Specialization of EpiLASIK/SUPERLASIK for Unique Eye Types

Most people do not have flawless eyes.  Maybe you suffer from nearsightedness, farsightedness or astigmatism, and have a unique eye that makes you an unsuccessful candidate for traditional LASIK surgery. If you do, there are other options, such as superLASIK and epiLASIK.

How LASIK works

Traditional LASIK surgery utilizes an excimer laser, a cool ultraviolet laser that corrects a misshaped cornea. Your cornea is the front surface of your eye that light passes through while traveling to your retina. The light that passes behind your cornea and forms an image on your retina, which is transmitted by your optic nerve to your brain.

If your cornea is misshaped, the light rays bend at the incorrect angle, focusing behind or in front of your retina instead of on top of it. This creates vision problems such as nearsightedness and farsightedness. Or, if your cornea contains small abnormalities in its circular shape, the light rays are received out of focus, which leads to blurred vision.

The excimer laser is used to vaporize miniscule pieces of your corneal tissue, which fixes the shape and surface of your cornea. This allows the rays of light to focus sharply on your retina and you may see clearly.

Role of your corneal flap

Before Dr. Khanna applies the laser beam on to your cornea to reshape it, he must cut a small flap on surface of your cornea and bend back to expose underlying tissue. The laser is then directed on that tissue and the flap is replaced. It heals itself in several days.

Corneal issues

If your corneas are too thin or too flat, traditional LASIK surgery is not advised. If your cornea is too thick, the little flap that must be cut may not be feasible. A flap that is completely detached will not heal correctly, and a flap that is does not fold back far enough will block the laser. Both will result in an unsuccessful procedure.

If your cornea is too flat, removing some of the tissue will just make your cornea flatter and your vision will not be improved.

SuperLASIK

The superLASIK procedure is ideal for anyone who has thin or abnormal corneas and cannot undergo standard LASIK surgery. A safer and more stable procedure, superLASIK blends PRK and LASIK with the use of an epikeratome instead of the microkeratome. This FDA-approved device raises a consistent 50 micron flap, which is even thinner than the flap created with Intralase.

Also, rather than using an alcohol-based solution to loosen the edges of the flap before its edges are lifted back--as in LASEK--a very fine plastic tool called an epithelial separator is used. This instrument is used instead of the alcohol solution because sometimes the alcohol may cause your epithelial cells to die. Because these cells comprise the surface cells on your cornea, your eye must actually grow more of these cells around the edges of the cut flap in order to heal properly.

Because there is no distortion to the design of your cornea, superLASIK provides a safer method of vision correction surgery for most people ages 18 and over. If you suffer from the following conditions, you may not be a candidate for this procedure:

• Keratoconus
• Pellucid marginal degeneration
• Other corneal diseases
• Some immunological disease
• Cataracts (in some cases)

The epithelial separator is in some ways a safer, more effective alternative to traditional LASIK. While vision improvement takes longer with epiLASIK, if you suffer from a thin cornea, this procedure is an ideal way to avoid complications.