LASIK vs. LASEK: Choosing the Right Laser Surgery for You

LASIK and LASEK eye surgery are very similar procedures in terms of goals, however, there are differences in the processes as well as the advantages and disadvantages of each procedure.

The key difference between LASIK and LASEK involves the corneal flap. With LASEK eye surgery, the corneal flap is significantly thinner than the corneal flap that is created during LASIK eye surgery. 

Both procedures are widely viewed as safe, though there are potential risks involved, as there are with any surgery. Both LASIK and LASEK have very high success rates.

More About LASIK

LASIK is a form of laser vision correction surgery used to treat conditions like myopia (nearsightedness), hyperopia (farsightedness), and astigmatism.

The primary objective of LASIK surgery is to change the shape of the cornea. This is done so the eye can better focus images onto the retina, resulting in clearer vision. 

With LASIK, a thicker flap is made. This corneal flap is created during LASIK using a microkeratome or a laser. 

Looking for the Best LASIK Near You?

Find a LASIK Surgeon

More About LASEK

LASEK (laser epithelial keratomileusis) can be thought of as combining the benefits of the most frequently performed vision correction procedures, PRK and LASIK. Like both of those surgeries, LASEK can treat myopia, hyperopia, and astigmatism.

During LASEK surgery, the surgeon makes a very shallow cut in the epithelial layer of the cornea. They then apply an alcohol solution to the cornea, which remains there for about 30 seconds. This loosens that top layer, allowing it to be easily folded back for the surgery. After the surgery on the middle corneal layer is complete, that top layer is folded back into place.

Advantages & Disadvantages of LASIK & LASEK

The choice between LASIK and LASEK will depend on your individual prescription, health, vision goals, and other factors. In some cases, your surgeon may recommend one procedure over the other.

As mentioned previously, one of the advantages of LASEK is that there isn’t such a sizable corneal flap created when compared to LASIK. This can reduce the risk of infection during the healing process. However, some patients report experiencing a longer recovery time with LASEK when compared to patients who underwent LASIK surgery.

Many LASEK patients report that they did not fully recover their working vision for one to two weeks after surgery. This extended healing time is also associated with PRK eye surgery.

Both surgeries have incredibly high success rates with good long-term results. However, LASEK patients were found to have slightly better long-term results in one review. If someone is prone to dry eye, LASEK may be the preferred procedure. 

Key Differences Between LASIK & LASEK 

The main difference between LASIK and LASEK is in regard to the corneal flap made during the procedure, but there are further differences. 

LASIK offers benefits, such as these:

• Fast recovery time
• Quick overall vision stabilization
• Minimally invasive procedure
• Minimal pain or discomfort
• Fewer complications when compared to other procedures

LASEK offers benefits, such as these:

• Effective treatment for thin corneas
• Beneficial for patients with high refractive errors
• Lower dry eye risk
• Little chance of flap complications, such as infection
• Comparable results to LASIK

Choosing Between LASEK & LASIK

Which procedure is best for you comes down to your own individual circumstances as well as the results you wish to achieve. For instance, if you have thinner corneas, dry eyes, or a high refractive error, LASEK may be the better procedure for you.

LASIK is the more popular of the two procedures, and the vast majority of patients are happy with the results. If you’re a candidate for LASIK, most surgeons will recommend this choice.

As part of an initial surgical assessment, the surgeon will perform a complete examination and take measurements of your eyes. This will all form the basis of their recommendation on the best surgery to correct your vision. 

There isn’t a catch-all recommendation on the best since it comes down to your individual eye health, overall health, refractive error, and vision goals.  

Are There Risks to LASIK & LASEK? 

Just as with any other surgical procedure, there are risks associated with both LASIK and LASEK eye surgery. 

Risks associated with LASIK include the following:

• Dry eyes
• Glare
• Halos around lights
• Double vision
• Astigmatism
• Flap issues or complications

There is a potential risk for undercorrections and overcorrections. These occur if the laser removes either too much or too little corneal tissue. If either occurs, additional procedures may need to be performed in order to achieve desired results. For an undercorrection, a LASIK enhancement, or follow-up surgery, can generally remove more tissue to achieve vision goals.

Risks associated with LASEK include the following:

• Blurred vision
• Glare
• Halos around lights
• Dry eyes
• Infection
• Irritation

Just as with LASIK, LASEK eye surgery can result in either overcorrection or undercorrection. Additional treatment can usually help patients achieve desired results in these cases. 

Making the Right Choice for You 

Again, the right choice for you will be an individual decision that you make in conjunction with your surgeon. 

If you have thin, flat, or irregularly shaped corneas, LASEK may be a better option for you. If you have a straightforward vision correction case, LASIK might be preferable.

Consult with an experienced eye care professional before you make a decision between LASIK and LASEK. An experienced eye doctor will assess your current health profile as well as your current vision issues. Together, you and your surgeon can come up with a proactive plan that will result in better, clearer vision for the long run.

References

1. Myopia: Mechanisms and Strategies to Slow Down Its Progression. (June 2022). Journal of Ophthalmology.

2. Long-Term Visual Quality After Small Incision Lenticule Extraction (SMILE) and Laser Assisted Subepithelial Keratomileusis (LASEK) for Low Myopia. (August 2022). BMC Ophthalmology.

3. Long Term Safety Results of LASIK Refractive Surgery: A Twenty-Year Retrospective Study. (September 2022). Research Square.

4. Astigmatism. (December 2022). StatPearls.

5. Laser‐Assisted Subepithelial Keratectomy (LASEK) Versus Laser‐Assisted In‐Situ Keratomileusis (LASIK) for Correcting Myopia. (February 2017). Cochrane Database of Systematic Reviews.

6. Safety, Efficacy, and Stability Indices of LASEK correction in Moderate Myopia and Astigmatism. (October 2004). Journal of Cataract & Refractive Surgery.

7. Comparison of Postoperative Visual Quality After SMILE and LASEK for High Myopia: A 1-Year Outcome. (August 2017). PLOS ONE.