LASEK (Laser-Assisted Sub-Epithelial Keratectomy)

LASEK is a type of laser eye surgery that reshapes the clear front window of the eye (the cornea) so light focuses sharply on the retina. It is a “surface ablation” procedure. That means the laser works on the corneal surface, after gently moving aside the paper-thin skin layer of the cornea (the epithelium). Unlike LASIK, LASEK does not make a deep corneal flap. Because no flap is created, more of the cornea’s strength is preserved, which can be helpful for people with thinner corneas or those at higher risk of eye trauma (for example, contact sports).

LASEK stands for Laser-Assisted Sub-Epithelial Keratectomy. It is a type of surface laser eye surgery used to fix blurry vision from refractive errors—mainly nearsightedness (myopia), farsightedness (hyperopia), and astigmatism. In LASEK, the surgeon gently loosens the corneal epithelium (the thin, skin-like top layer of your cornea) using a weak alcohol solution. This thin sheet of cells is lifted to the side, a cool excimer laser reshapes the firm middle part of the cornea (the stroma) to refocus light properly, and then the epithelium is carefully repositioned. A soft bandage contact lens is placed to protect the surface while it heals.

Think of the cornea like a clear window with several layers. LASEK works right at the top, without cutting a deep flap in the cornea (as happens in LASIK). Because no flap is made, LASEK preserves more corneal strength, which is helpful for people with thin corneas or certain lifestyles where a flap might be a risk (for example, if you play contact sports or have a job with eye-injury risk). The trade-off is that LASEK usually has more discomfort for a few days and slower visual recovery compared with LASIK. Most people reach their “new normal” vision over several weeks, with continued fine-tuning up to 3–6 months as the surface polishes and the tear film stabilizes.

In very simple terms:

• The surgeon loosens the cornea’s skin layer with a weak alcohol solution, slides that thin layer aside, uses a cold laser (excimer laser) to reshape the cornea, then replaces the skin layer and covers it with a soft bandage contact lens so it can heal.

• The goal is to reduce or remove glasses or contact lens dependence for nearsightedness (myopia), farsightedness (hyperopia), and astigmatism (curvature that is not perfectly round).

• Vision typically improves gradually over days to weeks as the surface heals and smooths. Comfort improves as the epithelium reseals and the bandage lens is removed.

Below you’ll find clear, plain-English explanations of: what LASEK is, how it works, types, 20 common reasons people consider LASEK, 15 symptoms (before and after surgery that people ask about), and 20 diagnostic tests doctors use to decide if LASEK is suitable and to monitor recovery.

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What happens during LASEK

1. Numbing drops are placed so the eye feels nothing sharp. The eyelids are gently held open with a small holder.

2. A dilute alcohol solution (commonly around 18–25%) touches the corneal surface for about 20–30 seconds. This loosens the corneal skin layer (epithelium) without harming deeper tissue.

3. The surgeon slides the loosened epithelium aside like opening a tiny hinged door or lifting a very thin sheet.

4. An excimer laser reshapes the cornea in seconds. This laser removes microscopic layers with high accuracy to fix the focusing error.

5. The epithelium is repositioned over the treated area.

6. A bandage contact lens is placed to protect the surface and reduce discomfort while the skin layer reseals.

7. The doctor prescribes eye drops (antibiotic to prevent infection, steroid to reduce haze/inflammation, lubricants for comfort). The bandage lens is usually removed after 3–5 days when the skin has healed.

Why choose LASEK over LASIK or PRK?
LASEK, PRK, and epi-LASIK are surface techniques with no deep flap, which preserves more corneal strength than LASIK. LASEK keeps the patient’s own epithelium as a sheet, rather than fully removing it like classic PRK. In practice, comfort and recovery time are similar across modern surface techniques, and surgeons choose based on corneal shape, thickness, lifestyle, and their experience.

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Benefits and limits

• Benefits: preserves corneal strength (no flap), avoids flap-related problems, suitable for some thinner corneas, good quality of vision once healed, fewer dry-eye symptoms than flap surgery for some people.

