Epi-LASIK

Epi-LASIK is a quasi form of LASIK although it is often considered to be cross between LASIK and LASEK. It was designed to deal with any potential complications with either of these two procedures.

It involves the use of a plastic blade called an ‘epikeratome’ which separates out a thin tissue in the outer layer of the cornea. This sheet is then moved to one side to allow access for the excimer laser.

What is ‘Epi-LASIK?’
How does it differ from LASIK and LASEK?
Who should consider Epi-LASIK?
If I am not suitable for Epi-LASIK then is there an alternative?
What are the risks of Epi-LASIK?
What are the benefits of Epi-LASIK?
What should I ask the surgeon at the consultation?
How much does Epi-LASIK cost?
What is the Epi-LASIK procedure?
How long do the effects of Epi-LASIK last for?
What does recovery from Epi-LASIK involve?

What is ‘Epi-LASIK?’

This stands for EPIthelial LASIK and is the medical name given to a form of laser eye surgery. It involves reshaping the cornea, thereby leading to perfect or near perfect vision.

How does it differ from LASIK and LASEK?

It may sound very similar to LASEK and is a very similar procedure to this and LASIK. The difference is in the initial stage of the procedure – the part where the outer layer of the cornea, called the epithelium has to be removed so that the laser can do its work.

With Epi-LASEK, the surgeon uses a plastic oscillating blade – called an epikeratome to access the epithelium.

With LASIK the surgeon makes a small incision in the epithelium using a microkeratome (blade).

LASEK involves the surgeon using a small tool or trephine to make an incision in the epithelium.

The rest of the procedure is the same across all of these.

Who should consider Epi-LASIK?

Epi-LASEK is a good choice for patients who have thin corneas or are not suitable for LASIK. It is also recommended for people with a low refractive error, for example, mild short-sightedness (myopia).

If you play contact sports or have a job in which there is a risk of injury to your eyes then the surgeon will advise you to have
Epi-LASEK.

Why?

This is because there is practically no risk of the corneal flap becoming dislodged as a result of a blow or knock to the eye. So, it is down to the technique used by the surgeon to access the cornea to administer the laser treatment.

The surgeon will take the following factors into account:

Age
Current state of health
Any eye diseases – now or in the past
Lifestyle

Your reasons for surgery will also be considered. As with any form of surgery it is important to have realistic expectations about what it can achieve.

Our General FAQS section contains more information about patient suitability.

If I am not suitable for Epi-LASIK then is there an alternative?

If you fall outside of the recommended criteria for laser eye surgery or have a medical/eye condition which rules you out then there is an alternative.

The alternative is an implantable contact lens (ICL), also known as an ‘Intra-Ocular lens’ or IOL. This is the insertion of a contact lens inside the eye to enable it to focus properly. If you already wear contact lenses then you may think that this doesn’t sound any different to the ones you already wear. However, the main difference here is that the ICL/IOL is implanted inside the eye.

With normal contact lens wear, the lens sits on top of the eye.

What are the risks of Epi-LASIK?

Unfortunately nothing in life is 100% risk free and this equally applies to laser eye surgery. Laser vision correction is a tried and tested form of surgery but complications do occur in a small minority of cases.

Complications with Epi-LASIK are:

Dry eye/s
Complications with the corneal flap
Over correction
Under correction
Glare
Halos
Starbursts

If you develop any of these then you may require follow up surgery.

The surgeon will advise you about the risks of Epi-LASIK, along with the benefits. You can then weigh these up before making a decision.

What are the benefits of Epi-LASIK?

The benefits are firstly, improved vision which is perfect or almost perfect (20/20). This can mean no more glasses or contact lenses.

Other benefits include:

Suitable for patients with thin corneas
Less risk of complications with the corneal flap
Reduced likelihood of dry eye syndrome

What should I ask the surgeon at the consultation?

It is a good idea to write down a list of questions beforehand so that you don’t forget anything important. Then, tick each of these off as you ask them.

Our Laser Eye Surgery: General FAQS section has a list of questions which you can take with you to the consultation.

How much does Epi-LASIK cost?

Laser eye surgery prices do vary from one clinic to another. This can be for a variety of reasons such as the surgeon’s fees, the type of technology used (state of the art lasers) and aftercare.

Prices for Epi-LASIK range from £800 to £1,300 per eye*

* Please note this is a rough guide only.

What is the Epi-LASIK procedure?

The procedure starts with the surgeon placing a special clip onto your eye to keep it open. He or she will then place anaesthetic drops into your eye to numb it.

The surgeon then uses a special instrument called an ‘epikeratome’ (a plastic oscillating blade) to make a thin sheet in the outer layer of the cornea or epithelium.

This sheet or flap is then lifted and folded (gently) to one side to enable the laser to access the cornea.

The surgeon will then use an excimer laser to reshape the cornea. It does this by removing tissue from the middle layer or stroma of the cornea.

The corneal flap is then folded back into position and a special contact lens or bandage lens is placed over the eye. This helps to keep the flap in place whilst the epithelium re-grows itself.

Antibiotic eye drops will be placed into your eye to prevent infection. You may be given ‘artificial tears’ to use which help to lubricate the eye. Dry eyes are a side effect of laser eye surgery but eye drops will help to deal with this.

How long do the effects of Epi-LASIK last for?

The effects are usually permanent. You will find that your vision improves after 3 to 4 days and continually over the next few months.

The one thing to keep in mind is that our eyes do change when we reach our forties as a result of the ageing process. So, you may need further surgery when you reach middle age.

What does recovery from Epi-LASIK involve?

The recovery will involve you visiting the clinic the next day so that the surgeon can check on your progress. You will be given painkillers as patients who’ve had Epi-LASIK find that they do experience some pain following this procedure.

This is more of a problem than with PRK or LASEK.

You should be able to remove the protective bandage lens after 4 days. The surgeon will advise you when you can do this.

It is a good idea to take a few days off work during this time. Ideally, arrange for a week to allow yourself time to recover.

It will be a week before you are able to drive.

Make sure you use any prescribed eye drops at this time and avoid touching or rubbing your eyes. It can be very tempting to do so especially if they feel ‘itchy’ but please resist that temptation.

You will notice a dramatic improvement in your vision and this will continue over a period of a few months.

There will be a series of check ups as part of your treatment package. These are designed to monitor your progress over the next few months.

If you do notice anything untoward then contact your surgeon immediately.