No Touch LASEK or Trans-PRK
Range treatable: +4D to -10D with up to 4D astigmatism. In traditional LASEK, diluted alcohol is used to soften and remove the protective outer layer (the epithelium) from the central corneal surface, prior to wavefront excimer laser reshaping. In No Touch LASEK (also known as Trans-PRK -TRANSEPITHELIAL PRK) the epithelium is removed directly by the excimer laser. The main advantage compared of No Touch LASEK over other laser vision correction techniques is that the corneal tissue is removed more superficially and hence the risk of long term negative biomechanics corneal change is minimal. . As a result No Touch LASEK is preferred in patients who have thin corneas, very high prescription, or certain corneal abnormalities, such as a mild and stable form of keratoconus. Also patients who practice full contact sports, or are in the police or army, might be better suited to No Touch LASEK because of the absence of a LASIK flap that could otherwise be disturbed following a contact trauma. The main disadvantage or NO Touch LASEK, however, is that there is more post-operative discomfort than Femto-LASIK (usually just a few days) and a longer visual recovery. During Trans-PRK, once the protective surface of the eye (the epithelium) is removed by the excimer laser, then the same excimer laser ablates the cornea beneath with sub-micrometrical precision to reshape it and to eliminate the refractive error in a super quick no touch procedure.
After No Touch LASEK, an anti-scarring drug named Mitomycin C (MMC) is often applied to the corneal surface to reduce haze (loss of corneal clarity) and regression (corneal shape changes during healing, which can dilute the effect of treatment). MMC is not licensed for this specific use but nonetheless has been used in eye surgery for decades as an adjuvant to improve results of laser vision correction and has shown a great safety profile. After the surgery a bandage contact lens is applied to protect the operated eye for a few days whilst the epithelium heals. Eye drops are used to minimise discomfort, but patients experience approximately 3 days during which the eyes are relatively sore, light sensitive and watery. Visual clarity returns over the next few weeks but most patients are able to be back in the office within one week or so.
Both FEmto-LASIK and No Touch LASEK procedures are safe and highly effective, with over 99% of patients able to achieve driving standard of vision or better without glasses or contact lenses after treatment. Most patients are able to return to work within 24-48 hours of treatment after Femto-LASIK, whilst with No Touch LASEK it may take longer for the vision to stabilise. Whilst visual recovery following No Touch LASEK laser eye surgery is slower, the final visual outcome are similar.
Ultimately, the goal of your consultation is to find out what the best treatment for you is, and at Mr Maurino’s practice, we can assess and carry out the most customised treatment for your unique needs.
How does LASEK work
Whilst with Femto-LASIK, a thin flap of corneal tissue (the protective tissue that covers the eye) needs to be cut to allow the laser clear access to the eye, with No Touch LASEK there is no need to cut a flap in the cornea. Instead, the tissue is removed using the excimer laser alone in less than a minute long procedure that is touch-less.
The LASEK procedure
- Step 1: The wavefront Excimer Laser is used in Trans-PRK mode to remove the corneal epithelium and reshape the underlying cornea.
- Step 2: MMC is applied for a few second to minimise the risks of corneal haze and scarring and the washed out.
- Step 3: Finally a ‘bandage’ contact lens is put onto the eye to cover the cornea. The procedure is completed in just minute in most cases.