Lasek vs. Lasik: Which One Is Right for You?

For those who wear corrective lenses, LASIK is a popular type of laser eye surgery that gives 90% of patients between 20/20 and 20/40 vision and allows them to say goodbye to wearing glasses or contact lenses.¹ However, not everyone is a candidate for this type of surgery.

But don't worry — you may still have options, including the lesser-known LASEK (laser-assisted epithelial keratomileusis)² eye surgery.

If you're not an ideal candidate for one type of procedure, you might meet the criteria for another. Learn more below about two of the top refractive treatments.

LASIK Eye Surgery and LASEK Eye Surgery: What Are They?

As mentioned above, both LASIK and LASEK are a type of laser eye surgery performed in service of vision correction, specifically involving the cornea.² Additionally, LASEK includes LASIK as part of its procedure.³

LASIK eye surgery

LASIK eye surgery is a commonly performed type of refractive eye surgery to correct vision in people who wear glasses or contact lenses.¹ LASIK permanently reshapes the clear cornea of the eye to correct refractive errors caused by the shape of the eye,² and improves the way light is focused on the retina in the back of the eye.¹

LASEK eye surgery

LASEK eye surgery is a type of eye surgery that combines the benefits of two of the most commonly performed eye surgeries: LASIK and photorefractive keratectomy, also known as PRK.² It doesn't involve the creation of a corneal flap during surgery, and the laser correction takes place directly over the surface of the cornea.² Overall, it is a more invasive surgery than LASIK.³

How LASIK and LASEK Eye Surgery Works

Both LASIK and LASEK involve lasers, and the surgery is done by an ophthalmologist in an outpatient setting.² Each procedure usually lasts under 30 minutes.²

LASIK

LASIK surgery helps correct common refractive errors by reshaping the cornea with a laser.¹

• This procedure is done in an outpatient surgery center or your ophthalmologist's office.¹
• Your doctor numbs your eyes with drops while you are awake and places an eyelid holder and suction ring on your eye to prevent you from blinking and keep the eye itself from moving.¹
• In some cases, your doctor may give you a mild sedative.⁴
• They will cut into the clear corneal tissue to create a small flap using a femtosecond laser³ or microkeratome blade.¹
• Your doctor lifts the flap to reveal the layer beneath it and uses an excimer laser³ to reshape the cornea and change its curvature.⁴
• Then, your doctor folds down the flap so the area underneath can heal.¹

LASEK

Like LASIK surgery, LASEK helps correct common refractive errors by reshaping the cornea with a laser.² During LASEK eye surgery, there is no large flap created in the cornea.² Instead, your doctor will only separate the outer layer of the cornea, called the epithelium, from the inner layer, creating a very thin flap.⁵

• This procedure is done in an outpatient surgery center or your ophthalmologist's office.²
• Your doctor numbs your eyes with drops while you are awake and uses a lid speculum to keep your eyelids open.⁵
• In some cases, your doctor may give you a mild sedative.⁵
• They will separate the outer layer of the cornea (the epithelium) from the inner layer using a blade called a trephine. The tissue remains attached to the eye.⁵
• Using an alcohol solution, your doctor soaks the flap to detach it and rolls it back.⁵
• Your doctor uses a laser to reshape the cornea and change its curvature.⁵
• Then, your doctor puts the epithelium back in place before smoothing it down.⁵
• Finally, they will put in a clear contact lens that acts as a bandage for four to six days while the epithelium heals.⁵

Conditions That LASIK and LASEK Eye Surgery Can Treat

LASIK¹ and LASEK² treat vision issues, including:

• Nearsightedness (myopia)
• Farsightedness (hyperopia)
• Astigmatism

Are LASIK and LASEK Eye Surgery Results Permanent?

Results for both LASIK and LASEK are considered permanent for the majority of patients, but there are some cases in which the patient may need additional work done after surgery.

