Epi-LASIK versus epi-LASEK.

PURPOSE: To compare the possible advantages and disadvantages of adding an alcohol solution (20%) to the epi-LASIK procedure. This study focuses on flap making, haze, and pain with and without alcohol.

METHODS: A prospective study was performed on 45 patients to compare epi-LASIK with epi-LASIK plus alcohol (ie, epi-LASEK). Alcohol (20%) was applied for 20 seconds before making the flap in the epi-LASEK treatment group. In each patient, one eye underwent epi-LASIK and the fellow eye had epi-LASEK. In the epi-LASIK treatment group, mean myopic (n = 40) spherical equivalent refraction was -5.60 +/- 3.30 diopters (D) and mean hyperopic (n = 5) spherical equivalent refraction was +2.90 +/- 1.80 D. Myopic mean astigmatism was 1.40 +/- 1.20 D, and hyperopic mean astigmatism was 0.60 +/- 0.60 D. In the epi-LASEK treatment group, myopic (n = 40) mean spherical equivalent refraction was -5.90 +/- 3.50 D and hyperopic (n = 5) mean spherical equivalent refraction was +3.00 +/- 1.90 D. Mean myopic astigmatism was 1.60 +/- 1.30, and mean hyperopic astigmatism was 0.60 +/- 0.90 D. No significant differences were noted between groups (P > .05). Refraction and topography were performed preoperatively and on postoperative days 6 (contact lenses just removed), 15, 30, 60, 120, and 360.

RESULTS: The epi-LASEK treatment group had less postoperative astigmatism and irregularities than the epi-LASIK group. Alcohol addition in the epi-LASEK treatment group contributed to better flap and hinge creation. Pain and haze did not increase in the epi-LASEK treatment group (P > .05).

CONCLUSIONS: Flap viability does not seem to be important postoperatively in reducing pain and speeding recovery time. Alcohol facilitates flap making and improves hinge quality, and does not increase postoperative pain or haze. Adding alcohol to the epi-LASIK procedure can be advantageous in obtaining an intact hinge and a perfect flap.