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S. D. Mitchell, R. M. Davis; Preliminary Clinical Results of XP Epi-Lasik Including Ultrastructural Characteristics of the Corneal Epithelial Specimens. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2920.
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To evaluate the post-operative outcomes of the initial patients who underwent Epi-Lasik in the US with the recently introduced XP microkeratome Epi-Lasik head by Bausch & Lomb.
IRB approval was obtained to prospectively evaluate human patients who underwent XP Epi-Lasik for the correction of myopia and myopia with astigmatism. Twenty one eyes were evaluated postoperatively for visual acuity, manifest refraction, and tissue microscopy. Fourteen eyes underwent custom Zyoptix with the Bausch & Lomb Technolas 100 hz laser (Advanced PT) and 7 eyes, planoscan. Eleven eyes were dry by self-report and/or Schirmer 1 testing < 20 mm. Eight of these eyes had punctal occlusion and/or topical cyclosporine.
The preoperative sphero-equivalent was -3.71 ± 2.53 (-0.12 to -8.75) Diopters. The superior-hinged epithelial flaps had uniform shape, stepped edges, and minimal stretching. Mean pain scores were less than 3 on a 0 - 10 scale. Mean uncorrected visual acuity was 20/80 on the first postoperative day. Uncorrected visual acuity was 20/20 or better in 30% after one week and in 85% after one month. The mean sphero-equivalent was 0.02 ± 0.45 (-1.0 to 1.0) Diopters one week and -0.14 ± 0.29 (0.37 to -0.62) Diopters one month postoperatively. Light microscopy demonstrated an atraumatic planar epithelial specimen. Electron microscopy demonstrated an intact basal epithelium with fragmentation at the epithelial basement membrane zone and minimal changes to the normal cells’ morphology. The ultrastructure of LASEK epithelial specimens is presented for comparison.
Preliminary outcomes of XP Epi-Lasik demonstrated excellent safety, predictability, and efficacy one month after surgery.
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