Epi-LASIK is a refractive surgery technique designed to reduce a person's dependency on eyeglasses and contact lenses. Invented by Dr. Ioannis Pallikaris (Crete, Greece), the technique is basically an automatic LASEK without alcohol:It can be better considered as superficial LASIK. The stromal bed is smoother than that obtained by mechanical methods or brush. Unlike alcohol (LASEK) there is no chance of damaging the limbal stem cells. It is also relatively less painful than LASEK.

A device similar to a microkeratome (called epi-keratome) slides over the surface of the cornea, just underneath the epithelial layer of cells while suction is applied.

The result is a hinged sheet of epithelium that is at least partially viable.

It is reflected out of the way so that the ablation can take place.

The sheet is repositioned and a bandage soft contact lens is placed on the eye.

Advantages

Less damage to corneal nerves, hence safer in dry eyes

If cornea is abnormal for LASIK, epilasik may still be an option. The first cases outside Greece were performed in September 2003.The strategy of Epi-LASIK is to push aside the epithelial cells to expose the underlying smooth basement membrane of the stroma layer of the cornea. This stromal layer is treated with the laser, and then the epithelial sheet is repositioned. The epithelial cells reestablish their adhesion points, and the cornea has a new contour.

Advantages of Epi-LASIK It eliminates creation of a stromal flap with a sharp bladed keratome or intrastromal laser as done in LASIK. Therefore, there is no risk of creating an irregular surface from complications in cutting the flap.

Indications for Epi-LASIK There are clear indications for Epi-LASIK, as opposed to LASIK. From a technical point of view, it is easier, and perhaps safer, to perform on people who have steep or flat corneas, and those who have thin corneas. Patients who have epithelial basement membrane disease, and those who are subject to recurrent breakdown of their surface epithelium may also do better with Epi-LASIK. Those who have deep-set eyes, and small palpebral fissures (distance through the lids) may be predisposed to difficulty with LASIK, and would be more easily handled with Epi-LASIK.