Epi-LASIK is a laser vision correction procedure that is very similar to LASIK and LASEK, and may be a good alternative to these procedures for certain eyes.In epi-LASIK, the flap created on the cornea is thinner than a LASIK flap. This can be an advantage for patients with thinner-than-normal corneas.

The epi-LASIK flap is very similar to the thin flap created in LASEK surgery. In both procedures, the flap contains only cells from the very thin outer layer of the cornea, called the epithelium.

The difference is how the epi-LASIK and LASEK flaps are produced.

A LASEK flap is created with a tool that has a sharp blade. In epi-LASIK, the flap is separated from the underlying corneal layer (the stroma) with an instrument called an epithelial separator that has an oscillating plastic blade that has a thin blunt edge.

And unlike in LASEK, an alcohol solution typically is not applied to the eye in epi-LASIK to loosen epithelial cells from the underlying corneal stroma. Some surgeons prefer epi-LASIK over LASEK for this reason, since alcohol is toxic to epithelial cells and can increase healing time after the procedure.

After the epi-LASIK flap is created, it is folded back and the underlying central stroma is reshaped with an excimer laser — steps identical to those performed in LASIK.

Because the epi-LASIK flap is so thin, the surgeon typically will apply a soft contact lens over the flap when it is repositioned after the laser treatment. The contact lens acts as a bandage to increase comfort and allow new epithelial cells to grow onto the cornea more quickly for faster healing.

Your surgeon or eye doctor will remove the bandage contact lens at one of your early follow-up visits a few days after your epi-LASIK procedure.

After Epi-LASIK

Your vision probably will 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 you can drive within 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 after surgery.

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 your doctor prescribes, and don’t miss any follow-up appointments.

Who Can Have Epi-LASIK

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 than LASIK for some patients. These include people who have thin corneas, with insufficient tissue for a good LASIK flap.

Epi-LASIK also may be safer than LASIK for people 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) 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.

Frequently Asked Questions

Risk or corneal scarring is more in epi lasik… (1-2%) as compared to less than 1% in lasik (flap surgery).Just needed an understanding of this.?
Patients with pupil diameter of more than 6.0 mm should be informed of the significant risk of night vision disturbances after epiLASIK. Generally, these symptoms abate over time. Just needed an understanding of this.
Results are generally not as good in patients with very large refractive errors of any type. You should discuss your expectations with your doctor and realize that you may still require glasses or contacts after the surgery.
For some farsighted patients, results may diminish with age. If you are farsighted, the level of improved vision you experience after surgery may decrease with age. This can occur if your manifest refraction (a vision exam with lenses before dilating drops) is very different from your cycloplegic refraction (a vision exam with lenses after dilating drops)
Long-term data is not available. LASIK is a relatively new technology. The first laser was approved for LASIK eye surgery in 1998. Therefore, the long-term safety and effectiveness of LASIK surgery is not known.
Local anaesthesia. Day/Day before the surgery, do i have to consume/ not consume specific foods?
Issues like cataract/ issues arising long term.?
Will I have normal vision/ 20-20 vision post surgery? Chances of retreatment/ touch-up. i.e. if there is any residual correction to be undertaken, is that included in the package? Also what is the probability of the same to occur?
Are Epi-LASIK surgeries also commonly performed at the hospital vis a vis a ‘normal’ lasik operation. Apart from the longer rest period, an epi-LASIK generally safer right?
The 4 days rest period post-the surgery? Discomfort/vision level, the general movement i am allowed, etc. Time frame I will have to be off work? (Can I after about 5-7 days go to my sites, im an architect/interior designer by profession), etc?
What is the mode of payment?
My evaluation was 2 months ago. Shall I need to be re-evaluated before the surgery?
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