LASIK Alternatives

EPI-LASIK (Laser Epithelial keratomileusis) is an ADVANCED surface ablation technique that builds upon all of our past experience with PRK to provide a safer procedure with faster healing than conventional PRK surgery. Initially developed to help those patients who did not qualify for Lasik surgery, it is now being used much more frequently for patients who prefer to have laser vision correction done without ANY cutting or the creation of any flap.

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Dr. Witlin is always searching for ways to find procedures that will give his patients the clearest vision with the least risk. While we continue to perform all-laser Lasik surgery as our primary laser refractive technique, we have found that EPI- LASIK has become an important additional tool at our Center for certain patients.

An EPI- LASIK procedure takes about 6-8 minutes per eye to perform. The cornea is not cut with the microkeratome. Only the surface layers of cells (6-10 cells thick) are separated using a special calibrated instrument. The excimer laser is then used, just as in Lasik, to sculpt the underlying corneal tissue. This is done in a custom treatment pattern. A bandage contact lens is placed onto the eye for 4-5 days. The patient takes eye drops post-operatively for 4-6 weeks.

In many ways, such as how we use the excimer laser, EPI-LASIK is similar to Lasik–but there are some important differences. The recovery of your vision with EPI-LASIK is slower for the first week or two; but it quickly catches up to that of Lasik patients and is the same at 4-6 weeks. You may experience more irritation for the first day or two after you EPI-LASIK procedure. You will be given "comfort drops" and other aids to help minimize the post-operative discomfort. Your eyes are checked more frequently for the first few days after your surgery until the contact lenses have been removed. You cannot resume normal activities until your contact lenses have been removed by your doctor.

The most frequent reason we choose to offer EPI-LASIK surgery to a patient is that a patient may have a cornea that is otherwise perfectly healthy but too thin to allow for a safe Lasik procedure to be done. We have helped many such patients who had been told by other surgeons that they could not undergo laser refractive surgery.

Other indications for EPI-LASIK surgery:

  • Lifestyle considerations. If you have a job or hobby that might risk direct eye injury, such as martial arts or boxing, we feel it is safer if you not have a Lasik flap that could be injured.
  • Patient choice. With EPI-LASIK, there is no flap created. The small risk of having a flap related complication is eliminated, making this an “all-laser” procedure. Some patients prefer this approach. There is a trade-off in that the rapid recovery of vision with Lasik does not happen.
  • Certain mild cornea diseases may exist in your eye and for technical reasons are better handled with EPI-LASIK, such as types of dry eyes.