• Barraquer Eye Hospital (Barcelona, Spain) - Ophthalmology Center
  • Barraquer Eye Hospital (Barcelona, Spain) - Ophthalmology Center

Lasek Vs Lasik: Which One Is Better?

“Lasek Vs Lasik” is one big dilemma when it comes to laser eye surgery, not only for patients but also among eye surgeons.

If you have myopia or another refractive error, you are no stranger to these terms. However, if you are considering refractive surgery, the details of each technique can be confusing.

The differences between the two types of laser eye treatments can be small but translate into changes in terms of benefits, recovery, and long-term results.

Ultimately, whichever technique you choose, having laser vision correction is a permanent, long-term solution. You will have a crisp and clear vision without the need for reading glasses or contact lenses.

Laser Eye Surgery

Laser eye surgery effectively reshapes the clear outer layer of your eye, known as the cornea, with a concentrated beam of light.

This procedure allows for correcting corneal imperfections that prevent your eye from focusing effectively, causing refractive errors, such as myopia (nearsightedness), hyperopia (farsightedness), and astigmatism.

Although it is often referred to as ‘surgery,’ there are no incisions or stitches involved. So the correct term would be laser surface eye treatment.

Currently, the most used laser eye treatment methods are LASIK and LASEK.

LASIK Treatment

LASIK stands for Laser-Assisted In-Situ Keratomileusis. During LASIK procedures, the first laser is a femtosecond laser which creates a thin circular protective flap on the clear layer of your eye (cornea). It traces a 3D pattern of small gas bubbles within the corneal tissue.

Then, this protective hinged flap is lifted, and an excimer laser is used to reshape the underlying corneal tissue to correct your vision.

The top layer of the cornea is then carefully placed back into the position and left to heal without the need for stitches. The flap is like a natural bandage, keeping the eye comfortable as it heals.

Laser procedure is complete in less than 15 minutes for both eyes.

LASEK Treatment

We can’t talk about LASEK procedures without explaining PRK surgery.

LASEK stands for Laser-Assisted Sub-Epithelial Keratectomy, and PRK stands for Photo-Refractive Keratectomy.

During both techniques, only the excimer laser will be used to correct your vision— rather than the two used in LASIK.

With PRK surgery, the surface eye cells (epithelium) are removed (and discarded) using a high-speed mechanical brush, diluted alcohol, or with the excimer laser itself (Transepithelial PRK). Then, the laser reshapes the stronger layer underneath (the stroma).

Ultimately, a new epithelial layer is supposed to grow back within five days.

Conversely, with LASEK procedures, the surface cells are loosened with a diluted alcohol solution. Then, they are gently moved to the side of your eye, away from the pupil. This gives your surgeon access to the stroma, the layer of your cornea treated by the laser.

Lastly, the epithelial sheet of now non-viable surface cells is replaced over the pupil to their original position on the cornea.

As you can see, the LASEK procedure involves a little of both LASIK and PRK. The ultra-thin top layer of the cornea is loosened, moved, and reattached.

However, the hinged flap made in LASEK surgery only uses the epithelial layer of the eye. It is much thinner than the corneal flap created in LASIK containing epithelial and deeper stromal tissues.

The whole LASEK/PRK process takes around 10 minutes for both eyes. After the laser has reshaped your cornea, the doctor will put a protective contact lens (bandage lens) on your eye to help with the healing process and increase comfort.

This lens is normally taken off after 3 to 5 days post-procedure.

Who Is Eligible for Laser Eye Surgery?

Most patients are suitable for eye laser surgery, whether LASIK or LASEK/PRK.

In general terms, you must:

  • Be at least 18 years old, and a maximum of 45.
  • Have a stable prescription for at least two years.
  • Be in general good health, not suffering from conditions such as diabetes, glaucoma, rheumatoid arthritis, lupus, herpes infection in the eye, or cataracts.
  • Not be pregnant or breastfeeding.

LASEK Vs LASIK: Pros and Cons

The main benefit of LASIK is the faster visual recovery.

Indeed, with LASEK/PRK procedures, the recovery period may be lengthier, more painful, and uncomfortable.

However, the longer recovery time of LASEK comes with slightly better long-term results and benefits, such as:

  • Decreased risk of infection
  • Smaller risk of dry eyes
  • Decreased incidence of corneal haze after LASEK

LASIK remains the most popular laser eye surgery, but for patients who are not suitable, PRK or LASEK may be better options and achieve comparable success rates to LASIK.

LASEK Vs LASIK: Which One Is Better?

The most appropriate technique mainly depends on the thickness of your cornea.

By avoiding a deeper flap, LASEK surgery is perfect for patients with thinner corneas or pre-existing eye conditions. LASEK may be better if you have a high degree of myopia (between -10 and -20 dioptres) since it requires more tissue removal from the central cornea to correct the refractive error.

Also, LASEK is a good option if your occupation or hobbies (contact sports) put you at high risk of having an eye injury and dislodging the LASIK corneal flap. However, this is controversial among eye surgeons.

In the end, both LASEK and LASIK are great options for correcting vision and have high success rates. Only your eye doctor will decide what type of laser eye surgery is best for you.

Special Considerations in Laser Eye Surgery

In the case of patients with high myopia, LASIK surgery is contraindicated.

In patients with high myopia, thinner corneas, and over 45 years old, your doctor may suggest cataract surgery with refractive correction purposes instead of LASEK surgery.

Also, remember that eye laser surgery is not necessarily a solution for presbyopia, a naturally occurring age-related loss of near vision. Your eye doctor should assess if you’re a suitable candidate for presbyopia surgery instead.

