Epi-LASIK is a relatively recent innovation in laser eye surgery and was developed in order to lessen some of the potential risks posed by the LASIK and LASEK methods. Epi-LASIK is, in some ways, a hybrid of the two systems but it differs in a few key ways. LASIK involves cutting a corneal flap by using either a sharp blade or a laser and this has the associated risk of cutting the flap too thickly. In the LASEK method the cornea’s outer layer (the epithelium) is cut by a fine blade into a thin sheet which has a hinge on the eye.
The Epi-LASIK procedure
In the Epi-LASIK method, the cornea’s outer layer is cut in a similar way to that of the LASEK treatment. However instead of using a fine blade, common to LASEK, Epi-LASIK makes use of a blunt, plastic blade which oscillates. Similarly, when undergoing LASEK surgery, alcohol is used to loosen the epithelial sheet. In the Epi-LASIK treatment this is substituted for a plastic blade, known as an epithelial separator which separates the sheet from the eye. This method was chosen as it has the benefit of avoiding the risk of an adverse reaction to the alcohol, which in some cases can kill epithelial cells. As it’s more difficult to create an epithelial flap in patients with steeper corneas (common in those who have higher amounts of myopia) the procedure is better suited to those with flatter corneas. After the flap is created, it’s then moved gently out of the way and folded. In a similar way to the PRK or LASIK methods an excimer laser is used to sculpt the corneal tissue. The epithelial flap is then placed back on the eye and a special contact lens is placed on the eye which will keep the flap in place and allow the epithelial cells to grow back correctly. It’s likely that you’ll experience some discomfort after the treatment but this is usually treatable with over-the-counter painkillers and patients report that there’s less than in LASEK or PRK.
After a couple of days following surgery your epithelial cells should have healed well enough to allow the removal of the contact lens. It’s unlikely that you’ll experience twenty-twenty vision immediately and as the time it takes for vision to stabilise differs greatly from case to case it may take between a week and six months to become fully stable. This is a significantly longer recovery time than is involved in the LASIK procedure which can usually bring stable vision within a couple of days after surgery. It’s important to follow any aftercare instructions you receive carefully as your final quality of vision will be affected by how well your corneas heal. It’s also common to be prescribed eye drops to help prevent infection and inflammation. Epi-LASIK is better suited to those with thin corneas, as they can often have trouble getting enough tissue to create a large enough LASIK flap.
Although the majority of all Epi-LASIK procedures are performed safely, as with any surgical procedure there is a slight risk of complications. Some of the risks associated with procedure include; an over or under correction if too much or too little tissue is taken, meaning your vision may not improve as expected. Flap complications, although rare, can also occur as can dry eye syndrome although this has a much lower rate of occurrence with Epi-LASIK than other visual correction procedures. Glaring, halos and problems seeing at night can also occur but the majority of all these complications are easily treated with follow-up surgery.