CustomCornea, Epi-LASIK provide excellent postop results

March 15, 2006

Lisbon, Portugal?LASIK and Epi-LASIK procedures performed using Alcon Laboratories' CustomCornea system provide patients with excellent results in uncorrected visual acuity (UCVA) levels and higher-order aberrations (HOAs).

The results are so good, in fact, that 100% of patients can be expected to have an UCVA of 20/25 or better 3 months after the procedure. Almost 40% of those who undergo Custom LASIK have an UCVA of at least 20/15, and half of those who undergo Custom Epi-LASIK achieve the same level, according to Rolando Toyos, MD.

Advantages of Epi-LASIK

Epi-LASIK offers some advantages over LASIK in that there is markedly less haze formation after the procedure, and Epi-LASIK allows patients with steep corneas to undergo the procedure. Patients with physical limitations such as thinner corneas and higher corrections can undergo the surgery because Epi-LASIK preserves more corneal tissue; it is ideal for patients with dry eye because nerves are not cut. Certain professionals, such as basketball players and military personnel who engage in combat, cannot undergo LASIK because the flap could be dislodged with extreme contact. Patients who fear flap creation with a blade can be spared that procedure. Finally, Epi-LASIK seems to provide better visual outcomes.

Dr. Toyos and colleagues compared the HOAs, visual acuity levels, and patient satisfaction between patients that received CustomCornea LASIK or CustomCornea Epi-LASIK. Patient satisfaction surveys were administered before and 1 and 3 months postoperatively. Visual acuity and HOAs were recorded during routine examination at the same time points. All surgeries were performed by Dr. Toyos at two laser facilities with the LADARVision 4000 Excimer Laser System (Alcon). Epi-LASIK was performed with the EpiLift System (Cooper Vision), which has an applanator for consistent results, Dr. Toyos explained.

In this study, 60 eyes of 34 patients (28 women, six men) underwent CustomCornea LASIK. The mean patient age was 36.91 ± 1.95 years. Sixteen eyes of 10 patients (seven women, three men) underwent Epi-LASIK CustomCornea. The mean patient age was 36.94 ± 2.10 years. In both procedures, the initial algorithm was used. Both patient groups were fairly equal at baseline. The Epi-LASIK group had more cylinder, –1.63 ± 0.33 D, compared with –0.86 ± 0.09 D in the LASIK group.

Postoperative results

"One month postoperatively, all patients in both groups had a mean visual acuity of 20/40 or better. There were no patients with acuity of 20/15 or better in the Epi-LASIK group. More than 80% of patients had acuity of 20/25 or better in both groups at 1 month. At 3 months postoperatively, 100% of patients in both groups had 20/30 acuity or better; 100% of the patients who underwent Epi-LASIK had 20/25 or better; 39.5% of the LASIK group and 50% Epi-LASIK group had 20/15 or better," Dr. Toyos reported.