Surface Laser (Lasek & PRK)2019-02-06T13:53:35+00:00

SURFACE LASER (LASEK & PRK)
THE OLDEST FORM OF LASER EYE SURGERY

What is surface laser eye surgery?

Surface laser is the variety of procedures that work directly on the outer surface of the cornea. PRK is the acronym for Photo Refractive Keratectomy, the precursor to LASIK eye surgery. Like LASIK eye surgery, PRK uses an Excimer laser to reshape the cornea. However, PRK works directly on the outer surface of the cornea.

Another name for a similar procedure is LASEK and epi-LASIK

Surface laser is safe and effective but has a very slow recovery and may leave patients with a tendency to recurrent erosion (pain in their eyes on waking in the morning)

At Custom Vision Clinic we now rarely perform surface laser eye surgery, because newer procedures offer similar benefits (like being able to treat those with thinner corneas or those who engage in contact sports and work). Keyhole laser eye surgery, where the laser reshapes the cornea without the need to make a flap, is called ReLEx SMILE ™.

This procedure has all the great benefits of LASIK (fast visual improvement and short recovery time) with the associated benefits of not cutting a flap in the cornea (no flap complications, less dry eye, improved comfort during the operation) and none of the downsides of surface laser eye surgery (more discomfort and shorter recovery time).

What surface laser treats

Who is suitable for surface laser eye surgery?

Ideal candidates for surface laser eye surgery include those patients who – for various reasons – are not suitable for LASIK.

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How does surface laser treatment work?

The vision correction treatment begins with anesthetic drops applied to numb your eye and prevent pain during the procedure. A lid speculum is placed in the eye to hold the lids apart for the procedure, eliminating possibility of blinking.

The surgeon will then gently remove the surface corneal cells (epithelium) and proceed with the laser aspect of the procedure. The laser is computer driven for accuracy and precision and it is programmed based on the patient’s refractive error such as nearsightedness, farsightedness, or astigmatism.

The eye correction surgery takes less than one minute for most patients. After the procedure a soft bandage contact lens is placed on the eye for three to five days until the epithelial layer regenerates.

Advantages and disadvantages of surface laser eye surgery

Advantages of surface laser eye surgery over other procedures

  • Uses less tissue*
  • Allows patients who are non-candidates with LASIK to have a laser refractive treatment
  • No flap created so no chance of a flap complication. Less than 1% chance of enhancement required*
  • The patient can resume all physical activities within 2 weeks*

*This is no longer an advantage when compared to ReLEx SMILE ™ laser eye surgery

Disadvantages to LASIK

  • Healing takes longer than LASIK (driving vision in 4 to 14 days)
  • Slight risk of haze (little risk with modern laser and adjunctive chemical therapy)
  • Delayed epithelial healing

Frequently asked questions about surface laser eye surgery

LASIK eye surgery involves raising a thin protective flap of epithelium and stroma from the cornea and applying the laser treatment beneath this. The flap is then re-positioned. PRK is a form of surface laser (as is LASEK or epi-LASIK). In surface laser the epithelium only is removed and this has to grow back after the laser has been applied. LASIK and surface laser are equally effective, but surface laser takes longer to settle down.
Wavefront measures the unique imperfections of the optics of your eye – the higher order aberrations. These irregularities affect the quality of your vision, beyond the normal refractive errors of Short-sightedness, Long-sightedness, and astigmatism. A wavefront aberrometer measures the higher order aberrations and feeds the information to the laser to improve the treatment which it provides. Different analysers measure different numbers of spots, ranging from as low as 60 to as high as 650. The Zeiss WASCA aberrometer used by Custom Vision Clinic has a resolution of 650. The laser used is able to use that information to refine the treatment if necessary.

Results at a glance

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Laser procedures
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Cataract procedures
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Better than the national average of complication rates
My eyesight following the operation is brilliant and better than I thought possible, and this is all down to your excellent surgeon Mr James Ball and not to forget all the very dedicated people around him who make these operations possible.
Keith Garlick
Two of the best decisions I ever made in my life were firstly to have lens exchange and secondly to have Mr James Ball carry out my operation.
Patricia Walton
Within minutes I could tell there was a difference. But now, only a couple of months later, my sight is better than it was seven years ago! I can even read the really tiny print on the car sales ads! If you want that confidence you probably felt when you were younger, this is the ideal solution.  Thanks to the treatment, I feel rejuvenated, independent and much younger!
John Hazelgrave
Many thanks for all your care and kindness. To me it appears a miracle that I can see so well. I feel very grateful. It is impossible to fully express my thanks.
Grace C.
May I offer grateful thanks for your expertise in operating on my eyes. It was intimated to me that you were the best, and from the results I am now enjoying, I am convinced that this is correct.
Jean D.
You are truly innovative. Thank you very much for curing the problems I have been having with my reading and near vision.
Sala M.
My work was becoming almost impossible. I had refractive lens exchange to both eyes with multifocal lens implants last July. I can now see better than 20/20 for distance and can read the tiniest print in newspapers - all without glasses! I have started reading for pleasure again, and I feel that my performance both at work and on the golf course has improved.
John

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My eyesight following the operation is brilliant and better than I thought possible, and this is all down to your excellent surgeon Mr James Ball and not to forget all the very dedicated people around him who make these operations possible.

