LASIK or LASEK...which is better for me

We have seen advertising lately that claims that LASEK is newer or safer than LASIK.  The board certified LASIK specialists at North Shore eye care in smithtown new york serving patients from Riverhead to Dix Hills felt that it was important to clarify the LASIK vs LASEK issue in an honest and easy to understand blog.  First, LASIK is simply a procedure where a flap is made in the superficial layers of the cornea.  This used to be more risky when we used blade machines that some eye doctors still use.  At North Shore eye care,  we are all bladeless with Intralase, a laser that makes the flap which is clearly safer and more precise.  In our hands, Intralase flap problems happen in far less than one percent of procedures and we have never seen loss of vision in that setting.  The benefit of LASIK is that recovery quick.  Patients are able to drive the next day and see well quickly.  Again, LASIK is putting the vision correction procedure under a flap.  LASIK is far more popular than LASEK with roughly 70 % of procedure done being LASIK. 

Now, LASEK is simply another type of PRK.  With LASEK, no flap is made.  The skin layer of the eye called the epithelium is removed and the laser is applied to the surface of the stroma or middle layer of the cornea.  In PRK, the epithelium is removed.... in LASEK, the epithelium is put back in place.  That epithelium that is put back in place simply dies and is replaced by new epithelium.  Either way, the down side is that healing takes 3 to 5 days with significant discomfort often needing strong pain relievers to get through the healing period.  Also, there is an open area of skin lasts much longer than LASIK and there are many published reports stating that the risk of infection is greater due to that.  The benefit of LASEK or PRK is that  there is no flap so there is one less step.  But the truth is there are about 30 % of people in our practice that do better with LASEK or PRK.  These are patients with thin corneas, irregular corneas, high prescriptions and significant dry eye.  In the first three, the eye surgeon wants to stay more superficial in the cornea because we all need enough corneal thickness untouched to live the rest of our lives with good vision.

So to summarize, Bladeless Custom LASIK is an excellent choice for roughly 70 % of those that qualify for laser vision correction.  It has a wonderful track record and especially in the blade-free platform, it is exceedingly safe.  LASEK or PRK is certainly not newer of safer, but may be beneficial when it is necessary to conserve as much cornea as necessary.  Any eye surgeon that tells a patient that one way or the other is the only way it should be done is simply not telling the whole story.  The investment in the blade free laser platforms for making LASIK flaps is significant and not every laser eye surgeon has made that investment.  However, at North Shore eye care, our board certified eye doctors insist on the best for their patients, period.  That is why we also invested in the PENTACAM.  The PENTACAM is the most advanced corneal measuring device that lets us know who is and who is not a good candidate for laser vision correction.  With the sophisticated analysis that the PENTACAM provides, it is easy to counsel patients to the correct procedure. 

If you are told LASEK or PRK only, ask about Intralase blade free custom LASIK and you too may be driving the very next day.