• Limits: more discomfort for the first few days compared with LASIK, slower visual recovery (often several days to a few weeks to feel “crisp”), risk of temporary corneal haze (cloudiness) in some cases, and strict drop schedule during healing.

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Types and technical variations of LASEK

1. Standard alcohol-assisted LASEK: uses a short exposure of dilute alcohol to loosen the epithelium, which is hinged, lifted, laser-treated, and then repositioned.

2. Low-alcohol LASEK: uses a lower alcohol concentration or shorter exposure to be gentler on the epithelium, aiming for faster surface recovery.

3. No-alcohol LASEK (mechanical separation): the epithelium is gently separated with a special instrument (“squeegee” technique) to avoid alcohol entirely.

4. Epi-LASIK (close cousin of LASEK): a blunt oscillating blade (epikeratome) lifts the epithelial sheet without alcohol; otherwise, steps and healing are similar to LASEK.

5. Wavefront-guided LASEK: the laser pattern is customized using a map of the eye’s tiny focusing errors (aberrations) to aim for sharper contrast and night vision.

6. Topography-guided LASEK: the laser pattern is customized using the cornea’s curvature map (topography) to smooth irregular shapes and reduce higher-order aberrations.

7. Transepithelial LASEK (single-step surface ablation): the laser removes the epithelium and reshapes the cornea in one sequence; it is conceptually similar to “trans-PRK.”

8. Mitomycin-C–assisted LASEK: a brief application of mitomycin-C (an anti-scarring medicine) reduces the chance of haze in eyes at higher risk (e.g., higher prescriptions).

9. Hinged vs free-cap epithelium: some surgeons keep a tiny hinge of epithelium to reposition it precisely; others remove and lay it back like a free cap. Both aim for smooth healing.

10. Same-day both eyes vs staged eyes: some people have both eyes treated the same day for convenience; others stage surgeries to keep one “untouched” eye for a few days.

Note: Your surgeon will recommend the approach that fits your cornea, prescription, lifestyle, and healing risk.

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Common reasons (“causes”) someone may be offered or prefer LASEK

These are practical, real-world reasons—anatomy, lifestyle, or medical factors—that “cause” a surgeon and patient to choose LASEK rather than LASIK or to choose vision surgery rather than glasses/contacts.

1. Myopia (nearsightedness): distant objects are blurry because the eye focuses too strongly; LASEK flattens the cornea to reduce power.

2. Hyperopia (farsightedness): near work is difficult and distance may blur; LASEK steepens the cornea to increase power.

3. Regular astigmatism: the cornea is shaped more like a rugby ball than a soccer ball; LASEK evens the curve.

4. Thin corneas: preserving corneal strength matters; surface surgery avoids a deep flap.

5. Borderline corneal shape: if a flap might be risky, surface ablation is safer. (Eyes with true ectasia/keratoconus are usually not candidates for standard LASEK.)

6. Contact sports or trauma risk: no flap means no flap-displacement risk in high-impact activities.

7. Dry-eye concerns: some people experience fewer dry-eye issues after surface ablation than after flap surgery.

8. Large pupils: customized, larger optical zones can help with night vision symptoms; surgeons often prefer surface ablation in these cases.

9. Occupational needs: certain military or safety roles historically preferred no-flap procedures.

10. Contact lens intolerance: red, irritated eyes or recurrent infections from lenses push some toward permanent correction.

11. Allergy to lens solutions: chemical sensitivity makes long-term lens wear uncomfortable.

12. Anisometropia: a big difference between the two eyes causes headache or double vision with glasses; laser can balance focus.

13. Desire for active lifestyle: water sports, hiking, dusty work—reducing dependence on corrective lenses is practical.

14. Desire to avoid glasses cosmetically: personal preference for life without spectacles.

15. Previous LASIK flap considerations: enhancements are often done as surface ablation to avoid re-lifting a flap.

16. Irregular surface fine-tuning: topography-guided surface treatment can smooth small irregularities.

17. Recurrent epithelial erosion history (careful selection): surface polishing (phototherapeutic keratectomy, PTK) with or without refractive treatment can help select cases.

18. Post-cataract “refractive surprise”: small leftover prescription after lens surgery sometimes corrected with surface ablation.

