Outcomes of Epi-LASIK for the Correction of High Myopia and Myopic Astigmatism after More than 1 Year

Abstract

Purpose: To present the clinical results of epi-LASIK in a high myopia and myopic astigmatic population followed for more than 1 year. Methods: This retrospective study comprised 67 eyes of 52 patients who underwent epi-LASIK for the correction of high myopia and myopic astigmatism. Epi-LASIK was performed with an automatically rotational epikeratome (KM-5000D, Wuxi Kangming Medical Device Corp., Wuxi, China) and the MEL80 (Carl Zeiss Meditec, Jena, Germany) excimer laser. The postoperative symptom, epithelial flap, vision, refraction and haze formation were investigated. The astigmatic change was calculated by the Alpins vector analysis method. Results: The follow-up period was 13.27 months. Mean preoperative spherical equivalent (SE) refraction and cylinder were –13.39 diopters (D) and –2.02 D. An integrated epithelial sheet with a diameter of about 8–9 mm was made in 65 (97.01%) eyes leaving a superior hinge of approximately 2–4 mm. The mean epithelial healing time was 5.55 days. More than 1 year after the treatment, no eye lost more than 1 line of best spectacle-corrected visual acuity. The mean SE and cylinder were –2.25 and –0.79 D. The mean astigmatism correction index was 1.06. The index of success of 0.51 reflected a 49% success in achieving cylinder correction. The change induced by the laser ablation at the intended axis of cylinder reduction was 93%. At the same interval, 7.46% of eyes had trace haze and others were clear. Haze did not affect the visual acuity in any eye. Conclusions: Epi-LASIK appeared to be effective and safe in the treatment of high myopia and myopic astigmatism with the advantages of having lower postoperative pain and satisfactory refractive and visual outcome postoperatively.

Vector analysis of astigmatic changes after cataract surgery with toric intraocular lens implantation

“…It can be determined whether the treatment was on axis or off axis and whether too much or too little effect was achieved. The Alpins method has been used by several authors to analyze the astigmatic changes induced with different surgical and nonsurgical options, including relaxing incisions, 34,35 excimer laser refractive surgery, [36][37][38][39][40] cataract surgery, 41 vitrectomy, 42 orthokeratology. 43 The information obtained with this analysis can help optimize the selection of toric IOL power and define predictive factors for a good visual outcome after cataract surgery with implantation of these IOLs.…”

Modification and refinement of astigmatism in keratoconic eyes with intrastromal corneal ring segments

“…The results indicate whether the treatment was on axis or off axis and whether the achieved effect is too great or too little. The Alpins method has been used to analyze astigmatic changes induced by many surgical and nonsurgical options, such as relaxing incisions, 25,26 excimer laser refractive surgery, [27][28][29][30][31] cataract surgery, 32 vitrectomy, 33 and orthokeratology. 34 However, to our knowledge, the method has not been used to analyze astigmatic changes after ICRS implantation in eyes with an ectatic cornea.…”

Bilateral Comparison of Conventional Epithelial Laser In Situ Keratomileusis and Lamellar Epithelial Debridement for Moderate to High Myopia

“…[6][7][8][9]19 In addition, the procedure was associated with reduced postoperative pain and corneal haze formation. 1,20,21 However, other reports and our previous results showed that epi-LASIK offered somewhat slower reepithelialization, improved pain relief, and better visual recovery in the early postoperative period.…”

“…4,5 Therefore, it has been reported that patients treated with epi-LASIK have less pain and show faster recovery compared with patients treated using other procedures, and it is known that epi-LASIK is safe and efficient in correction of low to moderate myopia and myopic astigmatism. [6][7][8][9] However, previous studies reported that, compared with patients undergoing other procedures, epi-LASIK patients had similar or less pain only during the immediate postoperative period. [10][11][12] Other reports and our previous studies found that patients suffered more postoperative pain after the epi-LASIK procedure than did patients undergoing photorefractive keratectomy (PRK) or laser-assisted subepithelial keratectomy (LASEK) in which epithelial flap was made after application of 20% (vol/vol) ethanol and was repositioned.…”