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KMID : 0360220070480121623
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Journal of the Korean Ophthalmological Society
2007 Volume.48 No. 12 p.1623 ~ p.1629
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Factors Associated with the Successful Separation of Corneal Epithelium in Epi-LASIK
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Kim Kyun-Hyung
Kim Jun-Heon
Song Jong-Suk
Kim Hyo-Myung
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Abstract
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Purpose: To determine the incidence and perioperative factors of flap-related complications from Epi-LASIK.
Methods: In this study, 122 eyes of 66 patients who had Epi-LASIK using Centurion SESTM epikeratome (Norwood Eye Care, Australia) were enrolled. Associations of pre-operative corneal curvature, white-to-white distance, central corneal thickness, refractive error, dry eye, punctate corneal erosion, pannus, and history of wearing contact lenses with flap-related complications were investigated. To decrease flap-related complications, surgeons pressed patients` eyelids with a speculum during epithelial separation, and the effect of this method was verified.
Results: Complete epithelial separation was achieved in 74 eyes (60.6%), incomplete separation in 29 eyes (23.8%), and free epithelial sheet in 19 eyes (15.6%). Thin corneas (P=.041), a history of wearing contact lenses (P=.008), and the duration of contact lens use (P=.003) significantly decreased the incidence of successful epithelial separation. Pressing down the eyelids with a speculum while separating the epithelial sheet increased the incidence of complete separation from 50.6% to 83.8% (P=.003).
Conclusions: The risk of flap-related complications from Epi-LASIK may be higher in people who use contact lenses and in people who have thin corneas. The risk can be reduced by pressing the eyelids with a speculum during epithelial separation.
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KEYWORD
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Epi-LASIK, Epithelial separation, Flap, Incomplete separation, Speculum
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