Laser-assisted sub-epithelial keratectomy, or LASEK, is a refractive surgical procedure used for vision correction. In this procedure, the cornea, which is the clear part at the front of the eye, is reshaped by a laser. This changes the way the cornea focuses light, which can correct problems in the vision such as nearsightedness, farsightedness, or astigmatism. Many people no longer need glasses or contact lenses after having the LASEK procedure. This procedure is often confused with LASIK, and it is very similar, though there are some differences in how the procedure is performed. Epi-LASIK is a very similar procedure to LASEK, and information about it is also included on this page.
If you’re choosing refractive surgery, make sure you’re choosing it because you really want it, not to please someone else or to fit an imagined ideal. No one else can make the choice for you; it’s your body, and you’re in charge of it. After you do your research and understand the procedure, if you believe that LASEK is right for you, then proceed. To help you in your decision-making process, we have some information about the risks and benefits of LASEK at Laser-Assisted Sub-Epithelial Keratectomy (LASEK): Risks and Benefits.
Please note that this page is for informational purposes only, and is not a substitute for qualified, individualized medical advice. You should discuss your potential elective procedure with your own doctor(s), including your primary care physician and the doctor who will perform your procedure if you decide to proceed.
How it’s done
You will be reclining in a surgical chair during the procedure. You will receive several drops of numbing medication in your eye. Next, an eyelid holder will be placed that prevents you from blinking during the procedure. A suction ring is then placed on the cornea, to hold it in place. Once this device is placed, your vision will be very dim until it’s removed.
A special alcohol solution is applied to the cornea to loosen the epithelium, the very thin outer layer of the cornea. Once it’s loose, the epithelium can be pushed out of the way. (In Epi-LASIK, the epithelium is loosened with a special vibrating device called a microkeratome; the procedure is otherwise the same.)
Next, the patient is asked to focus the vision on a light. After checking the positioning, the surgeon turns on the laser, which has been preprogrammed with the patient’s corneal measurements. The laser resculpts the cornea.
Finally, the surgeon places the epithelium back over the cornea. Then a contact lens is applied to hold the epithelium in place and promote healing. If there has been damage to the epithelium and it doesn’t easily slide back over the cornea, the surgeon may remove the epithelium, which converts the procedure from a LASEK (or Epi-LASIK) procedure into Photorefractive Keratotomy (PRK).
Preparing for the procedure
Choosing your surgeon
When choosing an eye surgeon for your refractive surgery, you want a highly-trained professional with experience in this type of surgery. A fellow of the American College of Surgeons has received training in surgery (look for the acronym FACS), and a member of the American Board of Ophthalmology has training and experience specifically in the surgical and nonsurgical care of eye diseases. Also, choose a surgeon with whom you feel comfortable and safe, and who listens to you and tries to understand your goals. If you have friends who’ve had refractive surgery, and you like their results, ask for a referral. While cost may be a consideration, don’t allow this to override more important factors in your decision. Your safety and the quality of your results are worth a little extra spending.
For more help in your search for a vision correction surgeon, visit our How to Find the Best Refractive Surgeon page. At Doctor Review, you can also search providers for patient reviews to help you find the very best.
Getting ready for the procedure
For at least a few weeks before your refractive surgery, you’ll need to stop wearing contact lenses and switch to glasses. Contact lenses can distort your corneas by pressing on them, which could lead to inaccurate measurements, meaning that the outcome of your surgery won’t be ideal.
Also, in order to minimize the amount of debris that’s in your eye during your surgery, you should skip using any eye creams or makeup the day before and the day of your surgery. Otherwise, there could be buildup in your eye, leading to inaccuracies during your procedure.
After the procedure, you’ll need a family member or trusted friend to drive you home. You should plan to spend the rest of the day resting. You will need to wear a “bandage” contact lens over each treated eye for about four days, until healing of the corneal epithelium is complete. It’s very important to protect your eye(s) during this time, since the unhealed epithelium leaves it vulnerable to damage.
You may be given a transparent eye shield to wear over the treated eye(s). The shield is intended to remind you not to touch or bump your eyes, as any touching of the eye could damage the cornea and cause it to heal incorrectly. You will need to wear the shield at least at night, though wearing it during the day may provide extra safety for your eye. You will also be given eyedrops, which you will need to use several times a day; the drops keep your cornea moist as it heals, and help to prevent infection and inflammation.
It will take three to six months for healing of your eye(s) to occur. At this point, your vision will stabilize, and the side effects from the healing will resolve. You will then be able to decide whether you want an enhancement, which is a second refractive surgery designed to provide minor corrections and bring the vision closer to ideal.