Epi – LASIK

The Epi-LASIK technique is very modern, it has been developed in 2004.

The method is based on a precise mechanical separation of cornea surface layer – the epithelium, from the following layer, the so called Bowman diaphragm. The operation is carried out using Epi-K separator, in a local corneal anesthesia. After epithelium separation, the laser correction follows. The epithelium id then returned to its original position and the cornea is covered by a healing contact lens for 3 – 5 days. A patient applies two kinds of eye drops containing antibiotic and artificial tears.

The vision is getting clearer for approximately one month which is faster than with PRK method but slower in comparison with LASIK technique. Epi-LASIK represents the best of PRK and LASIK methods.

The method is suitable to most of patients; especially it is preferred in drier eyes and in case of thinner cornea. The technique is unsuitable for unavailable and deeply located eyes and after any previous refractive operations. The method is precise, completely regardful of so called corneal basal lamina and leads to stable results. It has minimum risks. Postoperative sick leave is 4 – 7 days after the operation.

Our separator

For cornea separation, we are using a unique instrument Moria Epi-K, model 2006. It is still the only separator in world market that has received the certificate of American FDA. Principally, this is an automatic linear system with two independent motors, one for the oscillation and the other for an automatic drive. Single-use plastics head is utilized that is capable to precisely separate cornea surface layer. The warranty of the laser operation quality realization as well as unchallenged postoperative healing lies just in the epithelium precise separation.

Comparison of individual methods

1. According to hurtfulness
- PRK – painless during the operation, painful healing 2.5 days in short-sightedness and 3 days in long-sightedness
- LASIK – during the operation, for approximately 3 seconds feeling of pressure on the eye, approximately 3 – 4 after the operation a feeling of a foreign corpuscle in the eye
- Epi-LASIK – feeling of pressure during the operation for approximately 30 seconds, after the operation, this is painful for 3 – 4 days, but significantly less than after PRK

2. According to visual functions healing
- PRK – after one week, the vision acuity is approximately 70 %, the situation is getting better in weeks, stabilizing approximately after 5 – 6 months
- LASIK – the fastest healing, many patients can see 100% already on second day after the operation, the state stabilizing in 6 weeks, the smallest number of postoperative controls
- Epi-LASIK – smaller healing in comparison with LASIK, 5th day after the operation, approximately 90% of the vision are observed, after one month the situation is comparable with LASIK, stabilizing in 6 weeks to 5 months

3. Unsuitability of individual methods All of the methods are unsuitable to cornea irregularities, conical cornea or ectasia.

– PRK – unsuitable with some complex diseases, problematic collagen healing
- LASIK – unsuitable with thinner cornea, hardly available and deeply situated eye, elliptical and vascularized cornea, dry eyes, not much suitable in contact sports, in army
- Epi-LASIK – not suitable in unavailable eyes, after any previous refractive operations

4. Individual methods – comparison PRK versus LASIK

• In comparison with LASIC, PRK has the advantage that there are no problems associated with lamella stability (especially important in army and contact sports). The dioptric postoperative development can be better influenced by drops.
• As PRK disadvantages, slower rehabilitation and a bigger portion of discomfort are considered. PRK does not have so good reputation amongst oculists (but that is not deserved). In PRK, a risk of worse collagen healing and haze or scar originating should be taken into account.
• In comparison with PRK, LASIK is advantageous from the viewpoint of a minimum hurtfulness and fast vision rehabilitation.
• As LASIK disadvantage in comparison with PRK, a frequent postoperative dryness, night halo, a bigger risk of cornea ectasia (thinning or arching) and risk of striae must be considered.

Epi LASIK versus PRK

• Less discomfort in comparison with PRK, smaller haze risk in comparison with PRK
• Patients like it; most of them consider PRK as an old procedure
• There is faster vision rehabilitation
• Smaller number of postoperative controls

Epi-LASIK versus LASIK

• Is a safer alternative to LASIK, more suitable for drier eyes, after operation, the eye is less dry, there is no risk of epithelium growth into lamella as in LASIK case
• Epi-LASIK disadvantage- a quality epithelium does not have to be kept, then the conversion to PRK method becomes necessary – the healing is slow and there may originate epithelium defects (after operation during removal or after removal of healing contact lense); the defects require a new application of the healing contact lense
• With Epi-LASIK, the vision quality is improving significantly slower, there is a pain after operation, sight functions are stabilized after Epi-LASIK in a longer timescale
• In comparison with LASIK, the Epi-LASIK induces smaller number of sight aberrations, better keeps cornea integrity, excludes cornea lamella problems and decreases lamella potential risks.

  All laser operations are made by the chief ophthalmologist, doc. Smečka.

As our philosophy, reliability, credibility and awareness of personal responsibility are to be taken into account.