Before Having Eye Laser Surgery

During your initial consultation, your eyes will be scanned and tested. You will have the chance to discuss your suitability for the procedure and the potential risks and benefits with your surgeon.

If you use contact lenses, your eye doctor will instruct you to stop wearing them for some time before taking eye measurements, as contacts can change the cornea’s natural shape.

The Procedure

Laser eye treatment is a walk-in, walk-out procedure. It is safe, painless, and effective.

The surgery takes approximately 10-15 minutes, and you will experience little to no discomfort. Both eyes can be treated on the same day. Local anaesthetic drops will numb your eyes before the procedure. Additionally, you could receive a mild oral sedative to help you relax.

With LASIK surgery, during the creation of the flap (less than a minute), patients may experience slight pressure on their eyes and a “graying” out of vision.

LASEK Vs LASIK: Aftercare Following Laser Eye Treatment

Following LASIK surgery, you may feel between 4-6 hours of slight discomfort.

With LASEK/PRK treatment, patients may present with moderate discomfort/pain in their eye and sensitivity to light during the first 24 hours or even more. This is completely normal, and your doctor will prescribe eye drops and oral medication to ease the pain.

Your surgeon will give you precise instructions on aftercare and medication, including antibiotics and steroid drops to aid with the healing in case of LASEK/PRK surgery. Also, you will be provided with a pair of protective goggles or an eye shield to wear for the first 24 hrs, and then nightly for ten days. The idea is to prevent accidental rubbing of the eye.

Also, you should rest your eyes and limit screen time in the first 24 hours after your surgery. Remember that with LASEK/PRK surgery, you will have a special protective contact lens (bandage lens) taken off 3 to 5 days after surgery.

Both LASIK and LASEK/PRK patients must refrain from rigorous exercise to prevent increasing eye pressure or interfere with the healing process during the first month.

How is Recovery Time After LASEK or LASIK?

LASIK recovery is minimally invasive. Most patients experience total recovery within 24 to 48 hours, with some even going back to work the next day.  Discomfort is considerably less, vision recovery is faster, return to normal activities is quicker, and there is less need for post-operative medications.

With LASEK/PRK surgery, the recovery process is longer –between 1 and 2 weeks. Initially, your vision will be blurry, with improvements typically noticeable from mid-way through the first week.

However, you may need up to one month for vision to become clear after LASEK/PRK. Most patients need to take a week off work.

Whichever technique you choose, most patients achieve 20/20 vision after laser eye surgery, and the effects are permanent.

However, because your vision changes throughout your life and your eye keep aging, you may develop unrelated refractive errors down the line, such as presbyopia. But this is not a result of regression following the surgery!

LASEK Vs LASIK: Complications and Side Effects

Laser eye treatments are safe, and complications are rare. However, like any surgery, problems can occur, and patients must be aware of the risks involved.

There is a chance of overcorrection or under-correction, the need for follow-up surgery (touch-ups), decreased visual acuity, infections, and long-term side effects.

Both techniques have a low rate of side effects, though. These include mild eye irritation, dry eyes, glare or halos, decreased night vision, or induction of astigmatism.

Nearly 13% of LASIK or LASEK/PRK patients may require a touch-up. But retreatment is more common in patients with high myopia or astigmatism.

How Much does Lasek and Lasik Surgery Cost?

Laser eye surgery cost depends on the technique performed.

If you want a quote, please, fill in the contact form. If you have any medical reports or examination results from other centers, we would appreciate it if you could send these tests to us by email.

You can be sure that this information will always be treated with maximum confidentiality, and we will offer you the solution that best suits your needs.

BEST LASER EYE SURGERY SPECIALISTS AT BARRAQUER HOSPITAL

Doctor Juan P. Alvarez de Toledo Elizalde

Doctor Juan P. Alvarez de Toledo Elizalde

Doctor Paola Sauvageot

Doctor Paola Sauvageot

Doctor Andrés Picó García

Doctor Andrés Picó García

Doctor José Lamarca Mateu

Doctor José Lamarca Mateu

Doctor Marinka Kargacin

Doctor Marinka Kargacin

Doctor Milan Pesic

Doctor Milan Pesic

External links – Bibliography

Resolving refractive error after cataract surgery: IOL exchange, piggyback lens, or LASIK. Fernández-Buenaga R, Alió JL, Pérez Ardoy AL, Quesada AL, Pinilla-Cortés L, Barraquer RI.J Refract Surg. 2013 Oct;29

Femtosecond laser-assisted laser in situ keratomileusis Lasik versus photorefractive keratectomy: Effect on ocular surface condition. Sauvageot P, Julio G, Alvarez de Toledo J, Charoenrook V, Barraquer RI.J Cataract Refract Surg. 2017 Feb

New applanation tonometer for myopic patients after Lasik surgery. Iglesias M, Yebra F, Kudsieh B, Laiseca A, Santos C, Nadal J, Barraquer R, Casaroli-Marano RP.Sci Rep. 2020 Apr 27

Laser In Situ Keratomileusis (Lasik). Moshirfar M, Bennett P, Ronquillo Y.2020 Jul 31. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan

Resolving refractive error after cataract surgery: IOL exchange, piggyback lens, or LASIK. Fernández-Buenaga R, Alió JL, Pérez Ardoy AL, Quesada AL, Pinilla-Cortés L, Barraquer RI.J Refract Surg. 2013 Oct

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    Barraquer Eye Hospital

    Carrer de Muntaner, 314, 08021 Barcelona (Spain)

    Nearest Metro Stations:: Muntaner/ Gràcia

    Barraquer Ophthalmology Center Barcelona Spain Barraquer eye hospital Barcelona Spain