Epi-LASIK is a laser vision correction technique that combines
the advantages of
PRK
and
LASIK
and eliminates most of their
disadvantages.
PRK
uses alcohol to remove the surface
epithelium (the thin layer of skin covering the front surface of the cornea).
Then the surface of the eye is treated with the laser. After the procedure, a
bandage contact lens is placed in the eye for 4 to 6 days while the epithelium
slowly regenerates itself.
Traditional
LASEK also uses alcohol to separate the
epithelium, but with LASEK the epithelium is pushed aside during the laser
treatment then repositioned over the cornea before the bandage contact lens is
place on the eye.
In both PRK
and LASIK
, the use of alcohol kills the epithelial
cells
and causes mild to severe swelling of the cornea
that results in
discomfort, light sensitivity and a slower return to functional vision.
The epikeratome laser-assisted keratomileusis procedure,
(Epi-LASIK) uses a unique microkeratome
, called the EpiEdge epikeratome, to
mechanically separate the epithelium
to make a flap, similar to a traditional
LASIK flap. Unlike LASIK, no sharp blades or knives are required. And unlike
LASEK, no alcohol is required.
Advantages of Epi-LASIK
 | The EpiEdge epikeratome eliminates the need for the alcohol used in PRK
and LASIK
. Since alcohol is toxic to epithelial
cells
, removing the alcohol
application from the procedure results in faster healing and less pain
for patients. |
| The EpiEdge produces a precise, reproducible separation of the epithelium
.
With Epi-LASIK, many of the flap complications of LASIK are reduced.
|
| Epi-LASIK results in less post-operative haze. The
epithelial flap may protect the bare surface of the stroma (the inner tissue
of the cornea) after laser treatment and prevent the influx of inflammatory
cells from tears. |
| Because the corneal nerves
are not severed as with LASIK, there's a lower
risk of extended post-operative dry eye problems. |
| Epi-LASIK is is often a better option than LASIK for those with
thin corneas. With this procedure, approximately thirty-five percent
less tissue is removed. That means that many patients who have thin corneas
are now candidates for laser vision correction.
|
| Epi-LASIK provides a more predictable outcome for wavefront guided
"Custom" laser vision correction. Perhaps because LASIK can induce
third order aberrations |
What to expect on surgery day:
You will arrive at the laser center about an hour prior to
your procedure. Once you have been checked in you may be offered a sedative to
help you relax. You will then be prepared for surgery. The area around your eyes
will be cleaned and a sterile drape may be applied around your eye. Anesthetic
eye drops will be used to numb your eyes; no injections or needles will be used.
When your eye is completely numb, an eyelid holder will be placed between your
eyelids to keep you from blinking during the procedure.
Next, the epikeratome will be used to create a hinged
epithelial sheet, which will be reflected onto a contact lens. During this
process, you may feel a little pressure, but no pain. You will then be asked to
look directly at a target light while the laser reshapes your cornea. The
Excimer laser will be programmed with the
information gathered in your pre-operative exam. The laser treatment will be
completed in less than a minute or two, depending on the amount of correction
needed. Then, the epithelial sheet will be replaced along with the contact lens.
Your vision will probably be a little blurry at first, so someone will need to
drive you home. You should relax for the rest of the day. You may experience
some discomfort for 12 to 24 hours, but this is usually alleviated with an
over-the-counter pain reliever. Some people experience sensitivity to light, and
watering or swelling of their eyes for a few days following their procedure.
Realistic expectations:
The decision to have Epi-LASIK is an important one that only
you can make. The goal of any refractive surgical procedure is to reduce your
dependence on corrective lenses. However, we cannot guarantee you will have the
results you desire. The vast majority of our patients are extremely happy with
their vision after Epi-LASIK and can do most activities without dependence on
corrective lenses.
Serious complications with Epi-LASIK are extremely rare.
Epi-LASIK is a safe, effective and permanent procedure, but like any surgical
procedure, it does have some risks. Many of the risks and complications
associated with this procedure can be reduced or eliminated through careful
patient selection and thorough pre-operative testing using the latest
diagnostic technology.
After Epi-LASIK, you may experience some visual side effects.
These visual side effects are usually mild and diminish over time. But there is
a slight chance that some of these side effects won't go away completely, such
as feelings of dryness, glare and halos.
Since everyone heals somewhat differently, some patients may
over react to the procedure and some may under react resulting in
overcorrections and undercorrections. Once the eye has stabilized (3 to 6
months) you and your doctor can discuss whether a re-treatment could help fine
tune your vision if you are over or under corrected.
After a thorough eye exam, you and your doctor will determine
if Epi-LASIK is an option for you. If you are a good candidate, you will be
given additional information about the procedure that will allow you to make an
informed decision about whether to proceed. Be sure you have all your questions
answered to your satisfaction.