19. Stable prescription for years: stable eyes are better candidates; LASEK is one way to correct a long-standing stable error.

20. Monovision approach to presbyopia: one eye can be set slightly for near and the other for distance, reducing reading-glasses use.

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Symptoms people ask about (before and after LASEK)

Before surgery (from the refractive error itself):

1. Blurry distance vision (myopia) or blurry near vision (hyperopia) making signs, books, or screens hard to see.

2. Astigmatism ghosting/doubling: letters have shadows or smear.

3. Eye strain after reading or computer work.

4. Headaches from squinting or focusing effort.

5. Glare and halos at night, especially around headlights.

6. Frequent squinting to clear the view.

7. Frequent prescription changes, often in young myopes.

Early after LASEK (normal, short-term healing feelings):

8. Foreign-body sensation or scratchy pain for 2–4 days until the epithelium reseals.

9. Light sensitivity (photophobia) in the first week.

10. Watery eyes and redness during initial healing.

11. Fluctuating vision that clears over days to weeks.

Possible problems to report promptly:

12. Increasing pain after the first few days (could signal a problem).

13. Worsening haze (a milky blur) that does not improve.

14. New or dense glare/halos that interfere with night driving.

15. Drop-related irritation or allergy, such as burning or swelling.

Always call your surgeon if you notice pain that worsens, sudden vision drop, thick discharge, or marked light sensitivity—these can be warning signs.

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Diagnostic tests used before/after LASEK

Doctors combine your story (history), your goals, and several tests to judge safety and predict results. Below are 20 tests commonly used across clinics. They are grouped into Physical Exam, Manual Tests, Lab/Pathology, Electrodiagnostic, and Imaging.

A) Physical exam

1. External eye and eyelid exam: the doctor inspects lids, lashes, and eye surface for redness, blepharitis (oily, inflamed lid margins), and exposure issues that can worsen dryness after surgery.

2. Slit-lamp exam of the front of the eye: a microscope with a bright thin light checks the corneal surface, tear film, conjunctiva, and lens. It looks for scars, dry spots, micro-striae (fine lines), or early cataract.

3. Pupil size assessment (light and dark): the doctor measures how big the pupil gets in the dark. Larger pupils may need larger optical zones to reduce night glare.

4. Dilated fundus exam: after dilating drops, the retina and optic nerve are examined to rule out disease that could limit final vision (e.g., macular degeneration, retinal tears).

B) Manual tests

5. Visual acuity (distance and near): measures how small a line you can read with and without correction.

6. Manifest refraction: using a phoropter (“which is better, one or two?”) to find your exact glasses numbers.

7. Cycloplegic refraction: refraction after drops that relax focusing muscles; this uncovers hidden farsightedness and ensures stability before laser planning.

8. Keratometry (manual or automated): measures the steepness of the cornea in two main meridians to quantify astigmatism.

9. Goldmann applanation tonometry: a gentle touch test to measure eye pressure, because pressure problems (glaucoma risk) need attention before elective surgery.

C) Lab and pathological tests

10. Tear osmolarity: a tiny tear sample checks saltiness; higher osmolarity signals dry-eye disease, which should be treated before surgery for better healing.

11. MMP-9 tear test (point-of-care inflammation marker): detects surface inflammation that can blur vision and slow healing if untreated.

12. Corneal cultures and stains (if infection suspected): rarely needed in routine LASEK, but essential if pain, discharge, or an ulcer appears; guides antibiotic choice.

D) Electrodiagnostic tests

13. Visual evoked potential (VEP): checks the visual pathway from eye to brain by measuring tiny electrical responses to patterns; useful if vision seems limited beyond the cornea.

14. Full-field electroretinogram (ERG): evaluates overall retinal function (light-sensing layer), especially if the retina may be unhealthy for reasons unrelated to the cornea.

15. Multifocal ERG (mfERG): maps retinal function in many small areas to explain unexplained blur or glare when the cornea looks fine.

E) Imaging tests

16. Corneal topography/tomography (e.g., Placido or Scheimpflug): creates a color map of corneal curvature and thickness. It screens for early keratoconus and guides customized treatments.

