PRK, LASEK, LASIK, SMILE… What do they all mean?

screening patient for laser eye surgery

Laser Eye Surgery is one of those things many people shut down without a second thought.

I mean, even despite the unfortunate pairing of ‘laser’ and ‘eye’, who wants to spend all their time running between clinics, attempting to decode marketing jargon and medical terminology and figure out the differences between clinics and treatments?

Some people are missing out, though, as once you get beyond all the confusing branding and hyped-up promotions, Laser Eye Surgery is incredibly easy to understand. You can get your head around the whole market of treatments, including abbreviations like PRK, LASEK, LASIK, and SMILE, in a matter of minutes. The trick is to not start by talking with an overly-eager sales assistant, but by simply learning a bit more about the anatomy of the human eye.

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To understand Laser Eye Surgery, first understand the eye

The cornea — the transparent window of the eye — is made up of three main sections: the epithelium, stroma, and endothelium.

The epithelial tissue is the eye’s outermost barrier to the elements. It possesses an incredible ability to recover and repopulate its cells after damage. The ‘stromal’ tissue of the cornea is the permanent, fibrous layer underneath the epithelium. And lastly is the endothelium, the final and the innermost layer of the cornea that is responsible for keeping the cornea clear by pumping water seeping into the stroma out of the cornea.

All Laser Eye Surgery treatments work their magic by altering the ‘stromal’ tissue. But as the stroma sits in the middle of the cornea, it’s first necessary to pass through the endothelial cells that make up the outer layer. The four main types of Laser Eye Surgery can be categorised by the method they use to travel through the outer layer of cells.

PRK: The first of it’s kind

In PRK, the outer layer of cells is removed entirely to access the stromal tissue underneath. Once the stroma is reshaped and the treatment is complete, the epithelium needs to repopulate the surface. The patient wears a soft contact lens to encourage this process.

LASEK: Let’s loosen things up

LASEK is a very similar procedure to PRK. However, in LASEK, rather than remove the epithelium entirely, it’s loosened with an alcohol solution and pushed to one side. After the permanent layer is adjusted, it is then draped back to its original position.

Again, a contact lens is applied, and a whole new layer of cells repopulates the surface aided by the original epithelial layer, hopefully shortening the recovery time.

LASIK: A doorway to the stroma

LASIK introduced quicker healing time and more efficient method of passing through the surface and quickly became the most common form of Laser Eye Surgery.

In LASIK, a small flap is created in the epithelium and simply folded back to expose the bed of the cornea. After the set amount of stromal tissue is removed, the flap is returned to its original position. The natural processes of the eye immediately get to work sealing the edges of the flap, and thus patients spend much less time in recovery.

SMILE: A more subtle approach

SMILE is the latest generation of Laser Eye Surgery, and, much like LASIK did, it represents a significant leap forward in refractive surgery.

In SMILE, there’s no need to remove, push aside, or even cut a flap in the epithelium. Using the incredibly accurate Visumax laser, SMILE reaches the stromal tissue via a tiny keyhole incision.

Once a precise amount of tissue is removed through this incision, the procedure is complete. As there are no moving parts, the healing time for SMILE is much quicker than that of PRK, LASEK, and LASIK.

Don’t let marketing or medical speak get the better of you; check out our glossary of Laser Eye Surgery terminology and make sure you go into your next consultation ready for anything they throw at you.

If you’d like to find out more about your eyes or book a consultation with us, leave us a comment or call us on 020 7224 1005.

Lasik lasek prk smile … what do they all mean?

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