Epi-LASIK: What's All the Flap About



Posted: Saturday, September 08, 2007

by
http://www.Likely-LASIK.com

Epi-LASIK, a procedure that has commonalities with PRK, LASIK, and LASEK, is a laser eye surgery procedure that can be used for patients who have thin corneas and might not otherwise be good candidates for ordinary LASIK. Epi-LASIK is an acronym, where “Ep" stands for epithelial, the outer-most layer of the cornea, and LASIK stands for “laser in situ Keratomileusis." As with the other similar surgeries, Epi-LASIK can be used to correct correct nearsightedness, farsightedness, astigmatism, and presbyopia.

Epi-LASIK is similar to other laser eye surgery techniques, as it also uses a laser beam to reshape the cornea. It’s an extremely quick procedure, as are all laser eye surgeries, and is complete in less than 10 minutes. Epi-LASIK is mainly recommended for people who have acutely sensitive eyes and are uneasy with the effects of putting alcohol in their eyes (as is done in LASEK), or having a corneal incision made (as in LASIK). Epi-LASIK is safer than traditional LASIK for patients with thin corneas, but eye irritation is more common and recovery times are slightly longer, up to seven days.

In LASIK surgery, a flap is cut through the epithelial cells and into the stroma layer of the eye. Epi-LASIK is like LASEK where no flap is cut, but the epithelium is lifted as a sheet off the surface of the eye. However, in LASEK, alcohol is used to soften and separate the epithelial cells of the cornea, but Epi-LASIK is a fully mechanical procedure where a blunt plastic epithelial separator is used to gently lift the surface epithelium off the eye.

Despite the specific differences between each of these procedures, the terminology is sometimes used in a confusing way. Don’t be surprised if you hear people saying that Epi-LASIK and LASEK are the same surgery. And don’t be surprised if you hear people referring to the sheet of epithelium that’s lifted during LASEK and Epi-LASIK as a “flap." It’s a different kind of “flap" than that used in traditional LASIK surgery, one with far fewer associated complications.

Because Epi-LASIK preserves the structural integrity of the stroma, it’s been heralded as minimizing patient discomfort when compared to PRK and LASEK, shortening the length of time before visual recovery, and reducing the incidence of corneal haze. Epi-LASIK is perfect for people in high-risk professions such as the military, police, firefighters, professional athletes in contact sports, and others whose physical jobs put their eyes at risk, because there's no risk of the flap being dislodged.

The major advantage of Epi-LASIK is that it avoids complications associated with creating a conventional LASIK flap, such as an incomplete flap, an irregular flap, or abrasions. In traditional LASIK surgery, a flap is created with the use of a blade or laser. Because of this, complications sometimes associated with the blade, such as flap complications or aberrations induced by the flap, can be eliminated in Epi-LASIK. Typically, Epi-LASIK’s lifted epithelium fits more naturally back in place over the patient's eye and could heal in just three days compared to a week or more with PRK. Also, the Epi-LASIK epithelium cut is so thin that it does not penetrate the actual cornea, whereas LASIK actually penetrates into the cornea. After the epithelial separator has created this ultra thin separation of the epithelium, it’s lifted and carefully folded back. That is, there is no such risk as dislocated flap, folds in flap, epithelial in-growth and other risks from the LASIK flap.

Epi-LASIK is safer, but takes longer to achieve the full visual result and may be more painful post-operatively than traditional LASIK.

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