Epilasik
What is Epi-LASIK?
Epi-LASIK is an abbreviation for Epithelial Laser Assisted In-Situ Keratomileusis. Epi-LASIK is a laser vision correction technique that combines the advantages of PRK (photo refractive keratectomy) and LASIK and eliminates most of their disadvantages. The technique has many advantages for patients with thin corneas, dry eyes, or wide pupils.
PRK uses alcohol to remove the surface epithelium. Then the surface of the eye is treated with a laser. After the procedure, a bandage contact lens is placed in the eye for 4 to 6 days while the epithelium slowly regenerates itself.
Traditional LASEK also uses alcohol to separate the epithelium, but with LASEK the epithelium is pushed aside during the laser treatment then repositioned over the cornea before the bandage contact lens is placed on the eye.
In both PRK and LASEK, the use of alcohol kills the epithelial cells and causes mild to severe swelling of the cornea that results in discomfort, light sensitivity, and a slower return to functional vision.
The Epi-LASIK uses a unique epikeratome to mechanically separate the epithelium to make a flap, similar to the traditional LASIK flap. Unlike LASIK, no sharp blades or knives are required. And unlike LASEK, no alcohol is required.
Advantages of Epi-LASIK
1) The epikeratome eliminates the need for the alcohol used in PRK and LASEK. Since alcohol is toxic to epithelial cells, removing the alcohol application from the procedure results in faster healing and less pain for patients.
2) The epikeratome produces a precise, reproducible separation of the epithelium. With Epi-LASIK, many of the flap complications of LASIK are reduced. Epi-LASIK only needs to cut a flap 60 microns thick compared to 140 microns thick required for LASIK.
3) Epi-LASIK results in less post-operative haze. The epithelial flap may protect the bare surface of the stroma after laser treatment and prevent the influx of inflammatory cells from tears.
4) Because the corneal nerves are not severed as with LASIK, there is a lower risk of extended post-operative dry eye problems.
5) Epi-LASIK is often a better option than LASIK for those with thin corneas. With this procedure, approximately thirty five per-cent less tissue is removed. That means that many patients who have thin corneas are now candidates for laser vision correction.
6) Epi-LASIK provides a more predictable outcome for wavefront guided “Custom” laser vision correction. Perhaps because LASIK can induce third order abberrations.
Ideal Candidates for Epi-LASIK
1) Are of at least 18 years of age
2) Have had a stable eye prescription for at least one year
3) Not presently pregnant or breast feeding
4) Have no health issues affecting their eyes
5) Have no signs of glaucoma or cataracts
6) Not using medication such as anti-inflammatory, steroids, or immunosupressants
Epi-LASIK PROCEDURE
After a complete eye exam and a corneal topography is done, anesthetic eye drops are applied to the eye before surgery begins to immunize against infection and so that the treatment will be painless.
A device called epi-keratome slides over the surface of the cornea, just underneath the epithelial layer of cells while suction is applied. The result is a hinged sheet of epithelium that is at least partially viable. The sheet is reflected out of the way so that the ablation can take place.
Once the epithelial layer has been made, it is lifted and gently folded out of the way. An excimer laser is then applied and sculpts and reshapes the underlying corneal tissue to correct your prescription.
The epithelial flap is placed back on the eye with a kind of spatula. Eye drops are instilled and a special contact lens is placed on the eye to keep the flap in place while it re-epithelializes.
Why Choose Epi-LASIK?
Some patients have thin corneas, with not enough tissue for a good LASIK flap. ( less than 500 microns).
Epi-LASIK differs from LASIK in that the flap is cut so thin that it does not penetrate the actual cornea. Because flaps are so much thinner, chances of flap related complications such as wrinkled flaps and poor flap adherence to the eye’s surface are reduced. Patients with thinner corneas appear to have less likelihood of complications with epi-LASIK.
Surgeons using epi-LASIK have reported fewer instances of dry eye as a complication, possibly because the thinner flap does not hamper normal processes of corneal nerves involved in triggering responses necessary to moisten the eye’s surface.
Epi-LASIK is suggested for patients with wide pupils, or flat, or hollow corneas.
Compared to PRK and LASEK, the epi-LASIK procedure is safer, and the results are more predictable. Side effects are minimal, and complications are rare.
Microkeratome Amadeus II
This unique and highly advanced instrument from Advanced Medical Optics is used in the I Care Lasik Center to mechanically separate the epithelium to make a thin flap optimal to the success of the procedure.
Laser MEL-80
This modern and highly developed instrument is from Carl Zeiss in Germany. It is used by I Care Lasik. The instrument uses advanced aspheric lasik technology and can sculpt and reshape the cornea so that its natural shape can be kept so that the vision is as sharp as the natural condition. The rays of the excimer laser are emitted very fast with high precision and accuracy. The emissions take about 20 seconds per eye.
Expectations After the Operation
The goal of the operation is to reduce or eliminate the dependence on glasses or contact lenses for vision. Sometimes, even with the best efforts of the surgeon, normal vision of 20/20 may not be attainable. This is due to individual variation in the healing process and tissue density. However, a very large number of patients who undergo Epi-LASIK do reach a visual acuity of 20/20.
Nevertheless, there is a possibility that a small number of patients will not reach the standard of vision that they expected. It is very important to discuss your expectations of success with your eye surgeon before the procedure to avoid disappointment and to ascertain the realistic expectations achievable by the surgery based on your individual case.
Epi-LASIK Cannot Correct Presbyopic Error
As a person ages, he loses the ability to focus clearly at the reading distance. This is presbyopia. The age at which this occurs is on the average 40 years and over. Presbyopia is a gradual loss of focusing ability and is normal for everyone. It is not a disease. A patient with presbyopia will need more plus power to correct this problem.
LASIK will not do away with the need to wear reading glasses for presbyopia. Mono-vision correction is recommended by many Lasik surgeons for their patients aged 35 years and above who are presbyopic or who are likely to become so in the near future. The aim of the mono-vision correction is to enable the patient to have a close to full range of vision with much reduced dependence on glasses for both distance and near vision. This is achieved by aiming at full or close to full correction in the dominant eye and mild under-correction in the other, non-dominant eye.
With the combination of solid service, high technology, and a commitment to achieving the highest patient satisfaction, I Care provides an advanced solution for better vision and a brighter life.