17. Pachymetry (ultrasound or OCT): measures corneal thickness micrometer-by-micrometer to ensure enough tissue remains after laser reshaping for long-term safety.

18. Anterior segment OCT: cross-section scans of the cornea and front eye structures; helps assess epithelial thickness, wound healing, and any surface irregularities.

19. Wavefront aberrometry: measures higher-order aberrations (tiny focusing errors beyond simple glasses numbers) to plan wavefront-guided corrections.

20. Specular microscopy (endothelial cell count): photographs the inner corneal cell layer that keeps the cornea clear; while surface surgery spares this layer, baseline health is reassuring.

Non-pharmacological treatments

(Each item includes a short description, purpose, and mechanism in simple language.)

1. Bandage contact lens care
   Description: A soft, clear lens protects your healing surface for a few days.
   Purpose: Pain control and protection while cells re-attach.
   Mechanism: Shields nerve endings and reduces friction from blinking.

2. Cold compresses (short sessions)
   Description: Clean, cool compress for 5–10 minutes several times a day.
   Purpose: Comfort and swelling relief in the first few days.
   Mechanism: Cold calms surface nerves and slows inflammatory signals.

3. Dark sunglasses and indoor light control
   Description: Wraparound sunglasses outdoors; dim bright indoor lights.
   Purpose: Reduce light sensitivity and glare.
   Mechanism: Limits scattered light while the surface is uneven early on.

4. Protective eye shield at night
   Description: Lightweight plastic shield taped over the eye during sleep.
   Purpose: Prevents accidental rubbing.
   Mechanism: Physical barrier while you roll or touch your face in sleep.

5. Strict no-rub rule
   Description: Keep hands away from the eye, especially early.
   Purpose: Avoids dislodging the bandage lens or disturbing healing cells.
   Mechanism: Less mechanical stress means smoother regrowth.

6. Blink training and “20-20-20” breaks
   Description: Every 20 minutes, look 20 feet away for 20 seconds; full blinks.
   Purpose: Prevents digital-device dryness.
   Mechanism: Restores tear film and spreads natural oils.

7. Humidifier and environment control
   Description: Add moisture to dry rooms; avoid fans directly on the face.
   Purpose: Reduces evaporation of tears.
   Mechanism: Higher humidity slows tear breakup and irritation.

8. Warm compress for lids (after epithelium heals)
   Description: Warm pack over closed lids 5–10 minutes daily.
   Purpose: Helps meibomian glands release oils for a stable tear film.
   Mechanism: Thins thick oils so they flow better onto the eye.

9. Lid hygiene (gentle)
   Description: Clean lashes/lid margins with recommended wipes/foam.
   Purpose: Keeps bacteria and debris low; supports healthy tears.
   Mechanism: Reduces biofilm and inflammatory load around the eye.

10. Hydration and regular sleep
    Description: Drink water through the day; aim for consistent sleep.
    Purpose: Supports surface cell repair and tear production.
    Mechanism: Fluids and rest drive natural healing chemistry.

11. UV protection outdoors
    Description: Sunglasses labeled 100% UVA/UVB; hat with brim.
    Purpose: Lowers risk of haze while healing.
    Mechanism: Less UV activation of surface healing cells (keratocytes).

12. Driving restrictions until cleared
    Description: Don’t drive until your surgeon says vision is safe.
    Purpose: Safety for you and others during early blur.
    Mechanism: Vision can fluctuate; waiting reduces risk.

13. Contact lens holiday before surgery
    Description: Stop soft contacts for ~1–2 weeks (rigid lenses longer).
    Purpose: Lets cornea return to natural shape for accurate scans.
    Mechanism: Contacts can mold the cornea; time lets it rebound.

14. Allergy control (non-drug strategies)
    Description: Rinse face/hair after outdoor exposure; wash pillowcases often.
    Purpose: Less itch means less urge to rub the eyes.
    Mechanism: Reduces allergens that trigger histamine release.

