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Refractive eye surgery is not a good option for everybody. In particular, traditional LASIK is not a good option for quite a few people. But since LASIK was first approved by the FDA, ophthalmologists have devised more ways of doing it, and this has increased the pool of candidates.
LASEK is one of the ways do to LASIK for people who are not good candidates for traditional LASIK. LASEK stands for Laser Epithelial Keratomileusis. It's also called e-LASIK (epithelial LASIK). If you have been told that your have corneas that are too thin, too flat, or too steep for LASIK, you might still be able to have LASEK done.
The corneal flap
One of the factors that most often lead to complications after LASIK is the corneal flap made at the beginning of the procedure. This flap removes surface cells to expose the next layer down, the stroma. The laser then removes small pieces of stromal tissue to reshape the cornea. Then the flap is replaced.
If the cornea is too thin, there will not be enough tissue to create the flap, then remove unneeded tissue for vision correction, and still have enough tissue left to contain the eye's internal pressure. Our eyes are filled with fluid which exerts an outward pressure on the cornea. The too-thin cornea could then start bulging forward, distorting vision and undoing the good work of your LASIK procedure.
If the cornea is too flat (severe farsightedness -- hyperopia), removal of tissue will make it even flatter. The laser treatment for farsightedness removes tissue from the corneal edges to increase curvature. So again, the cornea may end up too thin to contain the eye's internal pressure.
If the cornea is too steep (severe nearsightedness - myopia), the problem is not in what remaining thickness of cornea there will be, but in creating the flap safely. It is more difficult to cut the flap safely on a steep curvature than on a flatter curvature. LASIK uses a microkeratome to cut the flap, an oscillating blade. The flap could be cut too deeply, or unevenly, or with a hole in the center, or only partially.
Flap creation in LASEK
To create a thin enough flap safely, a LASEK procedure does two things:
It uses a different instrument to cut the outline of the flap, called a trephine, which has a finer blade
It then uses an alcohol solution to weaken the cell connections. The solution is left on for about 30 seconds, and then your eye surgeon gently lifts the loosened flap tissue.
Afterwards, a bandage contact lens is used to protect the treated area while it heals. This takes between three and ten days, depending on how large an area was treated and the person's individual healing rate.
We offer LASEK as an alternative to LASIK, PRK, and SuperLASIK (also called epi-LASIK). To determine which procedure is best for you, you would need to come for a consultation first. Then Dr. Khanna would do a thorough eye examination and review your health history in general. He would explain the issues and alternatives for you so you could make a decision and move forward. Please contact us if you would like a personal LASEK consultation.