will also be given steroidal and anaesthetic drops to minimise the risk of infection while the epithelial flap heals.
The Pros and cons of LASEK
- Fewer post-operative complications: because only a shallow cut is made in the corneal tissue there tends to be a lower risk of infection than with other forms of laser eye surgery.
- More comfortable recovery: Unlike some procedures, such as PRK, which scrapes the tissue away from the surface of the eye, the flap created during LASEK is simply placed back over the eye resulting in a more comfortable healing process.
- Available for even the very short-sighted: Some procedures are not recommended for those who are extremely short sighted. However, LASEK has been proven to be more successful in such cases.
- Suitable for people with thin corneas: If you have thin corneas there is a risk, with other laser procedures, of too much tissue being removed and damaging your eyesight further. This is far less likely to occur during LASEK since a much shallower layer of tissue is removed.
- A robust procedure: For those whose occupation puts them at increased risk of eye injury such as rugby players, builders etc. LASEK is considered much safer as there is less chance of the corneal flap being dislodged by a knock or blow.
- Longer recovery period: It can take 2-3 weeks for patients to recover full vision, unlike LASIK
- Bandage contact lens: This will need to be worn for up to a week following the procedure.
- Steroidal drops: To aid healing, drops will need to be used for several weeks following the procedure, longer than with other procedures.
- Some discomfort: Although LASEK results in a less painful recovery than procedures where the corneal tissue is scraped from the eye, it is more uncomfortable than some other popular laser surgeries such as LASIK.
Lasek eye surgery recovery time
LASEK has a longer recovery period when compared to other types of laser eye surgery. This is due to two key factors. Firstly, the epithelial layer takes longer to re-bond with the surface of the eye which means a longer healing time. Secondly, it takes longer for full vision to be restored than with some other laser surgeries, so certain activities should be avoided until the eyes have completely healed.
You should take advice from your doctor if you have any more unusual hobbies. For example scuba divers may have to wait at least three months after surgery before taking to the water again. The following table outlines some everyday activities and states when you may expect to resume them after surgery.
|Activity||Period of time before re-starting activity|
|Returning to work||3 days to 1 week|
|Driving||1 week to 10 days|
|Wearing eye make-up||up to 2 weeks|
|Regaining full vision||Up to 2 weeks|
How much does LASEK eye surgery cost?
When compared to other procedures LASEK is marginally cheaper than LASIK and significantly cheaper than Lens Replacement Surgery. However, it is advised that cost should not be the motivating factor when considering any type of surgery.
|Average cost per eye||Consultation cost||Aftercare cost|
|£1432.50||£0-£250||Usually included in the cost of treatment|
Talk to a number of clinics and ask as many questions as you need to. A reputable surgeon will certainly not mind and you should feel completely comfortable with whoever you choose. Many clinics offer payment plans, allowing you to spread the payments over a year or 48 months.
As with all elective procedures, the cost of LASEK will vary depending on your individual circumstances, such as the strength of your prescription. Other factors that may affect the price are:
- After care: Should there be any problems during the healing period, you may pay for extra costs related to additional consultations with the surgeon.
- Surgeon costs: The level of qualification and the experience of your surgeon may also impact the overall cost. A surgeon with experience and who has been accredited by a body such as the Royal College of Ophthalmologists is likely to cost more.
- Clinic costs: Laser eye surgery is a constantly evolving procedure. The top clinics will invest in the latest technology and this will be reflected in the cost.
To compare a number of quotes and to get further information on the cost of LASEK and other laser eye surgeries, head over to our dedicated pricing page.
Risks, complications and side effects of LASEK
LASEK is a very safe procedure but as with all laser eye treatments there are some possible risks and side effects that you should be aware of.
|Side Effect||Symptom||Time||Treatment & Tips|
|Feeling of a foreign object in the eye||An uncomfortable sensation that something is the in eye||1-2 days||It will pass without any treatment|
|Pain||Discomfort while the eye heals||2-3 weeks||Over the counter painkillers|
|Dry eye||Dry scratchy eyes||Up to 6 months||Moisturising eye drops, Punctual occulusion|
|Hazy / cloudy vision||Slightly unfocused vision||6-9 months||Eye drops or Laser retreatment|
|Halos||Circles around light sources||Varies from patient to patient||Sunglasses, Wavefront eye tracking can reduce risk|
|Poor night vision||Glare from light sources in low light conditions||Up to 1 year||Eye drops|
|Eye infection||Redness, weeping or discomfort||Varies from patient to patient||Antibiotics|
Short-term side effects
- Some people report the sensation of having a foreign object in the eye; however this typically lasts only a few days.
- It is not uncommon for people to experience dry eyes following LASEK. This can generally be treated with the use of moisturising eye drops and should, in most cases, resolve itself within 6 months.
- Hazy or cloudy vision is also sometimes reported but, again, this is usually temporary and should disappear within 6 to 9 months.
- Some people report halos (circles which appear around light sources) and glare for a period of time. In some cases this can be a longer-term problem but advances in the eye tracking technology of modern lasers has significantly reduced this risk.
- Poor night vision can also be expected for up to a year after LASEK. Whilst driving at night you should wear glasses to ensure safety.
- Eye infection and irritation can occur whilst the tissue flap is healing and is normally avoided, or can be treated by using the antibiotic eye drops routinely prescribed following the procedure.
- You are likely to experience some mild discomfort following LASEK, more than you might following LASIK.
Complications following LASEK
Tissue loss: In a small proportion of cases the thin layer of tissue that was folded back to allow the laser clear access to the eye might not be strong enough to be replaced and may have to be removed altogether. This is not a problem in itself, as other types of laser eye surgery actually involve the removal of the tissue, however it can result in an increased possibility of hazy vision.
Over or under correction of vision: A small percentage of patients may find that their vision has been either over or under corrected. In many cases this can be corrected by a further laser procedure but in a small proportion of cases the patient may have to continue wearing glasses or contact lenses.
I had LASEK surgery early in 2014 and I am absolutely delighted with the results – I don’t remember ever seeing as well as this before (previously myopic and astigmatic). The results of the surgery were exactly as planned.
The first stage of the process was to have an assessment, consultation and tests. Information about the various types of surgery was provided in advance and the tests seemed very thorough. At this assessment I was found to have early stage Fuchs’ Dystrophy (a condition missed at routine eye tests), so I was advised to have LASEK surgery rather than the other procedures if I wanted to go ahead.
There was plenty of opportunity to ask questions and no pressure to take things further unless and until I wanted to do so.
The procedure was pain free with every step explained and excellent follow-up care (including an extra check when I had a minor problem with the bandage contact lenses that caused me some anxiety). – Anne Stoye