15. Screen-time pacing
    Description: Short sessions, frequent breaks, proper monitor height.
    Purpose: Less strain and more complete blinks.
    Mechanism: Prevents “stare mode” that dries the surface.

16. Clean air habits
    Description: Avoid smoke, aerosols, harsh cleaners near the eyes.
    Purpose: Reduces irritants that inflame the surface.
    Mechanism: Fewer chemical triggers means calmer healing.

17. Balanced activity
    Description: Gentle walks okay; avoid dusty gyms/pools until cleared.
    Purpose: Keeps circulation good without exposing eyes to irritants.
    Mechanism: Moderate blood flow helps tissue repair.

18. Keep shower water/soap out of the eyes
    Description: Face away from the stream; don’t splash directly.
    Purpose: Prevents stinging and contamination.
    Mechanism: Fewer irritants reaching the healing epithelium.

19. Artificial tear schedule (preservative-free, behavior-based use)
    Description: Although the drops are “drugs,” the technique is non-drug: use on a schedule and before strain (driving/screens), not just after you feel dry.
    Purpose: Keeps the tear film steady.
    Mechanism: Pre-emptive lubrication prevents sudden breakup.

20. Follow-up adherence and self-monitoring
    Description: Keep every check-up; note any red-flag changes.
    Purpose: Early course-correction if healing is off track.
    Mechanism: Timely adjustments prevent complications.

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Drug treatments commonly used around LASEK

(Class • typical dose/timing • purpose • simple mechanism • common side effects)

Caution: Doses are typical examples from clinical practice; your surgeon may adjust based on your eyes. Always follow your own post-op plan.

1. Topical antibiotic (e.g., moxifloxacin 0.5% or ofloxacin 0.3%)
   Dose/Timing: 1 drop 4 times daily for about 1 week or until the bandage lens is removed.
   Purpose: Prevents infection while the surface is open.
   Mechanism: Kills common bacteria before they can multiply.
   Side effects: Mild burning, temporary blur; rare allergy.

2. Topical steroid (e.g., fluorometholone 0.1% or loteprednol 0.5%)
   Dose/Timing: Often 4 times daily then taper over 2–6 weeks depending on prescription strength and haze risk.
   Purpose: Controls inflammation; reduces haze risk.
   Mechanism: Calms inflammatory pathways in healing cells.
   Side effects: Temporary pressure rise in steroid responders, delayed healing if overused—so taper as directed.

3. Topical NSAID (e.g., ketorolac 0.5% or nepafenac 0.1%)—short course
   Dose/Timing: Some surgeons use 1 drop up to 3–4 times daily for 2–3 days. Others avoid routine use to protect epithelial healing.
   Purpose: Pain relief in the first 48–72 hours.
   Mechanism: Blocks prostaglandins that signal pain.
   Side effects: Stinging; rare delayed healing if prolonged—use only if your surgeon prescribes it.

4. Cycloplegic (e.g., cyclopentolate 1%)
   Dose/Timing: 1 drop 2–3×/day for 1–3 days if deep ache or light sensitivity is strong.
   Purpose: Relieves focusing spasm and reduces light sensitivity.
   Mechanism: Temporarily relaxes the iris and ciliary muscle.
   Side effects: Light sensitivity, near blur while it’s working.

5. Preservative-free artificial tears (e.g., carboxymethylcellulose 0.5% or sodium hyaluronate 0.1–0.2%)
   Dose/Timing: Every 1–2 hours for the first 1–2 weeks, then as needed.
   Purpose: Comfort and smoother vision during healing.
   Mechanism: Restores tear layer and reduces friction.
   Side effects: Minimal; momentary blur.

6. Hypertonic saline (e.g., 5% NaCl drops or ointment)
   Dose/Timing: 1 drop 4×/day or ointment at bedtime for a limited period if surface swelling or micro-edema occurs.
   Purpose: Draws out extra fluid; can sharpen vision and comfort.
   Mechanism: Higher salt content pulls water out of the cornea.
   Side effects: Temporary stinging.

