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LASEK Workup

  • Author: Brad Feldman, MD; Chief Editor: Hampton Roy, Sr, MD  more...
 
Updated: Mar 31, 2014
 

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See Preoperative details.

 
 
Contributor Information and Disclosures
Author

Brad Feldman, MD Cornea, Cataract, and Refractive Surgeon, Philadelphia Eye Associates

Brad Feldman, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Coauthor(s)

Reecha Sachdeva, MD Resident Physician, Cole Eye Institute, Cleveland Clinic

Reecha Sachdeva, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Medical Student Association/Foundation

Disclosure: Nothing to disclose.

Sanjeev Grewal, MD, FRCSC Associate Professor of Ophthalmology, Chief, Cornea and Refractive Surgery, Residency Program Director, Department of Ophthalmology, Medical Faculty Associates, George Washington University

Sanjeev Grewal, MD, FRCSC is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, College of Physicians and Surgeons of Ontario, Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Ronald R Krueger, MD Medical Director, Department of Refractive Surgery, Division of Ophthalmology, Cole Eye Institute, Cleveland Clinic Foundation

Ronald R Krueger, MD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Cataract and Refractive Surgery, Association for Research in Vision and Ophthalmology, International Society of Refractive Surgery, SPIE

Disclosure: Nothing to disclose.

Specialty Editor Board

Simon K Law, MD, PharmD Clinical Professor of Health Sciences, Department of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, American Glaucoma Society

Disclosure: Nothing to disclose.

Louis E Probst, MD, MD Medical Director, TLC Laser Eye Centers

Louis E Probst, MD, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, International Society of Refractive Surgery

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy, Sr, MD Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy, Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

Daniel S Durrie, MD Director, Department of Ophthalmology, Division of Refractive Surgery, University of Kansas Medical Center

Daniel S Durrie, MD is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology

Disclosure: Received grant/research funds from Alcon Labs for independent contractor; Received grant/research funds from Abbott Medical Optics for independent contractor; Received ownership interest from Acufocus for consulting; Received ownership interest from WaveTec for consulting; Received grant/research funds from Topcon for independent contractor; Received grant/research funds from Avedro for independent contractor; Received grant/research funds from ReVitalVision for independent contractor.

References
  1. Scerrati E. Laser in situ keratomileusis vs. laser epithelial keratomileusis (LASIK vs. LASEK). J Refract Surg. 2001 Mar-Apr. 17(2 Suppl):S219-21. [Medline].

  2. Wolf A, Abdallat W, Kollias A, Frohlich SJ, Grueterich M, Lackerbauer CA. Mild topographic abnormalities that become more suspicious on Scheimpflug imaging. Eur J Ophthalmol. 2009 Jan-Feb. 19(1):10-7. [Medline].

  3. Schmidt GW, Yoon M, McGwin G, Lee PP, McLeod SD. Evaluation of the relationship between ablation diameter, pupil size, and visual function with vision-specific quality-of-life measures after laser in situ keratomileusis. Arch Ophthalmol. 2007 Aug. 125(8):1037-42. [Medline].

  4. Camellin M, Wyler D. Epi-LASIK versus epi-LASEK. J Refract Surg. 2008 Jan. 24(1):S57-63. [Medline].

  5. Hammond MD, Madigan WP Jr, Bower KS. Refractive surgery in the United States Army, 2000-2003. Ophthalmology. 2005 Feb. 112(2):184-90. [Medline].

  6. Zhao LQ, Wei RL, Cheng JW, Li Y, Cai JP, Ma XY. Meta-analysis: clinical outcomes of laser-assisted subepithelial keratectomy and photorefractive keratectomy in myopia. Ophthalmology. 2010 Oct. 117(10):1912-22. [Medline].

  7. Adams GW, Hubbard AD. Kennerley Bankes Clinical Ophthalmology: A Text and Color Atlas. 4th ed. 1999.

  8. [Guideline] American Academy of Ophthalmology Refractive Management/Intervention Panel. Refractive errors & refractive surgery. San Francisco (CA): American Academy of Ophthalmology; 2007. [Full Text].

  9. Aydin B, Cagil N, Erdogan S, Erdurmus M, Hasiripi H. Effectiveness of laser-assisted subepithelial keratectomy without mitomycin-C for the treatment of high myopia. J Cataract Refract Surg. 2008 Aug. 34(8):1280-7. [Medline].

  10. Brown MC, Schallhorn SC, Hettinger KA, Malady SE. Satisfaction of 13,655 patients with laser vision correction at 1 month after surgery. J Refract Surg. 2009 Jul. 25(7 Suppl):S642-6. [Medline].

