Last updated: 11/24/2009
Description
LASEK procedures are performed under local anesthesia which means that the patient is awake for the entire LASEK procedure but sensation in the eye is deadened. The eye is held open with an eye speculum which is simply a clamp that...
holds the eyelids apart.
There are several variations on the basic LASEK procedure that are being used today. The approach that is common to all of them is to create a thin epithelial flap which exposes the upper layers of the cornea and then employs an excimer laser to resurface the exposed cornea. The flap that is cut with LASEK is much thinner than that cut by the microtome in LASIK. LASEK employs a very thin trephine that just disturbs the very top, epithelial layer. An alcohol solution is often applied to the eye to help lift the epithelial flap up and away from the cornea. In situations where alcohol would be too painful or damaging to the eye itself, some eye surgeons offer an epi-LASEK procedure which uses an epikeratome to mechanically cut the entire flap rather than using alcohol to loosen the epithelial layer.
Once the epithelial layer has been flipped over (it is a flap) and the cornea is exposed, an excimer layer is used to superheat and resurface the cornea at the level of the Bowman layer. The Bowman layer is less deep than the stromal layer that is targeted in LASIK. The patient must maintain fixation during the LASEK
surgery which means that the eyes must be kept still throughout the laser resurfacing. Modern LASEK
eye surgery devices accommodate small eye movements, which are inevitable, but the patient is responsible to maintain a period of focused eye control.
As mentioned, there are various subtypes of LASEK eye surgery. They usually are known by the surgeon that pioneered them and a description of the technique. The first and most common technique is the Standard Camellin. Other procedures have names such as the Azar flap technique, the Vinciguerra butterfly technique, the McDonald gel-assisted technique, the Amolis cruciform technique, and, of course, Epi-LASIK. The procedure chosen is usually based on the training of your particular eye surgeon. There are some advantages and disadvantages between the techniques but they are quite similar overall.