7. Cyclosporine A 0.05–0.1% (or lifitegrast 5%)
   Dose/Timing: Twice daily, often started before surgery if dry eye exists and continued for months.
   Purpose: Treats inflammatory dry eye and stabilizes the tear film.
   Mechanism: Modulates T-cell activity on the ocular surface.
   Side effects: Burning on instillation, rare irritation.

8. Oral pain relief (e.g., acetaminophen 500–1000 mg; ibuprofen 400–600 mg)
   Dose/Timing: Every 6–8 hours for 2–3 days as needed.
   Purpose: Controls soreness while the epithelium seals.
   Mechanism: Central pain modulation (acetaminophen); prostaglandin blockade (ibuprofen).
   Side effects: Acetaminophen—liver safety limits; NSAIDs—stomach upset (take with food), avoid if contraindicated.

9. Antiviral prophylaxis (if history of herpes simplex eye disease)
   Options: Acyclovir 400 mg twice daily or valacyclovir 500 mg once daily starting 1–2 days before surgery and continuing 1–2 weeks post-op (only if your history warrants it).
   Purpose: Reduces risk of a herpes flare during surface healing.
   Mechanism: Inhibits viral DNA replication.
   Side effects: Nausea, headache; kidney dose considerations.

10. Intraoperative mitomycin-C (MMC 0.02% applied briefly by the surgeon)
    Dose/Timing: 10–20 seconds during surgery in higher-risk eyes (e.g., high myopia) to lower haze risk; then thoroughly irrigated.
    Purpose: Prevents overactive scar-like healing (haze).
    Mechanism: Temporarily quiets keratocyte activity in the upper stroma.
    Side effects: If overused, could slow healing or affect deeper cells—this is why it’s carefully timed and rinsed.

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Dietary, molecular, and other supportive supplements

(Dose ranges are common examples; discuss with your clinician, especially if pregnant, nursing, on blood thinners, or have medical conditions.)

1. Omega-3 (EPA/DHA)
   Dose: ~1–2 g/day combined EPA+DHA.
   Function: Supports a healthier tear film.
   Mechanism: Anti-inflammatory lipid mediators can improve meibomian gland oil quality.

2. Vitamin C
   Dose: 500–1000 mg/day (do not exceed your clinician’s guidance).
   Function: Collagen support and antioxidant activity.
   Mechanism: Helps normal collagen cross-linking during repair.

3. Vitamin D
   Dose: Often 1000–2000 IU/day if deficient (check levels).
   Function: Immune balance and epithelial health.
   Mechanism: Modulates surface immune responses.

4. Lutein + Zeaxanthin
   Dose: ~10 mg lutein + 2 mg zeaxanthin/day.
   Function: Ocular surface comfort via antioxidant support (better studied for retina but supportive overall).
   Mechanism: Quenches free radicals in ocular tissues.

5. Zinc
   Dose: 8–11 mg/day (avoid chronic >40 mg/day).
   Function: Cofactor for enzymes in wound healing.
   Mechanism: Supports DNA/RNA synthesis in regenerating cells.

6. N-acetylcysteine (NAC)
   Dose: 600 mg once or twice daily.
   Function: Mucolytic/antioxidant; may reduce tear film stringiness.
   Mechanism: Replenishes glutathione; breaks disulfide bonds in mucus.

7. Curcumin (with caution for interactions)
   Dose: 500–1000 mg/day with standardized extract.
   Function: Systemic anti-inflammatory support.
   Mechanism: Down-regulates NF-κB pathways.

8. Hyaluronic acid (oral)
   Dose: 120–240 mg/day.
   Function: Hydration support; adjunct to topical HA tears.
   Mechanism: Attracts water; may help mucosal moisture.

9. Coenzyme Q10
   Dose: 100–200 mg/day.
   Function: Mitochondrial energy support in healing cells.
   Mechanism: Electron transport cofactor; antioxidant.

10. Probiotics
    Dose: Per label (e.g., 1–10 billion CFU/day).
    Function: Gut–immune axis support.
    Mechanism: May balance systemic inflammation that affects tear quality.

11. Bilberry (anthocyanins)
    Dose: 80–160 mg 1–2×/day standardized extract.
    Function: Antioxidant support for ocular tissues.
    Mechanism: Scavenges free radicals.

