The strategy of Epi-LASIK is to push aside the epithelial cells


to expose the underlying smooth basement membrane of the stroma layer of the cornea.


This stromal layer is treated with the laser, and then the epithelial sheet is repositioned. The epithelial cells reestablish their adhesion points, and the cornea has a new contour.

Advantages of Epi-LASIK

It eliminates creation of a stromal flap with a sharp bladed keratome or intrastromal laser as done in LASIK. Therefore, there is no risk of creating an irregular surface from complications in cutting the flap.

Indications for Epi-LASIK

There are clear indications for Epi-LASIK, as opposed to LASIK. From a technical point of view, it is easier, and perhaps safer, to perform on people who have steep or flat corneas, and those who have thin corneas. Patients who have epithelial basement membrane disease, and those who are subject to recurrent breakdown of their surface epithelium may also do better with Epi-LASIK. Those who have deep-set eyes, and small palpebral fissures (distance through the lids) may be predisposed to difficulty with LASIK, and would be more easily handled with Epi-LASIK.

Contraindications for Epi-LASIK

The contraindications for Epi-LASIK are similar to LASIK, namely keratoconus, significant dry eye, autoimmune disease, Herpes simplex, keratitis, uncontrolled diabetes or glaucoma, pregnancy or nursing, Accutane/Cordarone use, a history of keloid formation or scarring, and unrealistic expectations regarding the outcome and their visual performance. 







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