Photorefractive keratectomy,
laser epithelial keratomileusis (
LASEK) and Epi-
LASIK are all variants of a similar type
refractive surgery involving
laser on the surface of the cornea and differ mainly in management of the epithelium. Although
laser in situ keratomileusis (
LASIK) is currently the most popular form of
refractive surgery,
LASEK is the procedure of choice in some patients. We highlight potential complications of
LASEK and how these may be managed. Following
laser refractive surgery, corneal thickness is reduced, which has implications for intraocular pressure measurement and
glaucoma screening and management. This is particularly important following surface
laser procedures where no evidence of previous surgery may be visible. In the event that
cataract surgery is required at a later date, correct calculation of the appropriate
intraocular lens power can be difficult and it thus important that patients are given their preoperative keratometry readings and refraction. Compared with
LASIK patients, those who undergo
LASEK are considered to be at lower risk of corneal
ectasia. Improved understanding of wound healing post
LASEK and better
postoperative pain management are ongoing challenges.