12. Taurine
    Dose: 500–1000 mg/day.
    Function: Osmoprotection and cell membrane stability.
    Mechanism: Acts as an osmolyte helping cell volume control.

13. Lactoferrin
    Dose: 100–300 mg/day.
    Function: Tear protein support; antimicrobial balance.
    Mechanism: Binds iron; modulates surface microbes.

14. Magnesium (glycinate or citrate)
    Dose: 200–400 mg/day (adjust for bowel tolerance).
    Function: Nerve/muscle relaxation; sleep quality.
    Mechanism: Cofactor in hundreds of enzymatic reactions.

15. Vitamin A (prefer dietary sources first)
    Dose: Prefer foods (liver, leafy greens, orange vegetables). If supplementing, keep within recommended daily allowance (700–900 mcg RAE/day) unless your clinician advises otherwise.
    Function: Epithelial health.
    Mechanism: Supports mucin production and cell differentiation.
    Safety note: Avoid excess—especially in pregnancy.

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Regenerative / biologic options

(Used selectively when the surface struggles to heal. Many are adjuncts or off-label; your cornea specialist will decide case-by-case.)

1. Autologous serum tears (20–50%)
   Dose: Often 4–8×/day for weeks.
   Function: Supplies natural growth factors from your own blood.
   Mechanism: Mimics natural tear proteins that help epithelium heal.

2. Platelet-rich plasma (PRP) eye drops
   Dose: Varies (e.g., 4–8×/day).
   Function: Delivers platelet growth factors to stubborn defects.
   Mechanism: Releases PDGF, TGF-β, and others to stimulate repair.

3. Umbilical cord serum or amniotic membrane extract drops
   Dose: Specialist-guided.
   Function: Potent biologic support for severe surface disease.
   Mechanism: Rich in anti-inflammatory and pro-healing factors.

4. Cenegermin (recombinant human nerve growth factor 0.002%)
   Dose: Typically 6×/day for 8 weeks (approved for neurotrophic keratitis).
   Function: For eyes with corneal nerve damage and poor healing.
   Mechanism: Encourages nerve regrowth and surface sensitivity.

5. Topical insulin (compounded; experimental)
   Dose: Specialist-directed in research settings.
   Function: May speed epithelial cell migration in persistent defects.
   Mechanism: Activates IGF signaling for cell proliferation.

6. RGTA® (matrix therapy; availability varies)
   Dose: Specialist-guided.
   Function: Protects and rebuilds extracellular matrix in difficult ulcers.
   Mechanism: Heparan sulfate mimetic that stabilizes growth factors.

Note: Amniotic membrane grafts are highly effective but are considered a device/surgical option (see below).

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Procedures relevant to LASEK care and alternatives

1. LASEK (the primary procedure)
   Procedure: Alcohol-assisted epithelial lift, laser reshape, reposition epithelium, bandage lens.
   Why it’s done: Corrects myopia/hyperopia/astigmatism without a flap; good for thinner corneas or when flap risks are undesirable.

2. PRK (Photorefractive Keratectomy)
   Procedure: Epithelium gently removed (not replaced), laser reshape, bandage lens; epithelium regrows.
   Why: Similar outcomes to LASEK; surgeon preference or anatomy may favor PRK.

3. Topography-guided PRK/LASEK enhancement
   Procedure: Customized laser pattern based on corneal map to smooth irregularities.
   Why: Used months after healing if small residual irregular astigmatism or quality issues remain.

4. PTK (Phototherapeutic Keratectomy)
   Procedure: Laser used to polish superficial haze or recurrent erosions.
   Why: Treats post-op haze or stubborn surface defects affecting vision or comfort.

5. Amniotic membrane placement (sutureless or sutured)
   Procedure: A biologic membrane is placed over the cornea.
   Why: Speeds healing in persistent epithelial defects or severe inflammation.

(Other alternatives your surgeon may discuss include LASIK or SMILE if you meet criteria, and corneal cross-linking only if true corneal weakness/ectasia is diagnosed.)

