In LASIK surgery, the physician uses a sharp blade or a laser to cut the corneal flap - but there is a risk involved of cutting too thick a flap. LASEK surgeons, on the other hand, use an ultra-fine blade to cut the eye's surface flap.
But prior to this, they apply alcohol to loosen the epithelial layer of the eye, which is the part that's folded back as a flap. The alcohol can kill epithelial cells, so Epi-LASIK doesn't use alcohol, and instead employs a blunt, rapidly moving plastic blade that separates the epithelium from the eye.
According to Dr. Richard Lindstrom, chief medical editor of Ocular Surgery News, when a surface-flap procedure is needed, he now uses epi-LASIK routinely. "I still do a lot of LASIK, and our group still does a lot of LASIK," he said. "We're impressed with the outcomes that we get from femtosecond LASIK, but when it comes to doing a surface [flap], I'm impressed that epi-LASIK is a significant advance over alcohol-assisted manual removal."
Lindstrom said that, with epi-LASIK, there is quicker visual recovery and faster epithelial wound healing. Pain levels also seem to improve. "We basically found minimal pain with either standard PRK [another laser eye surgery] or epi-LASIK because of our medical regimen," Lindstrom said.
"It has been a significant benefit to our patients to have the faster visual recovery and more rapid epithelial healing. This has made us more comfortable recommending bilateral, same-day surface [flap surgery], which is a convenience for patient, surgeon and laser center."