Friday, March 27, 2009

Epi Lasik Eye Surgery

Epi-Lasik-Eye-SurgeryEpi Lasik eye surgery or Epi-Lasik, which full means Epipolis Laser In Situ Keratomileusis is a one kind of laser lasik eye surgery which is very similiar with PRK LASIK and Lasik. The name epi-LASIK is derived from the greek word 'epipolis' that means superficial and the 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 pillikaris 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 different from LASIK in operation produres.

Epi LASIK eye surgery procedures:

Epi-LASIK eye surgery procedures is almost like as LASEK without creating epithelial flap of the cornea, which is outer most layer of the eye.
Dercribe here Epi-LASIK procedures keynotes step by step.
Epithelial Removal of the cornea : By placing 8.5 to 10.5 mm in size trephineon on the centre of the cornea epithelium is removed.
Alcohol treatment:20% ethyl alcohol kept in position for 60 second.
Separation of the epithelial flap : After one minute of Alcohol Traetment, this procedure is performed by the dge of the trephine marks.
Creation corneal flap : By Epikeratome.
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 :

Lasik may patch eye with pad for 24 hours.
--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 to 23 years of ages.
--Corrective refractive conditions stable for last 2 years or one years.
--Myopic upto -20 diopter.
--Hyperopic upto +6 diopter.
--Astigmatism +- 6 diopter.

Note: Don't undergo Epi LASIK for presbyopic patients.

Complications of Epi LASIK :

After epi-LASIK a patient can face some problems. Key notes of these problems are...
--Poor adhesion and anchoring.
--Flaire striae.
--Infectious keratitis.
--Epithelial in growth.
--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 5D 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 : Categories by excellent.
Complications rate : Medium.
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).