Epi-LASIK Eye Surgery
Epi-LASIK is a new laser eye surgery procedure developed to compensate for some of the potential problems of LASIK and LASEK. It's sort of a cross between the two; however, it differs in a few areas as well.
LASIK involves cutting a flap in the cornea with either a sharp blade or a laser; with LASIK also comes the risk of cutting the flap too thickly. LASEK involves cutting the cornea's outer layer, the epithelium, in a thin sheet that retains its hinge on the eye. This is done in Epi-LASIK too, but the surgeon uses a blunt, plastic oscillating blade instead of LASEK's finer blade. Also, instead of the alcohol that's used in LASEK to loosen the epithelial sheet, in Epi-LASIK the surgeon uses a plastic blade, called an epithelial separator, to separate the sheet from the eye. This avoids the possibility of a reaction or eye infection from the alcohol, which can kill epithelial cells.
Because it is more difficult to create the epithelial flap in people with steeper corneas (those with higher amounts of myopia), the procedure is more appropriate for people with less steep corneas (those with low myopia).
After the epithelial flap is made, it is lifted and gently folded out of the way. An excimer laser is used, as in LASIK or PRK, to sculpt the underlying corneal tissue. Then the epithelial flap is placed back on the eye with a kind of spatula. A special contact lens is placed on the eye to keep the flap in place while it re-epithelializes. Surgeons use a high-Dk contact lens for this, which means it is very oxygen-permeable. Without enough oxygen, the surface cells of the cornea would die.
If you have Epi-LASIK you'll likely experience some eye pain, which is manageable with over-the-counter painkillers. The pain is reportedly less than with PRK or LASEK.
After Epi-LASIK Surgery
By about the third day after surgery re-epithelialization has occurred, so the doctor may permit you to remove the contact lenses. Vision will probably not be perfect immediately: in three days many patients do have 20/40 or even 20/20 vision, but others take longer — possibly three or six months — to reach their final result. Usually people can drive about a week after surgery. These recovery times are significantly longer than with LASIK eye surgery, which usually allows people to achieve good vision from the same day up to a few weeks later and to drive by the day afterward.
As with any laser eye surgery, after Epi-LASIK it is very important to follow your surgeon's instructions exactly, because the quality of the final vision you achieve is affected by how well your corneas heal. In order to maintain proper eye care, don't neglect to use the eye drops or other medications you are prescribed, and don't miss any follow-up appointments.
Who Can Have Epi-LASIK Surgery?
If you are considering LASIK, but your doctor says you need Epi-LASIK instead, ask why. It's not for everyone, but many surgeons who perform Epi-LASIK consider it a better option for some patients who will probably not do very well with LASIK. These include people who have thin corneas, with not enough tissue for a good LASIK flap. And those who have professions or hobbies that increase the chance of being hit in the eye (such as soldiers, police officers, boxers, and racquet sports enthusiasts) may find Epi-LASIK safer than LASIK because there's no risk of the flap being dislodged.