Epi Lasik eye surgery or Epi-Lasik, which is an acronym for Epipolis Laser In Situ Keratomileusis is a one kind of laser vision procedure performed in our los angeles lasik center. It has evolved from PRK  and Los angeles Lasik. The name epi-LASIK is derived from the greek word ‘epipolis’ that means superficial and the word lasik. Epi-LASIK eye surgery is just like LASEK except that in it the epithelial flap is created with the help of an epikeratome and thus the epithelial cells are not damaged by chemical toxicity of alcohol. It was introduced by Ionnis Pallikaris in 2003. By this Epi-LASIK procedure a lasik surgeon can solve some problems which occur during LASIK and also LASEK. Although Epi-LASIK is very similiar with Lasik and PRK, it has some differences from LASIK in operative produres.

Epi LASIK eye surgery procedure:

Epi-LASIK eye surgery procedures is similiar  LASEK without the use of alcohol.
LASEK Epithelial Removal of the cornea : By placing 8.5 to 9.5 mm in size trephine  on the center of the cornea epithelium is removed.
Alcohol treatment:20% ethyl alcohol kept in position for 45 second.
Separation of the epithelial flap : After 45 seconds of Alcohol Treatment, this      procedure is performed by the dge of the trephine marks.
EPILASIK Creation of corneal flap : By Epikeratome which is an automated machine using a plastic separator.
Corneal stromal ablation : This procedure like as PRK.
Reposition of the epithelial flap : After ablation the surface this procedure is performed by washing, scrapping with normal saline.
Bandage with contact lens : Applied contact lens for 5 to 7 days.

After Epi LASIK surgery managemant :

–Topical NSAID ( Non steroidal anti inflammatory drug ) for four times daily.
–Topical steroid for healing corneal epithelium.
–Topical artificial tear eye drops for using frequently.
–Bandage with contact lenses.

Epi LASIK candidates:
–Patient who is not fit for LASIK.
–Must be at least 18  years of ages.
–Corrective refractive conditions stable for last1 years.
–Myopic upto -10 diopter.
–Hyperopic upto +4 diopter.
–Astigmatism +- 6 diopter.

Complications of Epi LASIK :

After epi-LASIK a patient can face some problems. Key notes of these problems are…
–Poor adhesion and anchoring or delayed epithelial healing.
–Flaire striae.
–Infectious keratitis.
–Dry eye syndrome.
–Lost flap post operatively.
–Under correction and over correction of the eye correction.
–Induced astigmatism.
–Haze cornea, haloes and glare.
–Corneal ectasia.
–Loss of central corneal sensitivity.

Advantages of Epi LASIK:

There are many advantages for Epi-LASIK. They are…
–Corneal ectasia is less likely as residual corneal bed thickness is more.
–Flap related complications are not high like as LASIK.
–Additional correction of myopia up to 3 D more than LASIK is possible.
–For thin cornea it is the best option.
–Easy to create flap cornea.
–Very good option for high myopia.
–Overcomes the limitations of lasik.

Disadvantages of Epi LASIK :

Some disadvantages of Epi-LASIK.
–Post operative pain is more than Lasik.
–Delayed recovery.
–Blurred vision more tham 7 to 10 days.
–Corneal haze similiar to PRK is definitely encountered on long-term follow up.

Result of Epi-LASIK :Excellent.
Complications rate : few.
Healing Period : Delayed.

Lasik versus(vs.) Epi LASIK :

Presently epi-lasik is a good alternative to LASIK where the latter is handicap, e.g. in patient with myopia >8D (diopter) and those with thin cornea.
It has some extra advantages also from PRK(photo refractive keratectomy), in the form of less pain and less haze.

About Rajesh Khanna MD

A passion to spread vision.
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