LASIK or LASEK eye surgery: whats the difference and whats best for me
“Patients often come to us with an idea of which treatment they want,” says Professor Reinstein, a specialist ophthalmic surgeon at the London Vision Clinic. “But then after the initial consultation, eye exam and medical evaluation and testing, we identify which treatment will be most suitable for a particular patient and it's often different to the one they had in mind.”
Professor Reinstein says he’s seen an increase in younger patients seeking laser eye surgery: “Some around eighteen and upwards, and they’re often motivated by sport and lifestyle choices, where glasses and contact lenses are inconvenient.
“Downtime after procedures varies, and recovery for each patient is individual,” he says. “The exact length of recovery depends on individual factors such as your age and what treatment you’ve had. But for most patients, they’re enjoying their normal routine within a day or two after surgery and back to work a couple to a few days later.”
Professor Reinstein Credit: London Vision Clinic
Professor Reinstein says patients are unable to drive or take public transport to the surgery (so it’s best to bring somebody with you on the day who can get you there and back), nor should they wear make-up, drink alcohol or wear anything woolen that may generate lint. Prices vary from £1,200 to £6,500, and the results are permanent. “However the eye is, of course, a living organ and can change over the years,” says Professor Reinstein. “The good news is that it’s relatively simple to go back to your surgeon and have a small adjustment made to adjust for any ageing changes.”
So, what are your options?
“This is the most common form of laser eye surgery, with over 40 million procedures performed to date,” says Professor Reinstein. “In LASIK, a flap is created within the outer layer of the cornea (the watch glass at the front of the eye) which is simply folded back to expose the internal surface of the stromal tissue (the inner portion of the cornea). After a computer controlled amount of tissue is removed, the flap is returned to its original position. The natural processes of the eye immediately get to work with the outer layer of the eye sealing the edges of the flap overnight. The rest of the cornea is unaffected, and most patients only feel mild discomfort for a few hours. Visual recovery is extremely fast, with the vast majority of patients seeing 20/20 or practically 20/20 by the next morning.”
“This is the latest generation of laser eye surgery, which is less invasive with no need to cut a flap and remove or push aside the surface skin (epithelium) of the cornea,” says Professor Reinstein. “Using the Carl Zeiss Meditec VisuMax femtosecond laser, this treatment is performed within the stromal tissue via a tiny keyhole incision. Once a precise amount of tissue is removed through this incision, the procedure is complete. The epithelium only needs to seal the opening of the small incision.
"This minimally-invasive procedure leads to less dry eye and enables patients to return to active sports sooner than the other options, as there are no moving parts. It can even be performed in patients who already have mild dry eye; something that is less commonly done with LASIK.
"This method also opens up laser eye surgery as an option for patients with higher prescriptions. There have been over 1.2 million procedures performed since its launch 2012.”
Avoid make-up, alcohol and driving on the day of your surgery Credit: Getty
“In LASEK - or PRK as it’s sometimes known - the surface skin/epithelium of the cornea is polished away to expose the stroma, and the laser evaporates the tissue required to change the prescription off the surface of the cornea itself,” explains Professor Reinstein. “The epithelium then takes 4-5 days to grow back under a protective specialised bandage contact lens. This procedure does not involve creating a corneal flap like LASIK and is the preferred procedure for surgeons with less experience in LASIK.
"In expert practices, PRK surface procedures are mainly used for patients with glasses who also have problems with the corneal surface, such as contact lens infections that have caused scarring or other recurrent erosion problems of the corneal surface. Surface procedures can be used to treat the pathology as well as the focusing of the eye simultaneously.”
PRESBYOND Laser Blended Vision
“This is the most effective way of treating ageing eyes or presbyopia, where age changes of the eye cause people to need reading glasses or bifocals,” says Professor Reinstein. “The actual surgery is the same as all three I’ve mentioned, but the optical changes are different in that they are designed to increase the depth of field of the eye to enable distance and near vision to be achieved.
"It is a significant improvement on the more commonly used technique for treating reading vision known as permanent lens replacement or clear lens exchange. PRESBYOND is less invasive, safer, and more accurate than permanent lens replacement plus it has fewer side effects and is adjustable and reversible.”
Original Date: Sep 13 2018
Written By: Maria Lally