Comparison of Epi-LASIK and Off-Flap Epi-LASIK for the Treatment of Low and Moderate Myopia

Kalyvianaki, Maria I.; Kymionis, George D.; Kounis, George A.; Panagopoulou, Sophia I; Grentzelos, Michael A.; Pallikaris, Ioannis G.

doi:10.1016/j.ophtha.2008.08.025

Cited by 39 publications

(37 citation statements)

References 17 publications

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“…It has recently been concluded that most of the epithelial cells were morphologically normal, with minor degeneration of cells after formation of an epithelial flap [20]. Some reports noted that although the corneal epithelium appeared to be normal immediately after surgery, on POD 1 it showed fewer basal cells and did not firmly adhere to the underlying stromal bed [17,18].…”

Section: Discussionmentioning

confidence: 99%

“…Wang et al [19] reported that off-flap epi-LASIK offers comparable postoperative pain, a lower level of corneal haze, faster visual recovery, and better visual quality in comparison with on-flap epi-LASIK. Kalyvianaki et al [20] reported that epi-LASIK and off-flap epi-LASIK had equal visual and refractive results for the treatment of low and moderate myopia.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Flap Removal in Myopic Epi-LASIK Surgery on Visual Rehabilitation and Postoperative Pain: A Prospective Intraindividual Study

Lee

Park

et al. 2010

Ophthalmologica

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Purpose: A prospective intraindividual study to evaluate the effect of flap removal in myopic epi-LASIK surgery on visual rehabilitation and postoperative pain. Methods: Ninety eyes of 45 patients were treated for myopia with epi-LASIK. In each patient, the epithelial flap was repositioned in one eye after epi-LASIK (group 1) while the flap was removed in the other (group 2). Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), spherical equivalent (SE) refraction, postoperative pain and corneal haze were examined for 6 months after surgery in both groups. Results: Group 2 had a better UCVA at 4 days and BCVA at 1 week after surgery (p = 0.001, p = 0.043) than group 1. No significant differences were observed between the two groups in terms of UCVA, BCVA, or SE refraction at 1 week and 1, 2 and 6 months. Postoperative pain scores were similar for both groups. In group 2, severe pain (pain level ≧6) was relatively less than in group 1 at 2 h and 12 h after surgery. Corneal haze levels in both groups were not different. Conclusions: Epi-LASIK surgery with flap removal was found to significantly promote re-epithelialization and visual recovery during the early postoperative period. It was also found to be more predictable and less painful than epi-LASIK surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of Flap Removal in Myopic Epi-LASIK Surgery on Visual Rehabilitation and Postoperative Pain: A Prospective Intraindividual Study

Lee

Park

et al. 2010

Ophthalmologica

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“…To decrease the continuous release of proinflammatory cytokines after Epi-LASIK, removal of the epithelial flap has also been suggested. Kalyvianaket et al suggested amputating the epithelial flap for a smoother stromal bed with less inflammation, thus reducing the pain and discomfort in the first hours after surgery (5) . More evidence is still needed to confirm this hypothesis.…”

Section: Discussionmentioning

confidence: 99%

“…However, it is more invasive, with a greater risk of intraoperative complications (4) . In 2003 Pallikariset al (5) proposed the technique known as epithelial laser-assisted in situ keratomileusis (Epi-LASIK), in which the epithelium is mechanically separated from Bowman's membrane using an epikeratome. The procedure is similar to laser-assisted in situ keratomileusis, but it involves using a blunt blade which oscillates at a high frequency to separate both tissues.…”

mentioning

confidence: 99%

Epi-LASIK e PRK: um ano de estudo comparativo em olhos contralaterais

Crestana¹,

Bechara²,

Blasbalg³

et al. 2013

Rev. bras.oftalmol.

