Abstract
Purpose::
EpiLASIK is a new technique in surface ablation. First results are very encouraging. With increasing numbers of patients undergoing EpiLASIK some patients will need surgery for enhancement. The aim of this study was to determine whether resurgery with an EpiLASIK microceratome after primary surface ablation (PRK, LASEK and EpiLASIK) is possible and whether this procedure is safe and effective.Setting: Klinikum Rechts der Isar ; technical University Munich, Germany,
Methods::
In the first part of this study 3 patients, who had previous EpiLASIK, underwent EpiLASIK re-surgery and the epithelial flap was removed and embedded for histological evaluation. In the second part EpiLASIK was performed in 30 eyes that had primary surface ablation for myopia (1 PRK, 16 LASEK and 13 EpiLASIK). The initial mean spherical equivalent (SE) was -6.3 diopters (D) (range -3.5 to -8.0 D), and the residual mean SE was -1.6 D (range -1.0 to -3.0 D). All EpiLASIK surgeries have been carried out with the Gebauer EpiVision microceratome. The laser ablation was made with a Carl Zeiss Meditec Mel 80. The follow-up after the second EpiLASIK treatment was at least 6 months.
Results::
All histologies showed intact basal epithelial cells and no stromal tissue was visible on all samples. The epithelial flap for repeated EpiLASIK was successfully created in all 30 eyes. There were no defects in the epithelial flaps or any stromal cuts. The postoperative course in the eyes was uneventful. Six months after EpiLASIK enhancement, the SE refraction was within -0.5 D in 27 of 30 eyes. No eye lost more than 1 line of best corrected visual acuity, and the uncorrected visual acuity was 20/20 or better in 26 eyes. Significant haze was not observed after repeated EpiLASIK (mean 0.35 after EpiLASIK enhancement).
Conclusions::
EpiLASIK enhancement appears to be safe and effective for the correction of residual myopia after primary surface ablation. Repeated epithelial flap preparation is possible without technical modifications.
Clinical Trial::
technical university munich
Keywords: refractive surgery: other technologies • cornea: epithelium • refractive surgery: complications