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LASEK = Laser Epithelial Keratomileusis
Laser Epithelial Keratomileusis (LASEK) is a new type of refractive surgery that combines the advantages of LASIK and the advantages of PRK and reduces the disadvantages of both. Dr. Soloway was the first doctor in New York to perform this surgery. LASEK is similar to LASIK, except that Dr. Soloway cuts a flap in the epithelium (the cornea's outer layer of cells), instead of through the epithelium and part of the stroma. LASEK is similiar to PRK except that Dr. Soloway preserves the epithelial layer as a replaceable flap instead if scraping or lasering it away. Dr. Soloway is part of an international team studying the benefits of LASEK, and he has designed many of the instrumentation used for this procedure. His early work with this surgery is proving it to be safer that PRK surgery in general, and more advantageous than LASIK for patients with corneas that are too thin for their prescription and dark light (scotopic) pupil sizes.
Steps to LASEK
Under the LADARVision excimer laser, the patient's eye is numbed using anesthetic drops, and cleaned with a sterile tear solution. The eye is tracked to freeze it on the LADARVision computer screen, and the area that will be reshaped is superimposed. A custom designed instrument is placed on the cornea surrounding the area to be reshaped and a solution is placed in this instrument for one minute to allow the epithelial flap to be created. After removing the solution and the instrument, Dr. Soloway uses another instrument of his own design to lift the epithelial flap from the underlying cornea. The LADARVision tracking / flying spot laser is then used to precisely reshape the outermost stromal layer of the cornea. After the laser reshaping is complete, Dr. Soloway cleans the surface of the newly shaped cornea, and then carefully replaces the epithelial flap. This flap is then allowed to dry slightly in order to start healing to the corneal stroma. A bandage contact lens is then applied on the eye to hold the epithelial flap in place, and eye drops are started. Unlike LASIK, the patient does not require eye shields to protect the epithelial flap.
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