gms | German Medical Science

The increase in wavefront-guided treatments and the possibility of flap related complications in LASIK has renewed interest in excimer laser surface ablation for the correction of refractive errors. Among various techniques LASEK has gained significant interest. Although the postoperative results up to -8,0 D are very good, the procedure is technically more difficult than LASIK. Another disadvantage is the intraoperative use of alcohol. Since 6 months LASEK can be done without alcohol by the use of a microceratome. This technique is called Epi-LASIK.

We report of our first experience with Epi-LASIK in 100 eyes. To create the epithelial flap we have used the Gebauer Epitom. The preoperative refraction was between -1,25 and -8,0 D (spherical equivalent). The follow-up was in all eyes 3 months with a maximum of 6 months.

In all eyes the epithelial flap could be created and the laser ablation was performed without any complications. A postoperative bandage contact lens was applied for 1 to 3 days. After 3 months 95% of the treated eyes were within 0,5 D and 100% within 1,0 D of emetropia. After 6 months we have observed a regression between -1,0 and 1,5 D in 3 eyes. These eyes were retreated with Epi-LASIK. None of the eyes showed a loss of best corrected visual acuity, 37% of the eyes gained 1 or more lines. In none of the eyes we have noted a significant corneal haze, 5 eyes showed a very trace subepithelial haze (grade 0,5) after 3 months. The uncorrected visual acuity was postoperatively at day 1 between 0,4 and 1,25 on day 2 between 0,6 and 1,0 and on day 3 between 0,5 and 1,0.

The Epi-LASIK is a save procedure for the treatment of myopia. Our first results show that the bandage contact lens can be removed on day 1 or day 2. This, together with the absent of alcohol for creating the epithelial flap, is a major advantage compared to conventional LASEK.