EXCIMER LASER SURFACE TECHNIQUES
WITHOUT CUTTING: PRK - LASEK - EPILASIK
History
PRK or refractive Photokeratectomy has been practiced since the 1980s. The LASEK is an improvement of the PRK technique invented in 1999, the EpiLASIK is performed since 2004 and is the latest improvement of this surgery type.
Surgical Technique
This ambulatory surgery is performed with topical anesthesia (eye drops).
La couche de surface de la cornée (l’épithelium) est détachée par grattage mécanique en cas de PRK, à l’aide d’alcool dilué en cas de LASEK ou avec un moteur automatisé en cas d’EpiLASIK.
The excimer laser treatment is performed on the surface of the deeper layer of the cornea (the stroma).
Afterwards, a new superficial corneal layer must rebuild itself within two days
The procedure is painless and lasts 10 minutes per eye. The operation time depends on the degree of the defect to be corrected (1.3 seconds per treated diopter).
Explanation in Video
Indications
Surgery of light to medium myopia (up to 5 diopters). Learn about all the operative techniques that can correct myopia.
Surgery of light myopic astigmatism (up to 2 Dioptres). Learn about all the techniques that help correct astigmatism.
Post-operative evolution
The post-operative evolution is painful for 2 to 3 days and it lasts 4 to 5 days before recovering a vision compatible with daily activities. The patient regains 10/10 in less than a week but may suffer imperfect visual quality for 3 to 4 weeks.
Possible complications
- The surgical procedure is simple and presents no risk
• A very limited risk of infection (0.1%) exists during the first 2 days
• One over or undercorrection
• Rarely, a perception of halos around light sources at night
Conclusions
PRK, LASEK and EpiLASIK are very reliable surgical techniques to correct myopia up to 5 - 6 Diopters.
Thanks to the absence of corneal cuttings, these are the surgeries with the lowest complication rate, provided that the indications are followed, namely myopia up to 5 - 6 Diopters.
They present a major disadvantage: the post-operative pain lasting two days and the slower recovery of perfect vision.
These techniques should not be used in case of high myopia or hyperopia because there is a high risk of abnormal healing (haze) with loss of some of the correction (regression).