First Author: R.Neves BRAZIL
Co Author(s): T. Yamada F. Cacho Casanova
Purpose:
To assess epithelial closure time and removal of bandage contact lens after off-flap (discarding) myopic Epi-LASIK using the Epi-K epikeratome (Moria SA, Antony, France) versus alcohol LASEK.
Setting:
: Eye Care Hospital, Sao Paulo, Brazil
Methods:
40 myopic eyes of 20 consecutive patients suitable for Epi-LASIK discarding the flap were treated on November 2010-February 2011 and divided into 2 groups:
• 20 randomly selected eyes of 20 patients were treated using a small Epi-K diameter ring (+1) for intended approximately 8.0mm diameter epithelial sheet;
• the remaining 20 contralateral eyes were treated using alcohol LASEK.
Preoperative parameters measured were: K values, preop sphere and cylinder.
Intraoperative parameter measured was: epithelial flap dimensions using calipers (vertical and horizontal diameters).
Epithelial healing recovery was assessed measuring epithelial closure time (ECT), removal of bandage contact lens (RBCL), time to return to work, pain and discomfort experienced by patients during the first postoperative days.
Results:
In every case, the Epi-LASIK eyes were always associated with smaller vertical - horizontal epithelial flap resections than the eyes treated with alcohol LASEK contralaterally as expected: 7.8 ± 0.1 - 8.0 ± 0.2 versus 8.3 ± 0.2 – 8.4 ± 0.4 respectively.
Smaller flaps were always associated with a faster ECT and RBCL than larger ones (2.4 ± 0.6 and 2.9 ± 0.6 versus 3.7 ± 0.8 and 4.0 ± 0.8 days respectively), linked with less pain and discomfort.
Conclusions:
Creating small flaps in flap-off myopic Epi-LASIK provides an optimally fast epithelial healing and visual recovery with limited pain and discomfort for patients: 2.5 days on average, compared to alcohol LASEK.
Achille’s heel of surface ablation (a long and painful visual recovery) can now be limited, approaching recovery time of LASIK without compromising corneal biomechanics.
Financial Disclosure:
No