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Prevention habits (before and after LASEK)

1. Get complete screening (topography/tomography) to rule out corneal weakness.

2. Stop contact lenses long enough before scans so your cornea returns to baseline.

3. Treat dry eye or blepharitis before surgery to improve healing.

4. Plan downtime for the first 3–5 days; avoid dusty, smoky places.

5. Don’t rub your eyes—ever—especially during healing.

6. Use your drops exactly as prescribed and don’t self-add extra meds.

7. Protect from UV with sunglasses and hats.

8. Manage allergies to cut itch and rubbing.

9. Keep hands clean and avoid getting water/soap directly in the eyes early on.

10. Go to every follow-up visit so small issues are fixed early.

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When to see the doctor urgently

• Sudden increase in pain, light sensitivity, or vision drop after initial improvement

• Increasing redness, thick discharge, or bad odor from the eye

• Bandage lens falls out early or feels very displaced

• Severe halos/glare that do not gradually improve

• Any new floaters/flashes or curtain-like shadow (retina warning—rare, but do not ignore)

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What to eat and what to avoid

Eat more of (supports healing and tears):

1. Fatty fish (salmon, sardines, mackerel) for omega-3s

2. Leafy greens (spinach, kale) for vitamin A precursors and lutein

3. Colorful vegetables (carrots, bell peppers) for antioxidants

4. Citrus/berries for vitamin C

5. Nuts/seeds (walnuts, flax, chia) for healthy oils

Avoid or limit (can irritate or dehydrate):
6) Very dry, salty snacks right after surgery (they can worsen dryness)
7) Excess alcohol (dehydrates and can affect sleep)
8) Smoking or secondhand smoke (surface irritant)
9) High-sugar ultra-processed foods (promote inflammation)
10) Energy drinks late in the day (sleep disruption; sleep is healing time)

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Frequently asked questions

1) Is LASEK painful?
During surgery, no (numbing drops). Days 1–3 can sting or ache; pain is usually well controlled with drops, cold compresses, and oral pain relievers.

2) How long until I can see clearly?
Most people notice steady improvement after the first week, with “near-final” clarity by 4–6 weeks, and subtle polishing up to 3–6 months.

3) Will I need glasses again?
Many people are free from glasses for distance. Age-related near blur (presbyopia) still happens in your 40s–50s, so near help may be needed later.

4) What’s the difference between LASEK and PRK?
Both are surface laser surgeries. LASEK repositions the epithelium; PRK removes it. Recovery and results are very similar; surgeons choose based on preference and details of your eye.

5) Why not just do LASIK?
LASIK is great for many—but LASEK avoids a flap, preserves more tissue, and can be safer for thin corneas or those at higher flap-trauma risk.

6) What is corneal haze?
A temporary cloudiness as the cornea heals. It’s usually mild and fades; steroids, UV protection, vitamin C, and (in selected cases) MMC help reduce risk.

7) Can LASEK cause dry eye?
Yes, temporarily. Surface nerves need time to regrow. Frequent preservative-free tears, lid care, and anti-inflammatory drops help.

8) Is the result permanent?
The cornea’s shape change is long-lasting, but eyes can change slowly with age. Small enhancements are sometimes done later if needed.

9) Can I exercise after LASEK?
Light walking quickly; avoid dusty gyms and contact sports until your surgeon clears you. No swimming until the surface is sealed and the bandage lens is out.

10) Is infection common?
No—rare with proper drop use and hygiene. Call urgently if pain, redness, or vision suddenly worsens.

11) Can I wear makeup?
Avoid eye makeup until your surgeon says it’s safe (usually after the bandage lens is out and the surface is stable).

12) What if I have allergies?
Control them (cool rinses, hygiene, doctor-approved drops). The goal is no rubbing.

13) Will I have halos at night?
Often in the first weeks while the surface smooths. They usually fade as healing completes.

14) Can LASEK cause ectasia?
The risk is low with proper screening, especially compared with flap procedures. That’s why corneal mapping is essential before surgery.

15) What if I’m not a candidate for any laser?
Options include contact lenses (including specialty lenses), clear lens exchange in selected cases, or waiting until the eye is healthier.

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members

Last Updated: August 10, 2025.