Epi-lasik vs Lasek

[lister]

I'm trying to decide between Lasek and Epi-Lasik, and came across a separate thread where someone asked a similar question. The doctor replying (Dr. William Trattler) said to "scratch off Epi-lasik, as there is extra risk without extra benefit" without providing much explanation as to why. Looking online there seems to be a lot of favorable literature for it (cleaner process vs. the alcohol and physical damage to epithelial layer in Lasek), and one local practice I talked to told me Epi-Lasik is superior to Lasek w.r.t. haze and recovery time.

Please could you elaborate on why you consider it riskier?

[William Trattler MD]

Thank you for your question.
In regards to risk - Epi-LASIK is in general very safe. I believe PRK is slightly safer. The difference is that with epi-LASIK, there is a small risk of a corneal injury with the device. The risk is extremely low with a technology called Gebauer, while the other devices available have just a bit more risk. But still - the overall risk with epi-LASIK is low. My point was just that between the two - PRK had slightly less risk than epi-LASIK.
There are some theoretical advantages to epi-LASIK - but the studies were borderline (in my opinion) at proving that patients actually had a significant advantage with epi-LASIK.
Regardless - it is always my feeling that if a surgeon has a preference of 1 proedure (technique) over another - I would go with that doctor's preferred technique. As well, I am only providing my opinion from my experience, and the surgeon may have a different experience and thus prefers epi-LASIK.
So I hope that explains things. Again - these are my current opinions based on my experiences and review of the medical literature. Again - since Epi-LASIK is a pretty simple and straightforward technique - I can't argue with another doctor having a preference of this procedure over standard PRK.

best regards

Bill Trattler, MD