It is likely that everything that you have heard up until now has been about LASIK. This literature is to inform you about a different procedure, called PRK/ LASEK/ epi-LASIK. It is unfortunate that the names selected for these two procedures are so similar as it leads to confusion. These group of procedures are also referred to as ADVANCED SURFACE ABLATIONS or SAFESIGHT LASER ( a term we prefer using).
LASIK is the procedure of CONVINIENCE for most people that are suitable – it is almost pain-free, offers a very fast visual recovery and both eyes can be treated at one sitting.These features just described explain why LASIK has become such a popular and commonly performed procedure.
During a LASIK procedure, a flap is made with the use of a machine called a “microkeratome” or a laser(Femto second laser), the excimer laser ablation is then applied underneath this flap. Once the laser has been completed, the flap is replaced.
In the event that your cornea is too thin, then it becomes impossible to make a flap and do the laser ablation, as it would leave too little residual corneal thickness. Traditionally this is where SafeSight laser (i.e PRK/LASEK/epi-LASIK) would be primarily indicated, as it is a procedure that saves corneal thickness. SafeSight Laser (i.e PRK, LASEK, epi-LASIK) is now increasingly becoming the procedure of choice for risk avers patients and surgeons, even when having thick enough cornea for LASIK.
No mechanical flap is fashioned. Instead, a flap of epithelium (the very thin layer of cells that covers the surface of the cornea) is gently lifted by the surgeon and rolled to one side to facilitate laser treatment. The level of laser treatment is now at 50 microns beneath the surface as opposed to 160 microns beneath the surface that is usually the case with LASIK.
This difference in the level at which the laser ablation is applied, has saved 110 microns of tissue and this can be crucial in certain cases. It needs to be remembered that the higher your refraction(MYOPIA/ HYPEROPIA/ASTIGMATISM), the more the tissue that needs to be removed. There are therefore cases where LASIK would simply not be possible due to the existing corneal thickness and the amount of tissue that needs to be removed. In these cases, SafeSight laser ( i.e. PRK/LASEK/ epi-LASIK) allows the procedure to go ahead as it saves 110 microns of tissue. This saved 110 microns is enough to treat an extra 8 Diopters of refraction. The more tissue you save, the more stable and safer your laser procedure would be.
How does it differ from patient’s perspective?
The procedure itself is very similar except that with SafeSight laser ( i.e. PRK/LASEK/ epi-LASIK) there is no pressure feeling during the procedure. It also lasts for approximately 5 minutes per eye, which is shorter than the time it takes to perform LASIK (usually about 15min per eye).
A Bandage Contact Lens is routinely placed on the eye for 4 or 5 days following the procedure. This implies that you will have the contact lens in permanently for these 4 or 5 days, including sleeping with the lens in at night. Drops will be applied directly on to the contact lens.
There is some discomfort for the first day after surgery and this improves quite steadily to the point that on the 3rd post-operative day, the eye is already quite comfortable.
It takes longer (3-5days more) than in LASIK before the vision is fully recovered. With LASIK, the vision is normally very good by the very next day. With SafeSight laser (i.e. PRK/ LASEK/ epi-LASIK) the vision takes longer to recover. Once the contact lens is removed on the 5th day, the vision is normally around 80% of what it is going to be eventually. The final visual acuity is achieved at approximately 1 month after the procedure although the quality of vision continues to improve for up to 6 months afterwards. With SafeSight laser (i.e. PRK/ LASEK/ epi-LASIK) most people are able to drive around day 3 and back at work day 5-7 (one week).
Is it safe?
The procedure is very safe. As there is no flap, its safer than LASIK. Very few complications occur with LASIK(about 5 in 100 patients), but when they do, they are almost invariably flap related (95%). There is no flap with SafeSight laser (PRK/ LASEK/ epi-LASIK) avoiding these complications. SAFESIGHT EYE LASER is 10X Safer than LASIK.
Interesting fact: THE MAJORITY OF EYE SURGEONS WHO UNDERGO LASER VISION CORRECTION SURGERIES THEMSELVES, PREFER SAFESIGHT EYE LASER ( LASEK/ epi-LASIK) FOR THEIR OWN EYES.
How does LASEK differ from PRK?
PRK is becoming more and more popular. With PRK the surface cells are removed and discarded. The cells then regenerated over the next 4 to 5 days. This explained why the procedure irritates slightly more than the newer LASEK procedure and why the vision takes slightly longer to recover. With LASEK, the cell layer is placed back into position and held in position with the use of the bandage contact lens. This has resulted in a bit more comfort and a bit more quicker visual recovery. LASEK can almost be described as a marriage between PRK and LASIK.
Why is SafeSight Laser (PRK/ LASEK/epi-LASIK) not the procedure of choice considering the fact that there can be no flap-related complications?
The biggest reason that almost everyone still chooses LASIK, is the fact that the procedure has such a small “inconvenience factor” – it is almost pain-free and the visual recovery is very fast(2 days). These features mean that the average person is out from work for just a couple of days and after these initial days, is functioning as well as they were before the procedure with the only difference now that they are without their glasses.
With SafeSight Laser (PRK/LASEK/ epi-LASIK), there is more discomfort and vision lags that of LASIK by about a week. Patients need to take off work for at least 5 days. The first few days(3) you cannot drive a car.
In the past number of years, the number of patients electing to undergo SafeSight Laser (PRK,LASEK, epi-LASIK) to both eyes on the same day has increased dramatically and at present, 95% of patients treat both eyes on the same day. This is most likely due to the fact that with the new modern bandage contact lenses that are worn for 5 days after SAFESIGHT EYE LASER (PRK/ LASEK epi-LASIK), the visual recovery is faster and the discomfort less than before.
So basically, it comes down to convenience vs safety on behalf of the patient. SafeSight Laser (PRK/ LASEK epi-LASIK) is 10X safer.
Can enhancements be done?
Enhancements (fine-tuning or adjustments) can be done but unlike LASIK, where they are relatively simple, here they are an exact replica of the initial procedure again. An interesting fact however is that SAFESIGHT EYE LASER (PRK/LASEK) patients need enhancements less regularly than LASIK patients (5% vs. 10% on average)
In what other situations may SafeSight Laser (PRK/ LASEK/ epi-LASIK) be indicated rather than LASIK?
a) In any situation where access to the eye with the microkeratome may be difficult (e.g. very deep-set eyes)
b) LASEK/ SAFESIGHT EYE LASER/ epi-LASIK tends to induce less dry eye than LASIK, so is sometimes used when tear production is inadequate and cannot be improved sufficiently to allow LASIK
c) Patients that are likely to sustain blows to their eye, either due to work( police, soldiers etc.) or recreational activities ( karate, football, rugby,cricket etc.). Relatively minor trauma can dislocate a LASIK flap even years after undergoing LASIK.
Remember that refractive surgery is always elective. This means that you always have the final say concerning whether you want to do any procedure at all and to choose which procedure you prefer.
Call us on 0815455385 for a consultation, and see if you qualify for Laser Eye Surgery.