Differences between PRK, LASEK and Epi-Lasik

San Francisco, Oakland & San Jose, California

Surface Ablation Procedures

Some optometrists argue that surface ablation procedures are safer procedures with better visual outcomes than LASIK surgery. Surface ablation procedures include LASEK, or PRK and epi-LASIK. With these procedures, no corneal flap is created, which reduces the risk of pain, scarring and complications.

PRK

Before LASIK was invented, Photo Refractive Keratectomy, or PRK was the primary method of refractive surgery that used an excimer laser to correct vision. Because it provides advantages that traditional LASIK surgery cannot, PRK is still widely performed throughout the country.

Instead of creating a flap, PRK uses the excimer laser to carefully vaporize corneal tissue at the surface or under the thin epithelial layer of your cornea. By doing this, PRK leaves more of your corneal tissue intact. A bandage contact lens is placed over your cornea to promote healing, which takes a week or two.

Since PRK affects less corneal tissue, it can be performed on patients who are not eligible for LASIK surgery. For example, if you have a great refractive error, you are often deemed unfit for LASIK surgery. However, you may be able to undergo PRK, which is ideal for correcting refractive errors.

Epi-LASIK

The procedure for Epi-LASIK and PRK are identical, except for one main difference: After the laser is applied in the epi-LASIK procedure, the epithelial cells (which have been loosened by an alcohol solution and removed) are laid back over the treatment area once your cornea is reshaped. In PRK they are removed entirely.

With epi-LASIK, the replacement of your epithelial cells is used to facilitate the healing of your new epithelium, the thin layer covering your cornea. The visual results of epi-LASIK and PRK are essentially the same, including a reduced chance of flap complications and a quicker recovery.

Some experts predict that epi-LASIK will become increasingly popular for patients who must undergo PRK. However, epi-LASIK will never replace LASIK.

LASEK

The LASEK and epi-LASIK procedures are also quite similar. Unlike LASIK, neither of these techniques requires making an incision, so they are less invasive. The main difference between LASEK and epi-LASIK is how the superficial corneal skin is handled. During the LASEK procedure the corneal skin is manually moved to the side during surgery. With epi-LASIK the skin is moved mechanically.

With LASEK, by sliding the corneal skin to the side, the pristine underlying collagen surface is then exposed. Using an excimer laser, the surface is reshaped and any irregularities that are causing blurred vision are corrected. The epithelial flap is then gently repositioned.

Without the initial incision, normal corneal sensation is maintained and clear vision is restored immediately. Vision is fully functional and continues to improve as the weeks pass. Recent studies have found that after three months, LASEK patients have equal or slightly better vision than patients of conventional LASIK surgery.

Serving the residents of San Francisco, Oakland and San Jose, Dr. Gary Kawesch and his team of experienced optometrists and friendly staff can help you see clearly once again. If you are interested in correcting your vision once and for all, please contact our office today.

Our Celebrity Clients

See the who's-who of vision correction and read what people are saying about us.