LASEK vs LASIK: A Deep Dive into the Safety of Vision Correction Surgeries

When it comes to laser vision correction, refractive surgeries like LASEK (Laser-Assisted Sub-Epithelial Keratectomy) and LASIK (Laser-Assisted In-Situ Keratomileusis) are popular choices. But which is safer: LASIK or LASEK?

While both LASEK and LASIK have proven effective at treating myopia (nearsightedness), hyperopia (farsightedness), and astigmatism, they involve different methods and risks. This article explores why LASEK is a safer option.

Understanding LASEK and LASIK Procedures

In LASIK, the surgeon creates a corneal flap using a microkeratome or a femtosecond laser. Once the flap is lifted, the underlying corneal tissue is reshaped with an excimer laser to correct vision. The flap is then repositioned without the need for stitches. Dr. Chynn himself performed over 5,000 LASIKs, but stopped when his own LASIK induced dry eyes & night glares in his left eye. 

LASEK, on the other hand, involves removing the thin layer of skin on top of the cornea either using an alcohol solution or a vacuum epi-keratome (part of the X-Press Recovery here at Park Avenue LASEK). The underlying corneal tissue is then reshaped to the shape of your glasses or contact lenses with the laser. After the treatment, a soft contact lens (“bandage contact lens”) is placed on the eye to aid healing. By inventing the vacuum-assisted LASEK, Dr. Emil Chynn achieved reducing LASEK’s recovery time to only 1-2 days longer than LASIK–with vastly better safety.

Why LASEK is ALWAYS Safer Than LASIK

1. Lower Risk of Corneal Ectasia: The most serious complication of LASIK is corneal ectasia, where the cornea bulges outward, destroying vision and sometimes requiring a corneal transplant, where the cornea from a dead person in stitched into your eye using as many as 36 sutures. The vision after a transplant is never perfect, and often has permanent astigmatism. Often, to achieve good vision, the patient would have to wear a special hard contact lens called a “scleral lens” which is very expensive and uncomfortable. Also, this patient started on the pathway of LASIK because he or she didn’t want to wear glasses or contacts. So forcing him into a hard scleral lens is not really a “solution” that the patient wants. Because LASEK creates no flap, it leaves more of the underlying corneal stroma untouched, thereby vastly reducing the risk of corneal ectasia.
2. Fewer Dry Eye Symptoms: LASIK severs the corneal nerves by cutting the flap, which can lead to a reduction in tear production and cause dry eye symptoms. As LASEK only involves the surface layer of the cornea, it doesn’t cause long-term dry eye symptoms because it doesn’t cut corneal nerves.
3. Less Risk of Flap Complications: LASEK reduces the potential for flap complications because it doesn’t involve a flap like in LASIK. Flap complications can include issues like flap dislocation, irregular flap, flap inflammation (DLK), and epithelial ingrowth. 
4. Suitability for Thin Corneas and Active Lifestyles: LASEK is a better choice for people with thinner corneas as it preserves more of the corneal thickness. Moreover, people with active lifestyles or jobs that involve physical contact might be safer choosing LASEK to avoid potential flap dislocation. This is why Dr. Emil William Chynn, MD, FACS, MBA has lasered so many extreme athletes and special forces soldiers; they are not allowed to get LASIK (they can go blind if they get punched in the eye).

However, as with any surgical procedure, individual suitability is key. Patients should discuss their individual circumstances, expectations, and concerns with their ophthalmologist to make the best decision for their vision correction needs. Dr. Chynn is the only doctor that takes into account your full visual needs before deciding whether to treat or not. For example, he’s the ONLY laser vision surgeon in NY, NJ or CT who will intentionally over-correct your prescription if you are less than 30 years old, he will enter a higher prescription into the laser, so you won’t later need an enhancement. And since he’s about to retire & doesn’t care about money anymore, he doesn’t push patients to get LASEK unless it’s the absolute best option for them.