LASEK corrective vision surgery is a relatively new and effective procedure used to treat shortsightedness, farsightedness and astigmatism. It could be described as a hybrid, combining the merits of two older types of laser eye surgery: LASIK and PRK.

LASIK involves the use of a microkeratome (sharp blade) to cut a hinged flap in the top of the cornea. In PRK the outer layer of the cornea, the epithelium, is rubbed away and the cornea reshaped.

In LASEK, an epithelial flap is created not by cutting but by using a solution of 20% alcohol under local anaesthesia. The flap is rolled back, the exposed corneal tissue is treated with the same laser as in LASIK and PARK surgery, and the top layer of cells replaced.

This technique has many benefits:

No corneal flap is created and, therefore, LASEK avoids the complications associated with LASIK surgery. Damage to or wrinkling of the corneal flap, together with penetration of the eye by the microkeratome, are some of the risks occasionally reported with LASIK.

In LASEK the healing process is much faster as alcohol, not a sharp blade, is used to create the epithelial flap. The flap acts as a natural bandage promoting healing.

LASEK causes less post-operative dry eye than LASIK surgery. Those with dry eye syndrome are more suitable candidates for LASEK as this procedure avoids the creation of a deeper flap. The LASIK flap and zap technique involves cutting the corneal nerves which, in turn, control the tear reflex.

After PRK surgery abnormal healing of the cornea can give rise to the development of haze which can occasionally result in permanently affected vision. With LASEK, less trauma is caused to the eye, consequently there is a lower risk of haze and scarring of the cornea.

But LASEK does have its drawbacks, including:

More discomfort than the LASIK procedure, although most patients experience post-operative discomfort for two days or less. PRK surgery is more painful than LASEK as the procedure entails making a large abrasion on the cornea.

The need to wear a protective contact lens for 3 to 4 days which acts as a bandage and buffer between the eyelids and treated eye. This is not necessary for LASIK or PRK procedures.

A relatively slow healing time of one to two weeks compared to the one or two days for LASIK patients.

The need to use topical steroid drops for several weeks. Following LASIK surgery they are typically used four times a day for a maximum of two weeks, but often for only a week.

Temporary side effects which can last from 6 to 12 months. LASEK patients may experience dry eyes, hazy or cloudy vision and reduced vision in low levels of light. As with all corrective vision surgery, good results cannot be guaranteed, and a very small number of patients will have permanently affected vision.

Who is a good candidate for LASEK surgery? Patients with particularly thin, steep or flat corneas can benefit from LASEK. That being said, new FDA-approved techniques used in LASIK do not now automatically disqualify this group of patients from having LASIK surgery. LASEK would seem a better choice simply because the surgeon will not face the difficulty of creating a corneal flap from very little tissue.

LASEK is also more suitable for those who take part in contact sports: since the LASIK procedure involves more cutting, any subsequent sports injury to the eye can be more serious. As we have already seen, LASEK suits better those patients with dry eye syndrome as the tearing reflex is left unaffected.

Your suitability for LASEK having been checked by the surgeon who will carry out a range of eye tests and diagnostic procedures, you will be treated on an outpatient basis. The eye will be cleaned, anaesthetic drops applied and a speculum applied to the eyelids preventing blinking.

As we've seen, the epithelium is first loosened by applying a diluted alcohol solution, then pushed to one side and laser pulses directed on to the exposed cornea. Sixty seconds later, the procedure is complete.

Expect blurred vision initially followed by a day or two's rest. Over the months to come your vision quality may be variable but, in the great majority of cases, these temporary problems will disappear.

To ensure your outcome is the best possible one, be proactive. Ask work colleagues, family and friends for recommendations of surgeons experienced in the LASEK technique. Don't be afraid to ask the surgeon both for names of satisfied patients and for information about the surgeon's expertise in the procedure. You owe it to your eyes.