Epi-K and PRK

Epi-LASIK Eye Surgery:
How It Works

Epi-LASIK is a newer laser eye surgery procedure that was developed to solve some of the potential problems with LASIK and with PRK. During LASIK, your surgeon cuts a flap in the cornea with a sharp blade or a laser. But this procedure carries the risk of cutting the flap too thickly.

Epi-LASIK involves temporarily removing the cornea's outer layer, the epithelium, in a thin sheet that retains its hinge on the eye. This technique is working with the outer most layer of the eye, the epithelium, which is also the fastest growing group of cells in the human body. Epi-LASIK can provide a more stable long term result versus traditional LASIK which is cutting the flap directly in the cornea because the epithelium flap grows back in place more rapidly than the corneal flap used in LASIK.

Also, instead of the alcohol that's used in PRK to loosen the epithelial sheet, in Epi-LASIK the surgeon typically uses the plastic blade, called an epithelial separator, to separate the sheet from the eye. This avoids the possibility of a reaction from the alcohol, which can kill epithelial cells.

After the epithelial flap is made, it is lifted and gently folded out of the way. An excimer laser is used, as in LASIK or PRK, to sculpt the underlying corneal tissue. Then the epithelial flap is placed back on the eye with a kind of spatula. A special contact lens is placed on the eye to keep the flap in place while the epithelium grows back. Surgeons use a High-Dk contact lens for this, which means it is very oxygen-permeable. The contact lens protects the surface of the eye and allows the epithelial cells to grow back properly.

After Epi-LASIK

By about the third day after surgery re-epithelialization has occurred, so the doctor may permit you to remove the contact lenses.

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 to reach their final result. Usually you can drive within a week after surgery.

Conclusion

As with any 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 eyes heal. Don't neglect to use the eye drops or other medications your doctor prescribes, and don't miss any follow-up appointments.

Dr. David O'Day prefers the results obtained with Epi-LASIK and offers it to all patients as an option. The main advantage of Epi-LASIK over traditional LASIK is that with Epi-LASIK, there is no deep corneal “flap” created which means that the healing process is more permanent since much less tissue is displaced than is the case with LASIK.

Many LASIK providers advertise the merits of "All Laser LASIK" or what is sometimes referred to as "Blade-free LASIK". These methods are promoted as superior means of creating the flap. Whether or not this is a true statement is a subject of much debate within the ophthalmology community which is why Dr. O’Day has chosen Epi-LASIK as a superior method; no corneal flap is better than either a razor bladed flap or a lasered flap.

The proof of the benefits of Epi-LASIK at Charleston Cornea and Refractive Surgery is in the thousands of exuberant patient stories and in the fact that Dr. O’Day is Charleston’s only practice which offers a 20/20 Money Back Guarantee to his patients. This guarantee is your assurance that Dr. O’Day has complete confidence in his ability to improve your vision to at least 20/20, and oftentimes even better.

PRK

PRK is necessary for certain eye conditions where the cornea is too thin to create a flap. Although outcomes are the same, PRK is a slightly less comfortable procedure than LASIK and can take up to two months to achieve the level of vision that LASIK can deliver in just a day or two, but PRK is better, when necessary, than the alternative of wearing contact lenses or glasses.