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.
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.
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.
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.
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.
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.
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.
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.