This article is more than 5 years old. Information may no longer be current.
Patients requesting surface ablation procedures, surgeon reports
|
SEATTLE — Requests from patients specifically for surface ablation refractive surgical procedures are increasing, according to Douglas D. Koch, MD.
“I have seen more and more patients coming in and asking for surface ablation,” Dr. Koch said. “They don’t want the flap.”
He spoke about the relative merits of surface ablation procedures, including laser epithelial keratomileusis, epi-LASIK and PRK, here at the ASCRS Summer Refractive Congress.
Eyes undergoing LASIK return “close to normal” after surgery, Dr. Koch said, but it is possible the eye is not making a full recovery.
“There is some residual nerve fiber loss at 3 years in post-LASIK eyes, but whether that matters or not I can’t say,” he said.
Dr. Koch said the advantages of surface ablation procedures over LASIK include a reduced risk of inducing dry eye and of causing postoperative corneal ectasia. However, he said, data is lacking on whether there is a difference in visual outcomes among the refractive procedures.
“To me the real issue is if [surface ablation] provides better vision, and I don’t have data on that,” he said. “But my sense is it does.”
He said the main differences among LASEK, epi-LASIK and PRK are the ways in which the epithelium is removed; these can include mechanical, alcohol-based or laser techniques. The epithelium is discarded in PRK, chemically modified in LASEK and removed mechanically in epi-LASIK, he said.
“Two clinical studies suggest there might be an advantage to replacing the epithelium to reduce the incidence of late corneal haze,” Dr. Koch said in the materials distributed at his presentation. “However, other literature and our experience suggest that simple epithelial removal without any form of replacement minimizes discomfort and hastens early visual recovery.”