Updated on October 31, 2024
Epi-LASIK: What to Consider Before Going Under the Laser
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Are you tired of relying on glasses or contact lenses to see clearly? Epi-LASIK surgery may be the solution you're looking for.
In this article, we'll discuss the details of Epi-LASIK surgery, exploring its benefits, risks, and suitability for different individuals. We'll also compare it to other vision correction options and provide insights into what you can expect before, during, and after the procedure.
What is Epi-LASIK Surgery?
Epithelial laser in-situ keratomileusis, commonly known as Epi-LASIK, is a type of refractive surgery. It combines the benefits of conventional LASIK (laser in-situ keratomileusis) and LASEK (laser epithelial keratomileusis).
It’s more similar to LASEK because the treatment involves the epithelium flap rather than a thicker corneal flap. The flap is the portion of the cornea that is cut and pulled back to allow for laser treatment.
Epi-LASIK is considered less invasive and safer than LASIK because it doesn’t require a deeper incision in the cornea. Just like LASIK, Epi-LASIK treats the following:
Who is A Good Candidate for Epi-LASIK Surgery?
Epi-LASIK surgery is good for people who don’t have thick corneas necessary for LASIK surgery. Other requirements for Epi-LASIK include:
- 18 years or older
- Good general health
- No eye diseases
- Large pupils
- Having trauma-related eyesight problems
- Having irregularly shaped corneas
It’s also good for people who want to avoid a thicker flap, as is the case with traditional LASIK.
Who Isn’t A Good Candidate for Epi-LASIK?
People below 18 years old are typically not allowed to undergo laser surgery. However, some people are also not good candidates for Epi-LASIK depending on their condition.
People who are pregnant or nursing can’t get Epi-LASIK because hormonal fluctuations can change the shape of their cornea.
People who are taking medications that can affect healing are also not allowed to have the procedure. You can’t get laser surgery either if you have a disease that can affect healing like diabetes.
Alternative Vision Correction Options
If you’re looking for alternatives to Epi-LASIK, here are some options to consider and talk about with your doctor:
- Implantable collamer lens (ICL) or Visian ICL
- Photorefractive keratectomy (PRK)
- Small incision lenticule extraction (SMILE)
- Intraocular lens implant (IOL)
- Refractive lens exchange surgery (RLE)
Side Effects & Risks of Epi-LASIK Surgery
Some potential side effects of Epi-LASIK surgery include:
- Mild pain
- Blurred vision
- Halos around light sources
- Sensitivity to light
- Watery eyes/excess tearing
- Clouding of the cornea (corneal haze)
Potential Complications of Epi-LASIK Surgery
Epi-LASIK has fewer risks compared to LASIK. This is because there is no deep penetration into the cornea.
It even has a lower risk of flap complications compared to traditional LASIK. The few complications of Epi-LASIK include under-correction or over-correction and Epithelium erosion (loss of corneal epithelium).
Success Rates and Outcomes for Epi-LASIK
Epi-LASIK and LASEK are similar in terms of visual outcomes. However, Epi-LASIK minimizes the drawbacks of LASEK, such as eliminating alcohol use.
The recovery time for Epi-LASIK is also shorter. Compared to LASEK treatment, which may take 5 to 7 days to recover, most patients report good eyesight three days after the Epi-LASIK procedure.
How Much Does Epi-LASIK Cost?
Epi-LASIK is considered elective surgery and is unlikely to be covered by insurance. Just like LASIK, PKR, and LASEK, initial examinations may be partially covered by your vision insurance.
A traditional Epi-LASIK procedure may cost you anything from $500 to $1,000 per eye. Custom Epi-LASIK surgery may cost up to $2,000 per eye. This cost may differ based on the facility, location, or surgeon.
What is the Epi-LASIK Procedure Like?
Like LASIK, Epi-LASIK surgery involves changing the shape of the cornea to enhance focus. The cornea is the clear part of your eye that focuses light on the retina, enabling clear vision.
