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LASEK

Laser Epithelial Keratomileusis

eyes

LASEK - laser epithelial keratomileusis - is a more recent version of laser eye surgery combining the benefits of LASIK and PRK.

In this procedure, the flap in the retina is cut not with a microkeratome but with a finer blade called a trephine and a 20% alcohol solution.

As a result the cutting and the reattaching of the flap goes much easier as well as the dry eye after the surgery is caused much less in LASEK than in LASIK.

eyes

But it has some disadvantages also as compared with LASIK:

  • Recovery time is longer.

  • The patient experiences more pain and discomfort after surgery.

  • A bandage contact lens just like after PRK is required to be worn for 3 or 4 days.

  • Steroid drops are to be used for a longer duration.

LASEK
LASEK
Credit: National Library of Medicine, National Institutes of Health

The side-effects of PRK are there in LASEK also, although to a lesser extent:

  • Foreign body sensation in the eye

  • Poor night vision

  • Dry eyes

  • Hazy vision

LASEK is recommended for patients having very thin corneas, which make it difficult for the surgeon to make a proper LASIK flap.

Eyes go more vulnerable to injuries after any kind of laser eye surgery, more so in LASIK than in LASEK. Hence people having a lifestyle that puts eyes under risk are better off with LASEK than LASIK.

People with dry eye syndrome should also opt for LASEK rather than LASIK. This is because in LASEK the corneal nerves responsible for the tearing reflex are not cut.

LASEK
LASEK
Credit: National Library of Medicine, National Institutes of Health

But I have a different question to ask here:

What, in fact, does the LASEK do to the eye?

Let us see:

Cornea is the front most transparent part of the eye that plays its part-role in bending the rays of light falling on the eye in order to focus them at fovea on retina.

If, for whatever reason, the said rays of light fail to focus on retina but do so rather short of it (myopia), behind it (hyperopia and presbyopia) or more so in one meridian and less so in another (astigmatism); a change in the shape of cornea will be able to correct the fault exactly the same way as is done by eyeglasses or contact lenses placed (as they are!) just in front of cornea. In other words, LASEK changes cornea to permanent eyeglasses or contact lenses inside the eye rather than in front of it.

LASEK
LASEK
Credit: National Library of Medicine, National Institutes of Health

Can this be called a treatment?

Or is it just a kind of management exactly like the one done by eyeglasses or contact lenses?

Only that the inconvenience of wearing eyeglasses on, or putting contact lenses in the eyes has been eased off!

What has been the real cause of the problem?

Is it the shape of the cornea, the shape of the lens or the shape of the eyeball?

We must be very clear about it.

If it is the shape, anyway, of anything, what does it mean when the diopter number of the eye increases?

Does the shape change?

What else, otherwise?

If yes, that means the shape is technically able to change.

And if the shape can change to increase the diopter number, it ought to be able to change in a way that decreases the diopter number as well!

Then why do we change it the surgical way?

LASEK

LASEK
Credit: National Library of Medicine, National Institutes of Health

Simply because we don't know how to change it non-surgically!

Change what?

The shape!

Of?

The cornea, the lens, or the eyeball?!

Whatever, but we don't know how.

But it does change of its own.

And it does so after the surgery too!

What shall we do then?

I personally came across numerous such cases as had been passed as successful and remained so till around eight years after the laser eye surgery but then rolled back to the same old number that was there before the surgery was done.

The diopter number is the same again but the structure of the eye has gone deformed!

What shall we do now?

LASEK

LASEK
After
Credit: National Library of Medicine, National Institutes of Health

Again scrap the cornea further?

How long shall we go on doing that?

Why are we going on deforming the structure of the eye?

We don't know when and why the shape again starts changing of its own. All our surgical changes, then, will not only go useless but may prove to be harmful too in the long run.

Why does the shape change, and shape of what?

Is it the cornea, or the lens or the eyeball?

Not cornea. It doesn't have the musculature.

Lens certainly does but temporarily and dynamically, according to the need of the moment (not the hour!).

Only the eyeball is left. And it can. It has the musculature to do so.

So it's the eyeball that can change its shape and give the eye a diopter number!

Even after laser eye surgery!

Or it can change the other way round and free the eye of its diopter number without the laser eye surgery!

But not after laser eye surgery! It is bound to keep itself deformed - and only to a particular extent set by the surgery, neither less nor more - in order to see clear because it is permanently wearing the surgical lenses that the cornea has been permanently changed to. Any deviation in any direction, and the eyesight will get the grunt of it. And it does!

The eyeball does keep changing the shape in the normal course of events. It's a dynamic and not a static structure.

But after the laser eye surgery, it is forced to keep itself static - in a deformed shape - just like a bespectacled eye is.

Unluckily, keeping the eyeball statically deformed is a continuous stress to the eye, to the body and to the mind.

Is there a way (of course, non-surgical!) to change the shape of this statically deformed eyeball and turn it dynamically natural?

Immediately?

So that the humanity may get rid of eyeglasses, contact lenses and the most importantly the laser eye surgery menace!

Vision therapy seems to do the job through opening the third eye; and that too, opening it instantaneously.

If it is really so, it must, at least, be given a try before going for any laser eye surgery including LASEK and causing a permanent deformity in the structure of the eye which can never be undone too!



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