I had epi lasek 6 weeks ago. My prescription was -4.25 both eyes. Now it is 0 right eye & +.25 left. However i now have a astigmatism .75 in my left eye which has not improved from my first check up. Do you think this may improve at all or will I have to have an enhancement? I am surprised how blurred it makes my vision.

Epi-Lasik is a surface ablation technique that disrupts the epithelium. The epithelium is the outermost layer of cells that protects and will smooth the surface of the cornea.

Because Epi-Lasik repositions the mortally wounded epithelial cells over the laser treatment area, your body needs to determine which cells are dead, which are dying, which are not quite dead yet, which need to be expelled, and which need to be replaced.

The epithelium will eventually need to expel and replace all the cells in the treatment area, thicken, and then smooth. This process takes time and this process does not always happen at the same rate in every location of the cornea. One spot on the cornea may be a bit thicker than another and even now it may not have become fully smoothed.

Although planned to get a desired result, Epi-Lasik is a wound to the cornea and a common wound response is edema (inflammation, swelling). This too does not happen at the same rate at every location across the cornea. If you have lingering edema on one spot on your cornea, this can cause astigmatism.

You may have induced astigmatism, but be patient. Don’t even think about having enhancement surgery until at least three months postop. You can always have it later, if you desire. Give your eyes time to fully heal and give that epithelium time to do its magic.

You will not be able to have Epi-Lasik for enhancement surgery, however you can have either PRK or LASEK, which are also surface ablation techniques. For details on Epi-Lasik, visit http://www.USAEyes.org and click on | Considerations | Which Surgery For You? | Epi-Lasik |

Glenn Hagele
http://USAEyes.org
Patient Advocacy & Surgeon Certification

I am not a doctor.