Laser epithelial keratomileusis in 2010 – a review

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.