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.