  11. Chen KH, Hsu WM, Lee SM, Lai JY, Li YS. Laser-assisted subepithelial keratectomy for dry eye associated with soft contact lenses. J Cataract Refract Surg. 2005 Dec. 31(12):2299-305. [Medline].

  12. Cleveland Clinic Foundation Health Information Center. LASEK: Overview. 2006. [Full Text].

  13. Gimbel HV, Penno EEA. Trends and Techniques. LASIK Complications. 3E. 184-90.

  14. Horwath-Winter J, Vidic B, Schwantzer G, Schmut O. Early changes in corneal sensation, ocular surface integrity, and tear-film function after laser-assisted subepithelial keratectomy. J Cataract Refract Surg. 2004 Nov. 30(11):2316-21. [Medline].

  15. Kanski, Menon, Boulton. A Systematic Approach. Clinical Ophthalmology. 5th ed. 2003. 56-63.

  16. Laplace O, Bourcier T, Chaumeil C, Cardine S, Nordmann JP. Early bacterial keratitis after laser-assisted subepithelial keratectomy. J Cataract Refract Surg. 2004 Dec. 30(12):2638-40. [Medline].

  17. Lee HK, Lee KS, Kim JK, Kim HC, Seo KR, Kim EK. Epithelial healing and clinical outcomes in excimer laser photorefractive surgery following three epithelial removal techniques: mechanical, alcohol, and excimer laser. Am J Ophthalmol. 2005 Jan. 139(1):56-63. [Medline].

  18. Samalonis LB. LASEK techniques. EyeWorld. 2002. 7(9):31-32.

  19. Sandoval HP, de Castro LE, Vroman DT, Solomon KD. Refractive Surgery Survey 2004. J Cataract Refract Surg. 2005 Jan. 31(1):221-33. [Medline].

  20. Taneri S, Zieske JD, Azar DT. Evolution, techniques, clinical outcomes, and pathophysiology of LASEK: review of the literature. Surv Ophthalmol. 2004 Nov-Dec. 49(6):576-602. [Medline].

  21. Vinciguerra P, Camesasca FI, Torres IM. Transition zone design and smoothing in custom laser-assisted subepithelial keratectomy. J Cataract Refract Surg. 2005 Jan. 31(1):39-47. [Medline].

  22. Li Y1, Tan O, Brass R, Weiss JL, Huang D. Corneal epithelial thickness mapping by Fourier-domain optical coherence tomography in normal and keratoconic eyes. Ophthalmology. Dec 2012. 119 (12):2425-33. [Full Text].

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Illustration of myopia.
Illustration of hyperopia.
Illustration of an astigmatic cornea.
Illustration depicting the layers of the human cornea.
Histologic slide of the human cornea identifying its layers: (1) corneal stratified squamous epithelium with underlying Bowman layer, (2) stroma with keratocytes dispersed throughout, (3) Descemet membrane, and (4) single layer of endothelium. Image courtesy of Mission for Vision. Retrieved from http://www.missionforvisionusa.org/anatomy/2005/10/cornea.html.
Example of corneal topography. This image depicts a large inferior cone (or bulging of the cornea) along the contour of the cornea, as illustrated through the inferior red portion, which shows the steepest area of the curvature, against the blue portion, which shows the flattest portion of the curvature. Retrieved from www.opt.indiana.edu, July 22, 2006.
This image depicts the epithelial flap of a porcine eye as it is folded along its hinge to reveal the surface for laser ablation. Image courtesy of Ronald R. Krueger, MD, Cole Eye Institute, The Cleveland Clinic Foundation.
This image, taken intraoperatively on a rabbit eye, depicts the creation of the epithelial flap using the microkeratome. Image courtesy of Ronald R. Krueger, MD, Cole Eye Institute, The Cleveland Clinic Foundation.
This image depicts the epithelial flap created in laser assisted subepithelial keratectomy (LASEK) surgery on a rabbit eye. Image courtesy of Ronald R. Krueger, MD, Cole Eye Institute, The Cleveland Clinic Foundation.
Image of corneal haze following refractive surgery, as viewed through a slit lamp. Image courtesy of Ronald R. Krueger, MD, Cole Eye Institute, The Cleveland Clinic Foundation.
Relative differences of laser assisted in situ keratomileusis (LASIK), laser assisted subepithelial keratectomy (LASEK), and photorefractive keratectomy (PRK). Adapted from Taneri S, et al: Evolution, techniques, clinical outcomes, and pathophysiology of LASEK: review of the literature. Surv Ophthalmol 2004 Nov-Dec; 49(6): 576-602.
 
 
 
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