LASEK (laser epithelial keratomileusis) is a relatively new procedure that is technically a variation of PRK. Also called epithelial LASIK or E-LASIK, LASEK is used mostly for people with corneas that are too thin or too flat for LASIK. It was developed to reduce the chance of complications that occur when the flap created during LASIK is not the ideal thickness or diameter. LASEK,
Laser epithelial keratomileusis is a newer form of laser vision correction.

It is used to treat astigmatism, nearsightedness or farsightedness. In LASEK, the epithelium, or outer layer of the cornea, is cut not with the microkeratome cutting tool used in LASIK, but with a finer blade called a trephine and a 20% alcohol solution.

LASEK may be better for patients who have steep or very thin corneas, which make it difficult for the surgeon to make a proper LASIK flap. Since traumatic injury to the eye is more serious after LASIK than LASEK, patients who engage in professional or leisure activities that put their eyes at increased risk for injury (such as boxing) may be better suited for LASEK. LASEK IS better for people with dry eye syndrome because in avoiding a deeper flap, the corneal nerves responsible for the tearing reflex are not cut.

LASEK is done under local anesthesia. During the procedure, the top layer of cells, or epithelium, is treated with alcohol for about 30 seconds to detach it from the underlying tissue. It is then lifted or rolled back so that the eye doctor can access the cornea tissue. The newly exposed tissue is treated with the same laser used in LASIK and PRK, and then the top layer of cells is replaced.

This is in contrast to LASIK, in which a cutting device makes a flap in the cornea. LASEK differs from PRK by preserving the top layer of cells, rather than scraping them away and waiting for them to grow back. This is believed to facilitate healing of the cornea with less discomfort than PRK.

After the LASEK procedure, expectations are similar to what can expected after LASIK. However, even though the flap created by LASEK heals in about a day, patient usually wear a special contact lens that acts as a bandage for up to four days after surgery. Patients also may experience irritation in their eye during the first day or two afterward. For patients who undergo the LASIK procedure, good vision is usually attained in a few days. For LASEK this may take as long as a week.