Epi-LASIK - Laser Eye Surgery Guide

Many people consider epi-LASIK to be a procedure that combines both LASIK and LASEK, although primarily it is a particular form of LASIK. Epi-LASIK has been created to resolve possible complications that are sometimes associated with generic LASIK or LASEK techniques. The procedure's name can be lengthened to its medically accurate term of epithelial LASIK. This epi-LASIK method incorporates the reshaping of the patient's cornea to drastically improve their vision.

Generally speaking, the epi-LASIK procedure involves the use of an epikeratome. This is a plastic blade employed to isolate a thin layer of tissue from the cornea. This is done to provide sufficient access for a laser called an "excimer laser" to perform optimally.

What defines epi-LASIK from LASEK and LASIK?

It can be hard to know the key differences between epi-LASIK and the two more typical procedures as the method incorporate aspects from both. However, the difference can be found when analysing the first step in the procedure. This is the moment with the top epithelial layer of the cornea is manoeuvred out of the way to allow the laser to act efficiently.

In epi-LASIK, an epikeratome is used to move this layer of tissue. The epikeratome is a plastic blade, which varies from the microkeratome used during LASIK as well as the trephine employed in LASEK.

Aside from this simple difference, the three procedures are identical although this one small variation can determine one's suitability for a specific treatment.

Who is a suitable candidate for Epi-LASIK?

The Epi-LASIK procedure is considered best suited to those who have got a thin cornea and may therefore not undergo generic LASIK to obtain optimal results. Another aspect that may make you a suitable candidate for the procedure is if your eyes have a slight refractive error such as mild myopia (or short-sighted). Alternatively, if your lifestyle incorporates the chance of eye injury, for example, if you are a player of a contact sport like rugby; then you may be also advised to undergo Epi-LASIK. The reason for the latter is due to the resilience of the corneal flap after the operation compared to other eyesight corrective treatments.

The general factors that will be considered by your surgeon during your consultation will include your age, health and lifestyle. They will require to know your medical history and if you have been subject to any diseases of the eye at some point in your life. Not only this, but you surgeon may wish to know why you would like to undergo the procedure. This is so that they can provide you with realistic expectations in regards to the outcome.

Alternatives to Epi-LASIK

If you are deemed unsuitable for undergoing Epi-LASIK then there are other options you may choose to consider.

One potential alternative is an intra-ocular lens (IOL), also referred to as an implantable contact lens or ICL. Such a procedure involves a contact lens being physically implanted into the eye to improve its focussing capacity. The lens will give a similar result to generic contact lenses, however rather than having to constantly remove and insert the lens, it will be constantly in the eye.

Are there any risks associated with Epi-LASIK?

As with all surgical procedures, there are some risks that you should consider prior to committing yourself to undergoing the Epi-LASIK procedure. These risks and complications are rare but they can happen so are worth thinking about and discussing with your surgeon.

Potential risks and complications that may result from Epi-LASIK include:

Under or over correction
The feeling of dry eyes, which may require the use of eye drops
Glare
Halos
Incorrect repositioning or damage to the small flap created from the corneal tissue

If you are one of the unfortunate few who do develop any of the above problems, then it may be necessary that you undergo subsequent surgery to correct the issue.

What are the key benefits of the Epi-LASIK procedure?

The primary benefit that is often focussed upon by both the surgeon and the patient is the potentially significantly improved vision. This improvement can cause the vision to become close to or completely perfect, banishing the requirement for removable contact lenses or glasses.

Other benefits that you may wish to consider about Epi-LASIK include the fact that it is a suitable procedure for those who have got thin corneas. Also, the surgery carries lower risk of cornea damage as well as dry eyes when compared to other corrective vision treatments.

Your Epi-LASIK Consultation

To ensure that you ask all the questions that you deem important about the Epi-LASIK procedure, you should write them all down prior to your consultation. As you ask your surgeon each question, tick it off so you are sure that you have got a sufficient answer for each of your queries. For ideas as to what sort of questions you may want to ask, take a look at our 'Laser Eye Surgery: General FAQs' page.

During your consultation, you may be given an estimate as to how much your individual procedure will cost. The price is variable depending on the clinic due to factors including the surgeon performing the Epi-LASIK, the technology that the clinic employs as well as the care given to you after the surgery. However, to give you a rough idea of cost, Epi-LASIK prices are generally within the range of £800-£1300 per eye.

What the Epi-LASIK procedure entails

During your consultation, your surgeon should give you a step-by-step run down as to what your Epi-LASIK procedure will involve. Typically, the surgery will include the following stages:

Your surgeon will position a specialised clip designed to hold your eye open and stop you from blinking throughout the procedure. Once this has been secured, your surgeon will proceed to administered eye drops to numb your eye.
Your surgeon will then use an epikeratome to cut a small flap from the epithelial layer of your cornea. This instrument is a plastic blade and is a defining feature of Epi-LASIK. The flap that has been created is then carefully moved out of the way to provide the laser with sufficient access to the cornea.
An excimer laser is then employed to excise tissue from the centre of the cornea. This allows the cornea to be reshaped in such a way that the eye can focus light better.
Once the laser has done its work, the flap of cornea epithelium is gently repositioned. This is then held in place by a bandage lens or a specially made contact lens. This step is important in aiding the rapid healing of the epithelium.
To ward off any infections, you will be administered some eye drops that work as antibiotics. Furthermore, you may be supplied with a solution to create fake tears to ensure the eye does not get too dry and remains lubricated.

How long can I expect the results of Epi-LASIK to last?

This is a relatively common question with a rather simply answer: the results are permanent. It may take a few days after the surgery for your eyes to significantly improve and this improvement will continue over the following months to last a lifetime.

However, you must remember that everybody's eyesight gets worse naturally with age and your initial laser eye surgery is unable to prevent this from happening. If you want to improve age-related eyesight issues then you may wish for further surgery and a consultation with a surgeon is recommended.

The Epi-LASIK recovery process

The day after your Epi-LASIK procedure, you will be required to return to the clinic to visit your surgeon for a check up. During this appointment you may be administered painkillers to ease any discomfort that you may be experiencing. This discomfort is rather common but is noted as being less noticeable than after LASEK or PRK procedures.

Around four days after your Epi-LASIK procedure, it is probable that you will be allowed to remove the bandage lens, however, you should only do so if advised by your surgeon. Also, to aid the healing and recovery process it is advisable that you take several days off work to relax. It is also recommended that you avoid driving for at least a week, as your eyesight may not yet be normal so judgement may be affected.

If your surgeon has prescribed you any eye drops, you should ensure that you taken them as per their instruction. You should also try and avoid touching your eyes or rubbing them as this can inhibit the healing process.

Many Epi-LASIK treatment packages involve a number of check up appointments over the months following your surgery. These appointments ensure that your eyes are improving as expected and it will also give you time to ask any further questions you may have considering the healing of your eyes and their future.

It is vital that if you notice anything that may be abnormal during the recovery period that you contact your surgeon imminently.