Epi-LASIK Philadelphia: Advanced Surface Ablation in HD

[anthonydim15]

why do they put a contact on your eye? wheres the clear gewy flap that was removed, how's it gonna get back? lmk thanks

[jslewisMDPC]

@anthonydim15 Contact lens protects the corneal nerves from stimulation and thereby reduces post-op pain. The epithelium grows back quickly and the contact lens is removed. (This lens is called a therapeutic lens and usually has no refractive power.)

[nanosurge83]

I see. Thank you for the explanation. However, I think the debate on the standard procedure for epi-lasik is far from over. I believe the data published so far is insufficient to form any kind of standardized procedure. Therefore, I think many surgeons do replace the flap.

So in your opinion, the epi-k keratome removes the epithelium more completely and produces a better surface for ablation? Is this, then the only benefit of epi-lasik over PRK? Thank you for the lively discussion!

[jslewisMDPC]

@nanosurge83 You are correct.

[jslewisMDPC]

Originally Epi-LASIK involved the replacement of the epithelial flap AND it was not that easy! When a patient had one flap successfully reattached it healed SLOWER than the eye in which the epithelial flap was lost. At that point epi-LASIK was redefined. Unlike PRK, Epi-LASIK "cleaves" the epithelium from Bowman's membrane without toxic chemicals (alcohol) or scraping (brush). High magnification in this video shows the quality of the resulting corneal surface. Epi-LASIK beats PRK hands down.

[nanosurge83]

After some research, I have discovered that removing the epithelial flap is becoming an increasingly common practice as benefits of epi-lasik are generally attributed to the clean and abrupt edge and the superior surface of stroma after epithelium removal. However, some surgeons still replace the flap, although it is not clear whether this really affects outcomes. I posted my original comment before doing the appropriate research.

[jslewisMDPC]

Originally Epi-LASIK involved the replacement of the epithelial flap AND it was not that easy! When a patient had one flap successfully reattached it healed SLOWER than the eye in which the epithelial flap was lost. At that point epi-LASIK was redefined. Unlike PRK, Epi-LASIK "cleaves" the epithelium from Bowman's membrane without toxic chemicals (alcohol) or scraping (brush). High magnification in this video shows the quality of the resulting corneal surface. Epi-LASIK beats PRK hands down.

[nanosurge83]

Epi-lasik? Are you kidding? In epi-lasik, the epithelial flap is placed back onto the cornea. This video claims it is epi-lasik, but the surgeon completely REMOVES the flap and never places it back on the cornea. This is more like PRK, nowhere near epi-lasik. Would you please comment on this?

[incrediblenick]

nanosurge83, i had been confused as you. i have learned it. So, i think the surgery that being showed on the vid is called "EPİ-LASEK". VİSİT : park avenue laser hospital website. sorry for my poor english :)