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 LASIK vs. LASEK vs. PRK vs. Epi-LASEK
 The difference between LASIK and LASEK

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T O P I C    R E V I E W
Dr. Q Posted - 11 February 2004 : 22:40:39
Your laser treatment, whether based on phoropter measurements or wavefront data, can be delivered in a number of ways that differ primarily on the layer of the cornea that is treated and how that layer is exposed.

With the popular LASIK procedure, a microkeratome is used to lift a "corneal flap" that includes the first few layers of the corneal surface. The laser treatment is then applied to the exposed middle layer. The flap is then repositioned over the treated surface. Because the surface layer is relatively undisturbed, LASIK is the most comfortable laser procedure and offers the most rapid healing.

Most LASIK flaps are still created with the reliable mechanical microkeratome, which uses a blade to make the flap. Recently, however, a laser system (a.k.a. "Intralase" or "All Laser LASIK" or “No blade LASIK”) has been developed to create the corneal flap. These units are new and their results are not yet proven to be any safer or otherwise better than those of traditional keratomes, despite adding significant cost to the procedure.

Unlike LASIK, with Advanced Surface Ablation (a.k.a. PRK, LASEK or Epi-LASEK), no flap is created. Instead, the epithelial cells over the treatment area are loosened and removed, and the laser treatment is performed directly on the surface of the eye. In the Epi-LASEK variant, an attempt is made to put the epithelial cells back into place after the laser treatment, but with standard PRK, no such attempt is made, and the epithelium heals when new cells grow in from the periphery.

Because the surface layer is disturbed, Advanced Surface Ablation (ASA) is less comfortable than LASIK and the eye heals more slowly. After ASA, you will need to wear a soft bandage contact lens for three to five days, until the surface is completely healed. This is to protect the cornea as it heals, as well as to keep the eye more comfortable. Your vision will improve daily, but it can take as much as a week for it to return to a functional level, and several weeks or months for it to reach its final clarity. For this reason, ASA is performed one eye at a time, with at least a week in between eyes. Postoperative follow-up is essential to assess the visual recovery.


For LASIK in Arizona, visit http://www.halevision.com

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