LASEK (Laser Epithelial Keratomileusis) is a type of laser eye surgery that corrects vision by reshaping the cornea. It works similarly to LASIK but skips the deep corneal flap, making it a better option for people with thinner corneas. Instead of cutting into the cornea’s deeper layers, LASEK gently lifts only the very thin outer skin of the eye, reshapes the tissue underneath with a laser, then lays that outer layer back down.
How LASEK Works
Your cornea has several layers. The outermost layer, called the epithelium, is extremely thin. During LASEK, the surgeon applies a dilute alcohol solution (typically 20% concentration) to the surface of your eye for about 25 to 35 seconds. This loosens the epithelium from the tissue beneath it. Using a fine surgical tool, the surgeon then peels the loosened epithelial sheet to one side, exposing the corneal surface underneath.
With the epithelium moved out of the way, an excimer laser reshapes the exposed corneal tissue. The laser removes microscopic amounts of tissue in a precise pattern calculated to correct your specific prescription, whether that’s nearsightedness, farsightedness, or astigmatism. After the reshaping is complete, the epithelial sheet is folded back into its original position. A soft bandage contact lens is placed over the eye to protect the surface while it heals, typically worn for about five days.
How LASEK Differs From LASIK and PRK
These three procedures all use the same type of excimer laser to reshape the cornea. The difference is how the surgeon accesses the tissue that needs reshaping.
- LASIK creates a thicker flap using a mechanical blade or femtosecond laser, cutting through the epithelium and into the deeper corneal tissue (the stroma). This flap is hinged open, the laser reshapes the exposed stroma, and the flap is laid back down. Because the epithelium stays intact on the flap, recovery is fast. Most people notice clear vision the next morning, and discomfort lasts only a few hours.
- PRK removes the epithelium entirely. The surgeon scrapes it off or dissolves it, applies the laser to the exposed surface, and then your eye regrows a new epithelial layer from scratch over several days. This means more pain and a longer recovery, but it avoids creating any flap at all.
- LASEK sits between the two. It preserves the epithelium as a thin sheet rather than discarding it (like PRK) or cutting deep into the cornea (like LASIK). Advocates of LASEK suggest this leads to less discomfort than PRK in the early recovery period, faster visual recovery, and less corneal haze.
The main advantage of LASIK over both LASEK and PRK is comfort and speed of recovery. But LASIK requires enough corneal thickness to safely create that deeper flap, which is where LASEK finds its niche.
Who Is a Good Candidate
LASEK is most commonly recommended for people whose corneas are too thin for LASIK. A normal cornea is roughly 540 to 560 micrometers thick. When corneal thickness falls below about 500 micrometers, LASIK becomes riskier because creating the deeper flap leaves less structural tissue behind. Surgeons generally want at least 275 to 300 micrometers of untouched corneal tissue remaining after surgery to maintain the eye’s structural integrity.
Because LASEK only lifts the paper-thin epithelium (rather than cutting a thicker flap), it preserves far more of the cornea’s structural tissue. This makes it suitable for people with naturally thin corneas, those with higher prescriptions requiring more tissue removal, and people in contact sports or occupations where a deeper LASIK flap could be dislodged by physical impact. People with certain corneal surface conditions, like epithelial basement membrane irregularities, may also be better candidates for a surface procedure like LASEK.
What Recovery Looks Like
Recovery from LASEK is slower than LASIK and requires more patience. Expect significant discomfort for the first two to four days. Stinging, burning, light sensitivity, and a foreign body sensation are all normal during this window. The bandage contact lens helps considerably, reducing pain and protecting the healing epithelium from the friction of blinking. Most surgeons recommend keeping it in for at least five days, at which point the epithelial surface has typically healed enough to remove it.
Vision will be noticeably blurry for the first week or two. Functional vision improves gradually over several weeks, but full stabilization can take three to six months. This is a key difference from LASIK, where many people see clearly within 24 hours. With LASEK, you should plan for a slower return to sharp vision and be prepared for fluctuations during the healing period.
Your surgeon will prescribe steroid eye drops to control inflammation and reduce the risk of corneal haze. You’ll also use lubricating drops frequently, since the procedure temporarily disrupts the corneal nerves responsible for tear production.
Corneal Haze and Dry Eyes
Almost all surface laser procedures (LASEK and PRK) cause some mild cloudiness in the cornea during healing. This is a normal response as corneal cells repair the treated area, and it typically resolves on its own within 6 to 12 months. In a small percentage of patients, a more significant haze develops from an abnormal healing response. Early-onset haze, appearing in the first three months, generally responds well to steroid drops. Late-onset haze, developing up to a year after surgery, can be more stubborn to treat.
Dry eye is the other common side effect. The corneal nerves that signal your eye to produce tears are disrupted during surgery, and this effect peaks around three to six months afterward. Studies report dry eye symptoms in roughly 43% of patients after surface laser procedures. For most people, this improves as the nerves regenerate, but some experience lingering dryness that requires ongoing use of artificial tears.
Success Rates
Laser vision correction has high success rates across all three procedure types, since the same excimer laser does the actual reshaping. A meta-analysis of FDA-approved laser devices found that 97% of patients achieved 20/40 vision or better (the threshold for driving without glasses in most states), and 62% achieved 20/20 vision. In some studies, 99% of treated eyes reached 20/40 or better.
These numbers reflect outcomes for myopia and myopic astigmatism, which are the most common reasons people seek laser vision correction. Results for farsightedness and very high prescriptions tend to be somewhat less predictable. Your surgeon will evaluate your specific prescription, corneal shape, and eye health to estimate how likely you are to reach your target vision.
LASEK vs. LASIK: Which Is Better
Neither procedure is universally better. LASIK offers faster recovery and less discomfort, which is why it remains the most popular choice when a patient’s corneas can safely accommodate it. LASEK sacrifices that quick recovery in exchange for preserving more corneal tissue, which matters when thickness is limited or when flap-related complications need to be avoided.
The visual end results, once healing is complete, are comparable. The choice between the two comes down to your corneal anatomy, your lifestyle, your tolerance for a longer recovery, and your surgeon’s assessment of which approach carries less risk for your specific eyes.