LASEK Questions and Answers

Question:

i am not sure what epithelial inclusions are. also i have not been able to get to the file on lasek from my computer. do you have some info on lasek. also why no prk. thanks audrey

Answer:

PRK can cause scaring after RK, and inclusions are cells in the incisions. Hope that information helps.

Ernest Kornmehl, MD
Brookline, MA

Question:

After my first appointment, I was told everything looks good for the Lasik procedure, but I may not be a canadate for enhancements because my cornias were to thin. Is this a cause for concern for the Lasik procedure in the first place?

Answer:

You may want to consider LASEK or PRK instead as an option.

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

Question:

Dear Dr., I had Lasek surgery less than a year ago. I would like to know if Lasek surgery can cause cataracts? I am 55 years old. Any information or direction would be greatly appreciated. Thank you.

Answer 1:

LASEK or PRK itself is not a known cause of cataracts as the laser does not penetrat through the cornea. Topical cortico-steroids that are used in refractive procedures can in some cases cause cataracts after prolonged use (many months or years), which is not usually the case with refractive surgery.

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

Answer 2:

LASIK, LASEK, and PRK do not cause cataracts. Andrew Caster, MD

Andrew Caster, MD, FACS
Beverly Hills, CA

Question:

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 1:

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

Answer 2:

It is great to hear your experience. I recommend and perform LASEK on people who are not good candidates for LASIK, such as people with thin corneas. Although the healing period is much longer than LASIK, it is an excellent alternative. Andrew Caster, MD Beverly Hills, CA

Andrew Caster, MD, FACS
Beverly Hills, CA

Question:

With me having to take Coumadin am I safe to have the Laser Vision Correction. This is something I'm interested in but don't know when I'll be able to. JL Stroud

Answer:

Because Coumadin is a blood thinner it may increase the potential for a reported serious LASIK complication, a subretinal/submacular hemorhage. People on bloodthinners should consider other means of refractive surgery if they are suitable candidates.(PRK/LASEK) Another option would be to come off the bloodthinners if you get the blessing of the doctor that prescribed them. Do not stop your blood thinners without consulting your primary medical doctor.

Byron Stratas, M.D., F.A.C.S.
Wilmington, NC

Question:

any new improvements on lasek surgery? I was told 4 yrs ago that my eyes were to conical for surgery and that I have macular degeneration. I have worn glasses and contact lenses since I was 6 yrs. I'm now 43.

Answer:

Dear Lisa, As you probably know, laser vision correctioncan only improve the "optics" of your eyes. So if your vision is still bad because of macular degeneration laser cannot help. We can now correct for astigmatism, which is the "conical shape" of your eyes. I suggest a re-evaluation to see if you can be treated. Sincerely, Dr. Alexandra Chebil M.D. The Lasik Center Irvine CA (800)841-3717

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