Refractive surgery: what patients need to know.

Objective: Most procedures to treat refractive error are based on laser surgery, but other techniques are available. We review the relative advantages and the risk associated with the different surgical options.

Areas Of Agreement: Laser refractive surgery is now a safe and effective alternative to glasses or contact lenses.

One-year clinical results after epi-LASIK for myopia.

Purpose: To evaluate the clinical results of epi-LASIK for the treatment of low to moderate myopia and myopic astigmatism.

Design: Retrospective, noncomparative, interventional case series.

Participants: Two hundred thirty-four eyes of 138 patients underwent epi-LASIK for the correction of low to moderate myopia.

Comparison of corneal sensitivity and tear function following Epi-LASIK or laser in situ keratomileusis for myopia.

Purpose: To compare the effect of Epi-LASIK or Laser In Situ Keratomileusis (LASIK) on corneal sensitivity and tear function.

Design: Prospective, non-randomized comparative clinical trial.

Methods: Seventy-nine eyes (Group A) underwent Epi-LASIK and 61 eyes underwent LASIK (Group B) for the treatment of myopia.

Epipolis laser in-situ keratomileusis: an evolving surface ablation procedure for refractive corrections.

Purpose Of Review: The aim of this article is to provide an update on epipolis laser in-situ keratomileusis--an alternative surface photorefractive surgical technique for the correction of myopia.

Recent Findings: In-vivo studies on animal models provide evidence that the replacement of the epithelial sheet on an ablated cornea can control corneal wound healing. Preliminary clinical data confirm that epipolis laser in-situ keratomileusis can provide excellent long-term visual and refractive results.

Epi-LASIK: histological findings of separated epithelial sheets 24 hours after treatment.

Purpose: To report the histological findings of four eyes of three patients who underwent epi-LASIK treatment for the correction of low myopia.

Methods: The epithelial sheets were harvested either immediately after separation (one eye) or were accidentally dislocated and harvested from the operative eyes 24 hours after treatment (three eyes). All sheets underwent optical and transmission electron microscopy.

Intraoperative management of partial flap during LASIK: a small case series report.

Purpose: To report the intraoperative management of incomplete microkeratome LASIK flaps.

Design: Small, retrospective, noncomparative, interventional case series.

Participants: Five outpatients.

Epi-LASIK: preliminary clinical results of an alternative surface ablation procedure.

Purpose: To evaluate the clinical results of epi-LASIK, a new surface ablation surgical technique for the treatment of low myopia.

Setting: Vardinoyannion Eye Institute of Crete, University of Crete, Greece.

Methods: Forty-four eyes of 31 patients had epi-LASIK for the correction of low myopia.

Epi-LASIK: comparative histological evaluation of mechanical and alcohol-assisted epithelial separation.

To compare the effect of mechanical and alcohol-assisted excision on the histological ultrastructure of epithelial disks from human corneas. Vardinoyiannion Eye Institute of Crete, University of Crete, Medical School, Crete, Greece. Ten eyes of 10 patients were deepithelialized by 1 of 2 two techniques.

Influence of ablation parameters on refractive changes after phototherapeutic keratectomy.

Purpose: The aim of the current study was to control the hypothetical effects of decreased laser energy delivered to the peripheral cornea during phototherapeutic keratectomy (PTK) and provide quantitative calculation of induced low and high order aberrations.

Methods: We employed a model eye to simulate the refractive effect of homogeneous laser corneal irradiation, as in PTK, for different laser fluences (range 125 to 225 mJ/cm2) and treatment depths up to 200 microm.

Results: The hyperopic shift induced by the relatively lower energy delivered at the peripheral ablation zone during PTK was proportional to the treatment depth and inversely proportional to the energy fluence.

Advances in subepithelial excimer refractive surgery techniques: Epi-LASIK.

The reports of an increasing incidence of iatrogenic ectasia, the evolution of wavefront aberrometry, and the suggestion that the laser in situ keratomileusis flap could lead to unpredictable biomechanical corneal changes have renewed interest in surface ablation and have set the stage for the introduction of alternative photorefractive treatment modalities. The theoretical advantage of surface procedures, such as laser epithelial keratomileusis that preserve the epithelial button, stems from the repositioning of the epithelial flap over the laser-ablated corneal surface. This epithelial sheet is thought to act as a natural contact lens that decreases postoperative pain and haze formation.

The PALM Technique: histological findings of masked phototherapeutic keratectomy on rabbit corneas.

Background: To compare the corneal healing response between conventional and phototherapeutic keratectomy through a masking agent, in rabbit corneas.

Methods: 24 adult rabbits underwent phototherapeutic keratectomy. Animals were divided in two groups: 12 received photoablation through a masking agent (PALM gel) and the remaining 12 received conventional phototherapeutic keratectomy of equal depth and served as control.

Laser in situ keratomileusis intraoperative complications using one type of microkeratome.

Objective: To identify the incidence and refractive outcome of intraoperative laser in situ keratomileusis (LASIK) complications using one type of microkeratome.

Design: Retrospective noncomparative case series.

Participants: Three hundred thirty-four consecutive myopic LASIK patients (September 1997 to November 1998) operated on by one surgeon.