Epi-LASIK and LASEK surgery:
A gentle approach to Vision Correction
Laser vision correction (LVC) is a popular and common type of refractive surgery opted by those who like to be free from glasses and contact lenses. There are broadly 3 types of LVC – advanced surface ablation (ASA), LASIK and ReLEx SMILE with LASIK being the most popular and most performed worldwide due to its fast vision recovery, track record of stability, accuracy and safety.
We can include the following procedures under ASA:
- Epi-LASIK
- LASEK
- PRK
- TransPRK
The above procedures have similarities in that the vision recovery is slower and the discomfort level is higher post-surgery as they are all surface-based treatments. They only differ in minor surgical techniques between them.
What are Epi-LASIK and LASEK?
In this article, we are going to delve deeper into Epi-LASIK and LASER, types of ASA. Unlike LASIK, Epi-LASIK and LASEK do not require a corneal flap to be created. Hence, they are often recommended in lieu of LASIK when the corneas are thinner. Most eyes are suitable for LASIK whereby the recovery is fast and the discomfort level is low post-surgery. For those whose corneas are on the thinner side, Epi-LASIK or LASEK is a good alternative as it removes lesser corneal tissue during surgery and this results in a thicker cornea post-surgery, which allows for long term stability and safety.
Advantages of Epi-LASIK and LASEK surgery
Pre-operative preparation
Prior to Epi-LASIK and LASEK, one has to go through a comprehensive pre-laser evaluation. Prior to that, contact lens users have to lay off soft lenses for 3 days or hard lenses for 14 days as contact lens usage may alter the corneal shape. During the evaluation, a myriad of eye tests are conducted to ascertain suitability for the surgery and they include:
- Visual acuity test
- Eye pressure test (to exclude glaucoma)
- Eye prescription test to measure the level of myopia, hyperopia, astigmatism and presbyopia
- Corneal thickness test
- Corneal shape test
- iDesign analysis* (3D mapping of corneal surface for a completely personalised laser treatment)
- Pupil dilation (to relax the eye muscles and allow the laser surgeon to examine the retina and optic nerve)
- Cyclo refraction (a second eye prescription test is measure after the eye muscles are relaxed after pupil dilation)
- Consultation with laser surgeon for thorough eye check, discuss surgical options and risks vs benefits
*Only applicable to Wavefront-guided treatment with the VISX STAR S4 IR Excimer Laser System.
The Epi-LASIK and LASEK procedure
In Epi-LASIK and LASEK, the surgeon will either apply alcohol onto the eye or use an epithelial separator to remove the most front part of the eye, known as the epithelium. The excimer laser is then applied to the eye to reshape the cornea. When the lasering completes, a bandage contact lens (BCL) is put on and will stay in the eye for about 5 to 7 days to help with healing.
Recovery & post-operative care
The vision recovery for Epi-LASIK and LASEK is slower and the discomfort level is higher compared to LASIK. With the BCL in the eye, the vision can remain hazy. Some will also experience tearing and difficulty opening their eye the first few days. When the BCL is removed, the vision and comfort level will improve as time goes by. Most can return to work then.
Eyedrops and medication are prescribed to minimise infection and inflammation. Use lubricating eyedrops and ointment generously as they will help with healing.
Most activities can be resumed except no rubbing of the eye for 2 weeks and avoid water and contact sports for 1 month.
Consult an eye care specialist
Please contact Lang Eye Centre at +65 6884 1000 or [email protected] to see our eye care specialist should you like to consider Epi-LASIK or LASEK to be free from glasses and contact lenses.
