LASEK (Laser epithelial keratomileusis)


LASEK (Laser epithelial keratomileusis)

Introduction


Nowadays excimer laser surgery is one of the most popular procedure in ophthalmology. Thousand of patients are operated year by year in US to correct different refractive errors. In this field, LASIK and PRK have become the most commonly performed surgical procedures due to they are safe and effective, but in both of them there are some disadvantages. In the case of PRK, haze, post operated pain and low visual recovery are some of the commonly complications. On the other hand, LASIK also has disadvantages, such as flap related complications (intra and post operated), interface related complications and ectasia post lasik.

LASEK (Laser epithelial keratomileusis) could avoid all those disadvantages and plus, combine the advantages of PRK and LASIK.

LASEK (Laser epithelial keratomileusis)

Procedure


There are different techniques for this procedure, but basically consist in produce an epithelial detachment with an alcohol diluted solution (18-20%). Once the alcohol solution is rinsed, epithelium is removed and a flap is folded creating a nasal or superior hinge. Later, laser ablation is performed and epithelium is replaced on the stroma with special attention to achieve correct alignment to avoid future complications. Finally, topical steroids and antibiotic are applied and a soft contact lens is placed. The soft contact lens has to be removed after a complete re-epithelialization (3 or 4 days).

Advantages


  • No free cap
  • No incomplete flap
  • No bottonhole
  • No flap striae / wrinkles
  • No flap infection
  • No flap traumatic dislocation
  • No epithelial ingrowth
  • No diffuse lamellar keratitis
  • Lower risk of ectasia