Photo-Astigmatic Refractive Keratectomy Questions and Answers

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Has anyone heard of LASEK? I had this procedure done March of this year. I was wearing -7's (contacts) in both my eyes and standard LASIK was not a good option for me. I had very thin corneas. Dr. Yee of Herman Eye Center is performing LASEK on patients with thin corneas and it is virtually painless - at least in my case. He makes a flap out of your epithelium which is a lot safer and painless like I said. Even his patients that are candidates for standard LASIK are choosing to do LASEK because of the low risk of injury to your corneal tisssue. He is currently co-authoring with other doctors over seas about this procedure and to my knowledge is the only doctor in Houston and possibly the US performing this procedure. I am six months out and seeing 20/15. It is wonderful.

Answer:

Dear Maria, LASEK (Laser assisted seu-epithelial keratectomy) as it is called has been aroung for several years and has become more popular in the United States recently. It is basically a version of PRK (Photorefractive Keratectomy) which I have been doing since 1994. I have done LASEK on similar cases like yours with great results (In fact, I believe that I am one of the first to do this procedure in the Palm Beaches). It has several advantages over LASIK in that you can treat thinner cornea. The corneal nerve regeneration is quicker. There are NO corneal flap complications that we all hear so much about. On the down side is the fact that you need to be on drops for a longer time, vision stays blurry for about one to two weeks. A bandage contact lense is used and pain is often greater. There is also a higher amount of haze in some patients, but this usually does noty affect vision and often goes away. The procedure basically is like PRK, but you spare the epithelium and remove it as a sheet after cutting it with a shallow trephine ring and 20% alcohol to help loosen this layer. This allows you to do the treatment directly on the cornea and replace the epithelium and place a bandage contact lens for 4 days. Drops are often need for at least a month unlike LASIK which is usually about 4-5 days. The advancement of newer lasers with smoother profiles and scanning lasers with trackers has made this a great and safe option for laser vision correction in many people. In fact some surgeons offer LASEK as the only procedure. I currently offer both procedures, but will do LASEK on a patient with thinner corneas. Thanks for your insight and comments on your successful procedure. David B. Cano,

David Cano, M.D.
West Palm Beach, FL

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