Epi-LASIK: Who is a Good Candidate?

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Determining if you are a good epi-LASIK candidate is something that only an experienced LASIK surgeon can do, after a thorough eye exam and many tests. If you have been told in the past that you are not a good LASIK candidate, you might still be a good epi-LASIK candidate.

How Thick Are Your Corneas?

One of the principal determining factors is the thickness of your corneas. The cornea is the clear front covering over the eye and is the place where the laser vision correction is done.

The eyes are filled with fluid which puts outward pressure on the eyeball wall. The cornea is part of the wall, along with the sclera (white part) and retina (camera film at the back). The eyeball wall must be thick enough to withstand that outward pressure without being damaged. Keep in mind that laser vision correction is done by removing little pieces of the cornea to reshape it. After tissue is removed there must still be enough thickness to maintain the eyeball’s shape.

Tissue removal from the right places corrects the way your corneas bend light entering the eyes.

• If you are nearsighted, your corneas are bending light too much; they are too steep in their curvature and are causing blurry far vision. Tissue is removed from the center area to slightly flatten the cornea.
• If you are farsighted, your corneas are not bending light enough and are too flat. That causes blurry near vision. Therefore tissue is removed from the periphery to create more steepness.
• If you are astigmatic, your corneas have an oval shape instead of spherical and are bending light two ways at once, which causes blurry vision at all distances. Correction removes tissue from whatever places will create a more spherical shape in your particular eyes.

The cornea has three main layers. The top one (epithelium) is not where vision correction is done. Reshaping done on this layer might not be very long-lasting because it is continually renewing itself by discarding old cells and replacing them with new ones.

The tissue removal for reshaping is done on the middle layer, the stroma. That means that somehow the laser must gain access to it and that is why a flap is first cut in the cornea, and folded back to enable treatment in the stroma. The LASIK flap consists of epithelial cells plus upper stromal cells. In a thin cornea this is too much tissue for safety.

Methods for a Thinner Corneal Flap

Corneal thickness is one of the tests done to establish your LASIK candidacy and also your candidacy for all LASIK variants, such as Intralase (also called iLASIK), LASEK, and epi-LASIK. The LASIK variant procedures were developed to offer thinner flaps for those whose corneas were too thin for LASIK.

PRK, which existed before LASIK, is another option, as it does not create a flap at all. Instead, it removes corneal epithelium completely. Since the epithelium is continually renewing itself the cells removed for PRK are soon replaced.

The Epi-LASIK Flap

Epi-LASIK creates a very thin flap by making it only the thickness of the epithelium and including none of the stroma. This leaves enough corneal tissue to allow for removal of some for vision correction and still keep enough to hold the eyeball’s shape.

Epi-LASIK Candidacy: Other Factors

A good epi_LASIK candidate not only has thinner-than-average corneas but also some other characteristics:
• A stable vision prescription for at least two years
• A realistic expectation as to procedure outcome
• Age of at least 18 years
• Desire for less dependence on glasses or contacts
• Willingness to follow the eye surgeon’s instructions during recovery

Epi-LASIK Advantages

Most of the potential risks of the standard LASIK flap are avoided in epi-LASIK. There is no actual cutting done to make the flap. The implement (an epikeratome) is more of a separator, since the flap is more shallow. Recovery is a little faster: three to four days, compared to seven for PRK and five to seven for LASEK.

Results can be as dramatic as any achieved by LASIK. If you have been rejected as a LASIK candidate, do not assume that you must continue to wear glasses or contact lenses. The best step would be to schedule a consultation with http://www.westernlasereye.com/about-dr-ellen-anderson-penno.html an experienced LASIK surgeon. Bring your questions and ask whether any of the LASIK alternative procedures would be good options for you.

In the Calgary, Alberta area, Western Laser Eye is an excellent facility for LASIK, PRK and Epi-LASIK and if you send an http://www.westernlasereye.com/contact.html email to eye surgeon Dr. Anderson Penno you will be on your way to clearer vision.



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