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RESUMOObjetivo: Comparar as técnicas de PRK e Epi-LASIK com relação à recuperação visual e sintomatologia pós-operatória. Métodos: Série de casos intervencionista que incluiu 38 olhos de 19 pacientes com miopia até 5DE e astigmatismo até 1DC. Foram selecionados pacientes com erros refracionais semelhantes nos dois olhos, realizando-se, no mesmo tempo cirúrgico, PRK em um olho e Epi-LASIK no olho contralateral. Os pacientes foram acompanhados por um ano, avaliando-se a eficácia refracional e grau de desconforto pós-operatório. Resultados: Durante as primeiras 12 horas, 79,9% dos pacientes (p=0,0003) referiram dor mais intensa no olho operado com a técnica Epi-LASIK. Após 24 horas, 63,2% dos pacientes (p=0,012) ainda referiam mais dor neste olho e apenas 10,5% no olho contralateral. A acuidade visual não corrigida foi melhor nos olhos do grupo PRK no primeiro dia (p=0,034). Nos demais dias não houve diferença significativa entre os grupos. Houve opacidade corneana grau 0,5 (Fantes) em três olhos do grupo PRK e em dois no grupo Epi-LASIK. Conclusão: Ambos os grupos apresentaram resultado visual refracional satisfatório, porém o grupo Epi-LASIK apresentou maior desconforto no pós-operatório imediato.Descritores: Ceratectomia fotorrefrativa; Acuidade visual; Dor; Resultado de tratamento; Miopia; Astigmatismo

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“…Recently, some prospective randomized controlled trials (RCTs) have shown that epi-LASIK without retained epithelial flaps (off-flap) had comparable or even better results in regard to postoperative pain, epithelial healing, or vision recovery [7,8,9]. However, the conclusion of a single RCT is limited by the small size, different population, follow-up period, and surgery technique.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Clinical Outcomes between ‘On-Flap’ and ‘Off-Flap’ Epi-LASIK for Myopia: A Meta-Analysis

Feng

Chen²,

Stojanović³

et al. 2011

Ophthalmologica

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Objective: To examine possible differences in clinical outcomes between off-flap and on-flap epipolis laser in situ keratomileusis (epi-LASIK) for myopia. Methods: Pertinent studies were selected by extensive searches. A total of 9 studies reporting on a total of 958 eyes were included in the present meta-analysis. Statistical analysis was performed using RevMan 5.0 software. Results: There were no significant differences in the final refractive spherical equivalent (p = 0.38), manifest refractive spherical equivalent within ±0.50 D of the target (p = 0.76), final uncorrected visual acuity (p = 0.90), loss of ≧1 line of best spectacle-corrected visual acuity (p = 0.99), and corneal haze at 3 months postoperatively (p = 0.96) or more than 6 months (p = 0.64). More patients felt severe pain in the on-flap group than in the off-flap group, although this finding was not statistically significant (p = 0.05). However, off-flap epi-LASIK had a better mean uncorrected visual acuity at 3 days (p = 0.04) and 5 days (p = 0.01), and faster re-epithelialization (p < 0.00001) after surgery. Conclusions: According to the available data, off-flap and on-flap epi-LASIK had equal visual and refractive outcomes for the treatment of myopia. Off-flap epi-LASIK had more rapid re-epithelialization and visual recovery compared to on-flap epi-LASIK.

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Comparison of Epi-LASIK and Off-Flap Epi-LASIK for the Treatment of Low and Moderate Myopia

Cited by 39 publications

References 17 publications

Effect of Flap Removal in Myopic Epi-LASIK Surgery on Visual Rehabilitation and Postoperative Pain: A Prospective Intraindividual Study

Effect of Flap Removal in Myopic Epi-LASIK Surgery on Visual Rehabilitation and Postoperative Pain: A Prospective Intraindividual Study

Epi-LASIK e PRK: um ano de estudo comparativo em olhos contralaterais

Comparison of Clinical Outcomes between ‘On-Flap’ and ‘Off-Flap’ Epi-LASIK for Myopia: A Meta-Analysis

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