Epi-LASIK Tips

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What is the Difference Between Epi-LASIK and PRK?


Epi-LASIK offers a faster visual recovery than with PRK, averaging three-five days for sufficient recovery as opposed to PRK, which often takes five to seven days for visual recovery to occur.

Both PRK and Epi-LASIK treat the surface of the cornea, but with PRK the surface layer of skin on the cornea is removed. This is not done with Epi-LASIK.

People having Epi-LASIK experience less swelling post-operative compared to PRK. Epi-LASIK also does not utilize alcohol in the surgical process like PRK does. In reality, Epi-LASIK takes the good things from PRK and eliminates the negatives.

Is Epi-LASIK going to be the next big thing?

Is Epi-LASIK the Next Big Thing?

Is Epi-LASIK the next big thing in laser eye surgery? No one knows for sure, but what is known is that Epi-LASIK is rising in popularity.

Epi-LASIK combines the best parts of LASIK eye surgery and LASEK and PRK eye surgery. Epi-LASIK is becoming more popular for a variety of reasons. The recovery time is quicker and the vision restoration is said to happen faster than with other laser eye surgeries. This, combined with very low risk factors, is making Epi-LASIK very popular with those whom the surgery is appropriate for.

Is Recovery Time Faster With Epi-LASIK Compared to Other Laser Eye Surgeries?

Fast Recovery With Epi-LASIK?

Recovering from Epi-LASIK may actually be longer than recovering from the traditional LASIK surgery but quicker than other types of laser eye surgeries. With traditional LASIK, patients may have improved vision from the day the surgery occurs and may see significant changes the following day.

With Epi-LASIK, it takes about a week until you should drive. Your vision may not be restored until about three days after surgery. However, in some cases it has taken longer than three days for vision to recover. Epi-LASIK may have more discomfort from pain compared to traditional LASIK surgery, but the pain is mild and less than with other laser eye surgeries.

What can I expect after epi-LASIK surgery?

What to Expect After Epi-LASIK Surgery

The recovery time for epi-LASIK is considerably longer than for standard LASIK surgery.

After the surgery, you'll have a special contact lens on that eye that acts as a sort of Band-Aid. You won't have normal vision at this point, so be sure to arrange for someone to drive you home from the clinic.

After about three days you'll be able to remove the special contact lens. You may have nearly perfect vision at this point, or it may take several weeks to stabilize. It will be about a week before you can drive.

During your recovery you may experience some pain, which should be manageable with over-the-counter medications.

How does epi-LASIK work?

How Epi-LASIK Works

Epi-LASIK surgery takes 10 to 15 minutes to perform. The patient is prepared as for a LASIK procedure, with the eye numbed with anesthetic drops and a special device holding the eye open.

The surgeon uses an oscillating plastic "blade" to gently separate the epithelemium (top layer of the cornea) from the cornea beneath. Once it is removed, a laser reshapes the cornea to correct the patient's vision.

After this correction is done, the ephithelemium is returned to its natural position with a spatula-like instrument, and a special contact lens is placed over the eye to act as a sort of Band-Aid.

For the next few days the bandage lens will stay in place, and the patient may experience irritation, watery eyes, and the sensation of a foreign body in the eye. It will be four to six weeks before full visual acuity is regained.

Does Epi-LASIK Involve Corneal Flaps?

Epi-LASIK and Corneal Flaps

With traditional LASIK procedures, a flap is created on the cornea with a blade or a laser, depending on the surgeon's choice of instruments. This flap has often caused complications after surgery with typical LASIK procedures.

With the Epi-LASIK procedure, there is no corneal flap made. Epi-LASIK uses an automated device that moves aside the corneal cells and the laser then treats the newly exposed cornea cells. This corrects the vision by reshaping the cornea.

Because there is no corneal flap in Epi-LASIK, the procedure is considered a much safer alternative to LASIK when treating high prescriptions and thinner corneas.

What is epi-LASIK?

What is Epi-LASIK?

Epi-LASIK is a refinement to the LASIK procedure, making it less invasive and available to a wider range of patients.