LASIK

For the majority of patients, LASIK results are permanent, but between 3% and 5% of patients may need a second surgery to enhance their results.⁴ During this second surgery, your doctor lifts the flap that they initially created to do further work on the cornea.⁴

LASEK

LASEK results are considered permanent and long-lasting for most patients, and no secondary procedure should be required.⁵ In fact, you may have better long-term results than with LASIK.³ However, if your vision was undercorrected or overcorrected, you may require a touch-up or enhancement to your surgery.⁵

Before getting any secondary procedure, you will likely need to wait until you get consistent eye measurements during two back-to-back visits with your eye doctor, each spaced three months apart.⁵

Recovery Time for LASIK and LASEK Eye Surgery

Recovery time for LASIK is, in general, quicker than with LASEK.

LASIK

Most patients achieve better vision with LASIK within 48 hours of the procedure.⁴ Your doctor will most likely give you prescription eye drops to help with healing and decrease inflammation after your surgery.¹

LASEK

Unlike with LASIK, LASEK recovery time takes about a week after surgery.⁵ However, you may be able to return to work within three to six days.⁵

The bandage contact lens will help protect your eye and reduce pain during the healing process.⁵ You'll have to wear it for up to five days.⁵ In addition, you'll need to use steroid eye drops for several weeks after surgery.⁶

Side Effects From LASIK and LASEK Eye Surgery

Yes, you can expect side effects — some common, some rare — from LASIK and LASEK eye surgery. Some of these side effects may last only a few months; some may persist up to a year; some can be permanent.

LASIK

• Dry eye
• Corneal flap dislocation⁴
• Seeing halos around objects
• Glare
• Trouble with night vision
• Sensitivity to light
• Bruising around the eye
• A scratchy sensation
• Eye pain¹

Most side effects subside over time, usually within three to 12 months.⁸ Dry eye is one of the most common side effects, affecting as many as 95% of patients, and can become permanent after surgery, though this is not common.⁴

Overall, the success rate for LASIK is quite high, with less than 1% of patients experiencing serious, long-lasting consequences like impaired vision.⁸

Very rarely, some may experience serious and sometimes permanent side effects like:¹

• Blindness
• Worse vision than before surgery
• Eye infection

LASEK

• Discomfort,² including a scratchy sensation
• Trouble seeing in low-light conditions
• Dry eye
• Blurry vision, also known as stromal haze²
• Pain in the eye during recovery²
• Temporary damage to the epithelium²
• Slower healing time than LASIK²
• Halos⁵

Most side effects are temporary, but may last for up to 12 months.⁶ In addition, the incidence of dry eye occurs much less frequently with LASEK than with LASIK.⁶ However, there is a greater chance of developing stromal haze,² which should only last six to nine months.⁶

Cost of LASIK and LASEK Eye Surgery

The average cost of LASIK eye surgery is between $3,000 and $6,000 for both eyes.² The average cost of LASEK eye surgery is about the same as LASIK, again ranging from $3,000 to $6,000 for both eyes.² Generally, LASIK will cost slightly more than LASEK eye surgery.²

LASIK

Factors that can affect the cost of your surgery include:

• Where you have it done. Doctors in larger cities, such as New York or Los Angeles, may charge a higher price than those in smaller markets.⁹
• The skill level of your surgeon. More highly skilled doctors will charge more for their surgeries.⁹
• Choice of tools. Whether your doctor uses two lasers or a microkeratome blade and an excimer laser.²
• How much vision correction you need. You'll likely pay more to correct a much stronger and complex prescription than a simple one.⁹
• The quality of the equipment used. Lower-cost surgeries could involve equipment that's out of date.⁵

Note that because LASIK is considered an elective procedure that's not medically necessary in most cases, it is typically not covered by health insurance.²

LASEK

Factors that can affect the cost of your surgery include:

• Where you have it done. Doctors in larger cities, such as New York or Los Angeles, may charge a higher price than those in smaller markets.⁹
• The skill level of your surgeon. More highly skilled doctors will charge more for their surgeries.⁹
• The quality of the equipment used. Lower-cost surgeries could involve equipment that's out-of-date.⁵

Because LASEK, like LASIK, is considered an elective procedure that's not medically necessary in most cases, it typically is not covered by health insurance.²

Number of Treatments Needed for LASIK and LASEK Eye Surgery

Most patients will need only one treatment with LASIK and LASEK eye surgery, though time, age and how much your vision was corrected can affect the need for additional surgery or a touch-up to your original procedure.