During the LASIK procedure, the doctor will make a thin flap with an epithelial separator. This allows them to treat the cornea underneath with a laser.
After the cornea has been reshaped, the doctor will reposition the flap and apply a special bandage contact lens to hold it in place. This promotes comfort, prevents injury, and enhances the healing process.
The process may take 2 hours, including preparation, after-surgery care, and the required paperwork. However, the treatment procedure takes 30 minutes or less.
What to Expect Before the Surgery
Before the procedure, your eye doctor will evaluate your qualifications for the procedure. You’ll be expected to abstain from using contact lenses for some time to allow your cornea to adjust to its standard shape:
- If you use soft contact lenses, stop wearing them two weeks before the first evaluation.
- If you use toric soft lenses or rigid gas-permeable (RGP) lenses, stop wearing them at least three weeks before the evaluation.
- If you use hard lenses, stop wearing them four weeks before the initial evaluation.
Your eye doctor may need to evaluate you several times before the surgery to ensure you’re fit for the procedure. They will also discuss the benefits, risks, and expectations after the procedure.
What to Do After The Surgery
After Epi-LASIK surgery, you may not have perfect vision immediately. However, research shows that most patients achieve 20/40 or better vision by day three.
Others may take longer (3 to 6 months) to achieve the intended visual outcomes. Usually, most people can return to normal activities, such as driving within a week after surgery.
It’s essential to follow up with your surgeon at least 24 hours after surgery and consistently after that for monitoring. Also, strictly follow your medication regimen as prescribed by your doctor.
What’s the Difference Between Epi-LASIK and LASEK?
The main difference between LASEK and Epi-LASIK is how the flaps are created and handled. Epi-LASIK minimizes the drawbacks of the LASEK procedure.
During the LASEK procedure, an alcohol solution softens the corneal epithelium and separates it from the corneal stroma (central layer of the cornea). The cornea is then reshaped with an excimer laser.
In epi-LASIK, the surgeon creates the flap using an epithelial separator, a device with an oscillating blunt plastic blade. The tool separates the flap and folds it back to expose the stroma, allowing for laser treatment.
Your surgeon won’t use alcohol to treat the epithelial flap during the Epi-LASIK procedure. Most surgeons prefer Epi-LASIK because the alcohol solution is harmful to epithelial cells and can also prolong the healing time.
Pros and Cons of Epi-LASIK
| Pros | Cons |
| Can treat thin corneas | Longer healing time compared to LASIK |
| Similar vision quality as LASIK | Slight discomfort after surgery |
| Low risk of flap complications | |
| Low risk of dry eyes | |
| Quick recovery time |
Pros and Cons of LASEK
| Pros | Cons |
| Ideal for thin Corneas | Possibility of under or overcorrection |
| High chances of success | Thinning of the cornea over time |
| Can achieve 20/40 vision or better | Prolonged recovery period (6 to 9 months) |
| Long-lasting results |
Epi-LASIK surgery presents a promising option with its less invasive approach and potential for quick recovery. However, it's crucial to consult with an experienced eye care professional.
While technology continues to advance, individual results may vary. By making informed decisions and following post-operative care instructions, you can maximize your chances of achieving the desired visual outcome
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Updated on October 31, 2024
Updated on October 31, 2024
About Our Contributors
Vincent Ayaga is a medical researcher and seasoned content writer with a bachelor's degree in Medical Microbiology. Specializing in disease investigation, prevention, and control, Vincent is dedicated to raising awareness about visual problems and the latest evidence-based solutions in ophthalmology. He strongly believes in the transformative power of ophthalmic education through research to inform and educate those seeking knowledge in eye health.
Dr. Melody Huang is an optometrist and freelance health writer with a passion for educating people about eye health. With her unique blend of clinical expertise and writing skills, Dr. Huang seeks to guide individuals towards healthier and happier lives. Her interests extend to Eastern medicine and integrative healthcare approaches. Outside of work, she enjoys exploring new skincare products, experimenting with food recipes, and spending time with her adopted cats.