LASEK (laser epithelial keratomileusis) is a newer variation of PRK, a procedure in which laser energy is applied directly to the eye’s outer surface for reshaping and vision correction.

To understand how LASEK works, you first must know the fundamental differences between LASIK, PRK and LASEK:

LASEK LASIK PRK difference

• With LASIK, a thin flap is cut into the eye’s surface and then lifted. Laser energy is applied to the eye for reshaping, and the flap is replaced to serve as a type of natural bandage for quicker healing.

• An eye surgeon using PRK does not cut a thin flap into the eye’s surface, as occurs with LASIK. The ultra thin, outer layer of the eye (epithelium) is removed completely by hands using special brush then laser energy is applied directly to the eye’s surface.

• A LASEK procedure involves preserving the extremely thin epithelial layer by lifting it from the eye’s surface before laser energy is applied for reshaping. After the LASEK procedure, the epithelium is replaced on the eye’s surface.

In LASIK, the thicker flap is created with a microkeratome cutting tool or a special laser. With LASEK, the ultra thin flap is created with a special cutting tool known as a trephine.

LASEK was developed to reduce the chance of complications that occur when the flap created during LASIK does not have the ideal thickness or diameter.

The popularity of LASEK is growing among refractive eye surgeons. However, eyes undergoing LASEK procedures generally heal a bit slower and result in some complaints of discomfort than with LASIK.

The LASEK Procedure

During LASEK, your surgeon uses local anesthesia. Then he or she cuts the epithelium, or outer layer of the cornea, with a fine blade (trephine). Then the surgeon covers the eye with a diluted alcohol solution for approximately 30 seconds, which loosens the edges of the epithelium.

After sponging the alcohol solution from the eye, the surgeon uses a tiny hoe to lift the edge of the epithelial flap and gently fold it back out of the way.

Then the same excimer laser used for LASIK or PRK sculpts the corneal tissue underneath. Afterward, a type of spatula is used to place the epithelial flap back on the eye.

In a new variation of LASEK, the same plastic blade (epithelial separator) used in epi-LASIK creates the thin epithelial flap. But because alcohol is applied during the procedure as it is in straight LASEK, the procedure is called epi-LASEK.


In many ways, LASEK vision recovery is a bit slower than LASIK recovery, but there are some differences. According to doctors who perform LASEK, the flap edge heals in about a day, though patients usually wear a bandage contact lens for approximately four days to protect the eye.

Talking to Your Doctor

If you are considering LASIK, but your doctor says you need LASEK, ask why. It’s not for everyone, but many surgeons who perform LASEK consider it a better option for some patients who will probably not do very well with LASIK.

Also, in some studies LASEK has been associated with faster recovery of sensation or nerve function in the eye’s surface (cornea) compared with LASIK. It also may cause dry eye less frequently than LASIK.

However, keep in mind that a 2011 study published in the Journal of Cataract and Refractive Surgery concluded that the outcome of laser vision correction depends on the surgeon’s experience. Therefore, it’s always a good idea to ask how many procedures your surgeon has performed. Lirema Eye Clinic’s surgeons perform more than 1000 procedures annually.

Custom laser eye surgery

Custom laser eye surgery aims to achieve better vision than standard laser treatment or glasses. After treatment, about 99% of patients achieve standard driving vision. Custom treatment is available to both LASIK and LASEK procedures..

What is Custom treatment?

It is also known as Custom Wavefront LASIK. Wavefront guided treatment replaces ‘the one treatment fits all’ with a procedure that is tailored to the precise optics of the eye. Whilst standard laser eye treatment (without Wavefront/Topography guidance) gives very high quality results for the majority of patients, many peoples’ eyes are not ‘standard’.

Wavefront technology is groundbreaking because it has the potential to improve not only how much you can see, visual acuity measured by the standard 20/20 eye chart, but also how well you can see, in terms of contrast sensitivity and fine detail.

Everybody who visit Lirema eye clinic has their eyes measured, not just for prescription strength, but to assess their optical performance in terms of quality of vision when the prescription is in place.

Glasses lenses are standard shapes and their optical performance is made to fit the average population as a whole, whilst the laser improves individual physical and optical characteristics precisely for each eye. Patients who are suitable for Custom treatment can achieve better results than wearing glasses/contact lenses can.

 Wavefront optimised and Night Vision

Wavefront is a big advantage to those with large pupils and poor night time vision. The optical performance of the eye is measured at each and every place on the cornea, including the part which is used when the pupil is large. Laser treatment is then programmed to each tiny part of the corneal surface so that every area of the cornea gets the optimised dosage. Contrast sensitivity in low lighting levels is increased and the risk of developing night time halos and glare is greatly decreased.