LASIK

Ninety-six percent of patients achieve their desired vision, although the remaining percentage may need a second surgery.⁷ This may be due to undercorrection or overcorrection during surgery.¹ Or, your vision might naturally degrade over time due to age, thus requiring a second surgery to restore the original correction years after your initial procedure.⁷

LASEK

As with LASIK, most patients need only one LASEK eye surgery. If your vision was undercorrected, you may require a secondary touch-up to your surgery.⁵

Good Candidates for LASIK or LASEK Eye Surgery

Not everyone is a good candidate for LASIK eye surgery, but the good news is that LASEK eye surgery is a great alternative.

LASIK

For those considering LASIK, it works best for those who:¹

• Are over 18 years old (ideally over 21)
• Have generally healthy eyes
• Have a glasses or contact lens prescription that hasn't changed much in the past year
• Have a refractive error that LASIK can correct

LASIK eye surgery doesn't work for those with:¹

• Thin corneas
• Diabetes, keratoconus or glaucoma
• Cataracts
• Severe dry eye
• A history of eye infections
• A prescription that has frequently changed
• Corneal problems

LASEK

For those considering LASEK, it works best for those with:⁵

• Thin corneas
• A high degree of nearsightedness (myopia)
• Dry eyes
• A career that is at high-risk for eye trauma

How Are LASIK and LASEK Eye Surgery Similar?

In both LASIK and LASEK eye surgery procedures, the eye surgeon uses a laser to cut into and reshape the cornea.³ This changes the way the eye focuses light on the retina, which can lead to improved vision without the need for eyeglasses or contact lenses.⁵

Both LASIK and LASEK eye surgery procedures are time-tested and provide similar outcomes⁵ — including the possibility that a second surgery might be needed or that you may still need glasses in some situations. The worse your initial eye condition, the more likely you'll need re-treatment or eyewear.⁵

How Are LASIK and LASEK Eye Surgery Different?

The primary difference between LASIK and LASEK is in the corneal flap that is created during the reshaping process. During LASEK eye surgery, only the outer layer of the cornea is pushed aside and then put back into place, so it is a very thin flap.³

The LASEK eye surgery technique may also lower the risk of developing dry eyes post-surgery and minimize complications related to the deeper LASIK cut. However, LASEK recovery tends to involve more discomfort and more time. Your vision may appear hazier during the first week post-surgery with LASEK than with LASIK.³

LASIK vs. LASEK: A Comparison Overview

Here is a quick breakdown comparing LASIK and LASEK eye surgery.

How to Decide Between LASIK and LASEK Eye Surgery

Both types of eye surgery are safe, effective and have similar results.² In general, LASIK eye surgery remains the primary choice for a higher percentage of patients, with LASEK being a good option when a patient isn't a great candidate for LASIK.²

LASEK may be a better choice for patients who aren't ideal LASIK candidates due to thin corneas.³ LASEK may also be a better option for those with severe myopia⁵ and for those whose work or hobbies have a high potential for dislodging the corneal flap created in LASIK surgery.⁶ Your eye doctor can help you make the best decision for you.³

Financing LASIK or LASEK Eye Surgery With the CareCredit Credit Card

If you'd like to be less dependent on glasses or contact lenses, you may want to consider taking the first step to determine if you're a good candidate for LASIK or LASEK eye surgery. Schedule an appointment for an eye exam and a pre-operative consultation with your eye doctor, who can review your eye health and answer your questions. Remember that the CareCredit credit card provides a convenient option for financing not only your LASIK or LASEK consultation and procedure but other vision care, too.* Apply today and use our Acceptance Locator to find a vision specialist near you that accepts CareCredit. Continue to invest in your wellness journey by downloading the CareCredit Mobile App to easily manage your account, find a provider on the go and easily access the Well U hub for more great articles, podcasts and videos.

Author Bio

Susan Paretts is a freelance writer with 19 years of experience covering health and wellness, pet care and more. Her work has been published by the American Kennel Club, Bayer Animal Health, Elanco, LIVESTRONG.com, The San Francisco Chronicle, Chewy and more.