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Epi-LASIK Eye Surgery:
Epi-LASIK is a new laser eye
surgery procedure that was
developed to solve some of
the potential problems with
LASIK and LASEK. It's kind
of a cross between the two,
but differs in a few key
areas.
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 the plastic blade,
called an epithelial
separator, to separate the
sheet from the eye. This
avoids the possibility of a
reaction from the alcohol,
which can kill epithelial
cells.
Because it is more difficult
to create the epithelial
flap in people with steeper
corneas (who have higher
amounts of myopia), the
procedure is more
appropriate for people with
less steep corneas (who have
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. The
contact lens protects the
surface of the eye and
allows the epithelial cells
to grow back properly.
If you have Epi-LASIK you'll
likely experience some pain,
which is manageable with
over-the-counter
painkillers. The pain is
reportedly less than with
PRK or LASEK.
Post OP Management:
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 in about a week
after surgery.
These recovery times are
significantly longer than
with LASIK, 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.
Don't neglect to use the eye
drops or other medications
you are prescribed, and
don't miss any follow-up
appointments.
Epi-LASIK Indications:
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.
If you have Epi-LASIK, you
will likely experience some
discomfort after the
procedure. This is usually
manageable with
over-the-counter
painkillers. The discomfort
after Epi-LASIK is
reportedly less than that
experienced after PRK or
LASEK.
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