In LASIK, a tiny blade is used to cut a flap in the cornea. In epi-LASIK, the layers of the cornea are gently separated instead of cut, and no alcohol is used. This makes it possible to use epi-LASIK on patients who have conditions, such as dry eyes or extremely thin corneas, that would prevent them from being eligible for LASIK surgery.

The procedure takes slightly longer than LASIK, and epi-LASIK patients may experience more pain and take longer to recover than LASIK surgery patients. If you've been told you're a poor candidate for LASIK, it's worth asking whether epi-LASIK would be right for you.

Why is Epi-LASIK Appropriate For Those With Low Myopia?

Epi-LASIK for Low Myopia

Epi-LASIK is deemed a safe and appropriate procedure for those who have low myopia. Low myopia is commonly known as nearsightedness. Epi-LASIK on those with low myopia had fewer incidences of haze when compared to those who had PRK or LASEK.

Early studies have shown that Epi-LASIK on people with low myopia have no significant sight-loss complications, no endothelial cell loss that was not typical and no significant loss of distinction of vision. That added with a fairly nice healing time and patient satisfaction with the results shows why Epi-LASIK is suitable for those with low myopia.


Differences between LASIK and Epi-LASIK

In LASIK surgery, a flap is cut in the cornea with a blade or laser. Epi-LASIK surgery is gentler on the cornea, using a blunt plastic oscillating blade. Because it is less invasive, it is possible to achieve good results with epi-LASIK in people whose corneas are too thin or unusually shaped, making them poor candidates for LASIK.

Standard LASIK surgery has a shorter recovery time with less pain than epi-LASIK. Epi-LASIK eye surgery may also be an option for those who are at risk of being struck in the eye -- police officers and athletes, for example. This risk makes them poor candidates for standard LASIK, because a blow to the eye could dislodge the cut flap.

What are the possible complications of epi-LASIK?

Possible Complications of Epi-LASIK

The risk of vision-damaging complications of epi-LASIK is quite low, but can never be said to be zero. Epi-LASIK surgery eliminates some of the risks of traditional LASIK, including a decreased risk of flap complications, infections and haze.

In the first few weeks after an epi-LASIK procedure, it is possible that you will experience "ghosts" or other abnormalities in vision. If this occurs, see your surgeon. It is possible that you have some leftover astigmatism that will need to be corrected, either with lenses or with enhancement surgery.

You may also experience some difficulty with night driving, particularly just after the surgery.


Benefits of Epi-LASIK

Epi-LASIK eye surgery is considered safer than standard LASIK because it is not as invasive. The surgeon cuts a smaller amount of tissue, and the eye heals completely afterwards.

Epi-LASIK is an advancement that allows patients with thin or abnormal corneas, or those with dry eye syndrome, who are not good candidates for LASIK, to correct their vision surgically.

The recovery time for epi-LASIK surgery is faster than PRK and other alternatives to LASIK. Survey results show most patients experience minimal to no pain during their recovery, and epi-LASIK patients experience less trouble with "dry eye" after their surgery than those who had LASIK surgery.

Can epi-LASIK work for me?

Are You a Candidate for Epi-LASIK?

If you've been told you cannot have LASIK surgery because of thin or abnormal corneas, or because of dry eyes, you may still be eligible for epilasik eye surgery.

However, many of the other restrictions on refractive eye surgery apply to epi-LASIK as well. If your eyes are unstable, if you are under 18, or if you are pregnant or planning to become pregnant soon, you will most likely be advised to wait or seek other forms of vision correction.

Epi-LASIK is the treatment of choice for people who have eyes with high powers of correction needed, or who have particularly steep or flat corneas.

Can epi-LASIK help me correct my vision while enjoying an active lifestyle?

Epi-LASIK for Active People

With standard LASIK surgery, patients are warned not to engage in careers or sports that could result in trauma to the eye. A blow to the eye could dislodge the flap in the cornea created during surgery, damaging the vision.

Epi-LASIK is therefore safer and more suitable for such people, who include police officers, firefighters, boxers, soccer players, and martial arts practitioners.

It should be noted that the U.S. armed forces have restrictions on whether service members can receive any type of refractive surgery. If you are a service member or reservist, or if you are contemplating joining the armed services, consult your health officer for information before choosing any form of surgical vision correction.

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Lynda Moultry