Keith Garlick

Two of the best decisions I ever made in my life were firstly to have lens exchange and secondly to have Mr James Ball carry out my operation.

Patricia Walton

Within minutes I could tell there was a difference. But now, only a couple of months later, my sight is better than it was seven years ago! I can even read the really tiny print on the car sales ads! If you want that confidence you probably felt when you were younger, this is the ideal solution.  Thanks to the treatment, I feel rejuvenated, independent and much younger!

John Hazelgrave

My work was becoming almost impossible. I had refractive lens exchange to both eyes with multifocal lens implants last July. I can now see better than 20/20 for distance and can read the tiniest print in newspapers – all without glasses! I have started reading for pleasure again, and I feel that my performance both at work and on the golf course has improved.

John

Laser eye surgery has changed my life. Now, having had laser, I wake up in the morning and I can see and it’s unbelievable.

Claire Varley

Laser eye surgery has greatly improved my quality of life. I’ve been able to discard my glasses after thirty years!

Arthur Brown

If you are thinking of having Laser Eye Surgery, try these guys – they really are the best in their field.

Mr CE Poulter

I felt I was treated as an individual and all my questions were answered. From my experiences – I can highly recommend Mr Ball.

Janet Howden

Wonderful, Wonderful, Wonderful! I am so grateful to you and your team. Thank you very much indeed.

Dorothy S.

Thank you for your skilled interventions which have given me my sight back.

Doreen G.

To me it appears a miracle that I can see so well. I feel very grateful. It is impossible to fully express my thanks.

Grace C.

Thank you very much for the treatment you gave me –  I can see so well now, and reading has once again become a real pleasure.

Charles S.

It was intimated to me that you were the best, and from the results I am now enjoying, I am convinced that this is correct.

Jean D.

You are truly innovative. Thank you very much for curing the problems I have been having with my reading and near vision.

Sala M.

I had LASIK on both eyes at Custom Vision Clinics, and can now see better than 20/20, without my glasses or contact lenses. More importantly, I now feel that I can get more out of my busy life.

Karen

At the consultation, Mr Ball found that I had early cataracts. Following cataract surgery at Custom Vision Clinics, I am almost completely independent from glasses.

Anne

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MORE USEFUL INFORMATION

Read more about laser eye surgery

New refractive surgery guidelines from The Royal College of Ophthalmologists, together with patient information on Laser Vision Correction, Phakic Intraocular Lens Implantation, Refractive Lens Exchange and a Checklist for patients will be published in April 2017. Click here for more information

Take this checklist to your consultation with your refractive surgeon performing the procedure. Discuss each item with your surgeon to help you make the decision that is right for you before having
refractive surgery. Click here for more information

The Royal College of Ophthalmologists’ Laser Vision Correction Patient Information booklet (PDF). Click here for more information

Tips for patients interested in laser eye surgery. The road to laser eye surgery can sometimes be confusing. Thinking of the journey as a step-by-step process, from an early interest in laser eye surgery all the way to post-operative care, might make it easier. The following supporting materials will help you learn more about what happens during the process, and answer questions along the way. However, it is recommended to consult with an eye care provider to get more knowledgable of the procedure and to find out whether laser eye surgery might be an option. Click here for more information
Discover how laser eye surgeries differ and compare. The following chart provides an overview of all key facts and figures when it comes to laser eye surgery. While all three Laser Vision Correction procedures have a high success rate, they differ slightly in the refractive errors treated, the treatment method used, and the clinical specifics of each procedure. A doctor or clinic representative can help you understand which procedure is best for your individual eye condition. Click here for more information

SMILE corrects myopia and astigmatism, or a combination of both refractive errors with only a very small incision at the corneal surface. This high-precision procedure is the latest development in the refractive laser treatments. Includes videos, treatment steps, and questions and answers.
Click here for more information

LASIK treats refractive errors by folding away the top layer of the eye and re-shaping tissue underneath. If a femtosecond laser is used, this type of procedure is called Femto-LASIK. Includes videos, treatment steps and questions and answers. Click here for more information

PRK/LASEK procedures remove a thin cell layer from the top of the eye so the laser can reshape the underlying cornea. This surgery may be an option for those who are not eligible for LASIK or those who look for the most economic option for refractive laser surgery. Includes videos, treatment steps, and questions and answers. Click here for more information

Laser eye surgery treatments are clinically proven and established procedures. Like all surgeries, however, laser eye surgery is not free of risks and side effects. Only your ophthalmologist can explain the individual risks and decide whether laser eye treatment is an option. Some complications that can occur are… Click here for more information
Photorefractive (laser) surgery for the correction of refractive errors. Understanding NICE guidance – information for people considering the procedure, and for the public. Click here for more information
Custom Vision Clinic’s YouTube Channel features James Ball answering hundreds of eye-related questions on video – ranging from laser refractive surgery, lens exchange and keratoconus treatment. Click here for more information
Laser eye surgery reviews of Custom Vision Clinic on Trustpilot. Click here for more information

About the author

Mr James Ball | Consultant Ophthalmic Surgeon

MA (Cantab) MB BChir FRCOphth CertLRS

I am a Consultant Ophthalmic Surgeon at Custom Vision Clinic, The Yorkshire Eye Hospital, St James’s University Hospital, and Nuffield Hospital. My major interest is in refractive surgery and finding the best treatment suitable for each patient.

Learn more about me