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Surface Ablation

Contents
1. What is Surface Ablation?
2. How is LASEK performed?
3. What are the benefits of LASEK?
4. What to expect after the surgery
5. What side effects, risks and complications should I be aware of?

What is Surface Ablation?

Surface ablation refers to a group of procedures that involve the use of a laser called the excimer laser to treat the surface of the cornea to correct

  • Short-sightedness (myopia)
  • Far-sightedness (hyperopia)
  • Astigmatism

Surface ablation procedures include

  • Photorefractive keratectomy (PRK)
  • Laser epithelial keratomileusis (LASEK)
  • Epipolis laser insitu keratomileusis (EpiLASIK)

LASEK is one of the most commonly performed surface ablation procedure today and it is the surface ablation procedure of choice at Dr Cordelia Chan’s practice. It is an excellent alternative to LASIK or ReLEx SMILE, especially in cases where the cornea is too thin for correction by these procedures.

lasers

How is LASEK performed?

This is how LASEK is performed, and the points to note:

  1. It is performed as an outpatient procedure.
  2. You will be awake during the surgery and no sedation is necessary.
  3. The surgery is generally a comfortable experience with minimal pain.
  4. The eye is first numbed with anaesthetic eyedrops.
  5. The epithelium (“skin”) of the cornea is removed in a smooth sheet after softening with very dilute alcohol.
  6. A specialized laser, the excimer laser is then used to re-shape the cornea to correct the refractive error. This process causes the centre of the cornea to flatten in the case of short- sightedness, steepen in the case of far-sightedness or become more rounded in the case of astigmatism, changing the focusing power of the cornea and improving your vision.
  7. Following excimer laser treatment, in most cases, a special chemical called mitomycin C that reduces cornea haze or scarring is applied to the cornea.
  8. At the end of the procedure, a bandage contact lens is placed in the eye and this is kept for approximately 5 – 10 days to allow for the new epithelium (“skin”) to heal over.

A video showing how LASEK is performed. The surface skin (epithelium) of the cornea is gently removed and the excimer laser applied to alter the shape of the cornea. The white sponge applied contains the special chemical called mitomycin C to reduce the incidence of cornea haze after surgery.

What are the benefits of LASEK?

LASEK is a safe procedure with excellent visual outcomes, and its long term visual results are similar to that of LASIK.
LASEK is a flap-free cornea procedure, and so it may be more useful in individuals who are involved in high impact sports or certain vocations.
The risk of weakening of the cornea after LASEK is much lower than other laser vision correction procedures.
The goal of LASEK is to improve your vision and to reduce your dependence on spectacles or contact lenses. Most individuals may be able to be fully independent of glasses or contact lenses, but if you are beyond 45 years of age and require glasses for reading (a condition called presbyopia), you will probably still need your reading glasses after LASEK.

What to expect after the surgery

Generally, visual recovery after LASEK is slightly slower than after LASIK or SMILE. Discomfort or pain is usually more intense and prolonged. When the effect of the anaesthetic eyedrops wears off, most patients will experience pain, tearing, burning sensation, scratchiness and / or difficulty opening their eyes, the severity of which varies from patient to patient. These symptoms usually last for 2-3 days. You will be prescribed antibiotic and steroid eyedrops as well as artificial tears to keep the eyes moist, and painkillers to cope with the pain after surgery the first few days.
Although the visual recovery from LASEK is slightly slower than that of LASIK and SMILE, the long term outcomes are the same. LASEK is also a very rewarding procedure for the patient and the surgeon!

What side effects, risks and complications should I be aware of?

LASEK has side effects that you need to aware of, but fortunately, LASEK is very safe and most of the side effects are mild and temporary. These include pain after surgery (as described above), redness, dry eye, haze or fine scarring of the cornea, fluctuating vision, haloes, glare, starbursts and light sensitivity. Over- or under-correction may occur, and additional surgery may be required in some cases. The serious side-effects that can result in permanent loss of vision eg infection, are fortunately rare. Weakening of the cornea (keratectasia) after LASEK is also very rare.
Depending on the individual’s healing response towards the excimer laser, the cornea may show variable degrees of scarring or haze which can affect quality of vision. This is usually more frequently seen with higher degrees of correction. In most cases, this haze is treatable with topical steroids and does not usually affect the final quality of vision.

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Eye Surgeons @ Novena, Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road #09-28 Singapore 329563
Contact: +65 66940400,  eyesurgeonsnovena@gmail.com