Wavefront Epi-LASIK (also known as Modern PRK, Advanced Surface Ablation, Photo Refractive Keratectomy, and LASEK) is a popular “bladeless” laser vision correction procedure, which does not require making a flap or using ANY sharp instruments during the procedure. Rather than using a laser to create a LASIK flap, the surface epithelial skin cells are instead brushed away with a “soft brush” epithelial polisher before the wavefront excimer laser reshapes the cornea. In Epi-LASIK, the actual procedure is completely painless, but patients usually report moderate discomfort during the first 3-4 days, as the corneal epithelial skin cells heal over the laser-treatment area.
The final results are identical with LASIK and Epi-LASIK. Though LASIK has a faster healing time and less discomfort, in certain clinical scenarios Epi-LASIK may be the treatment of choice. While we strive for an ideal patient experience, we always prioritize long-term safety over achieving an instant recovery.
The laser procedures in modern vision correction are all very similar in terms of time to perform. Their methods are slightly different and each one uses a different combination of lasers. Your doctor will help determine which method is best for you following our Advanced Vision Analysis.
Both Epi-LASIK and LASIK have proven to be equally-effective methods for laser vision correction. While the initial recovery is usually slower with Epi-LASIK compared to LASIK, the final vision result is the same with either method. In my ophthalmology practice, I currently perform about 70% LASIK and 30% Epi-LASIK. Given the fact that LASIK has a quicker recovery and less discomfort, why would anyone choose to have Epi-LASIK instead of LASIK? The reason is that in some clinical scenarios, Epi-LASIK may have a safety advantage LASIK.
For patients with certain corneal measurements, there may be an elevated risk of a LASIK flap problem. For these patients, it is safer to select Epi-LASIK, which avoids the flap problem all together. What’s the downside? With Epi-LASIK, there is a slower initial recovery and more initial discomfort. However, recent improvements in our “Soft Brush” Epi-LASIK techniques have greatly reduced the initial discomfort that was associated with the original PRK procedure. We have fine-tuned our post-operative Epi-LASIK regimen to make the initial healing phase as comfortable and quick as possible for our patients. When I recommend Epi-LASIK, it is because long-term safety is more important than achieving an instant recovery. Ultimately, this is a clinical decision that requires experience and judgment.
• Patients with thin corneas or irregularly shaped corneas
• Patients predisposed to extreme trauma (i.e. boxer)
• Soldiers in the US Marines/US Army are preferred to have Epi-LASIK/PRK instead of LASIK
• Patients with certain corneal dystrophies
• Patients with very large pupils
• Patients that previously had eye surgery, such as LASIK, radial keratotomy, retinal detachment repair, or glaucoma surgery
• Any patient who just doesn’t want a LASIK flap!
In “Soft Brush” Epi-LASIK, rather than creating a LASIK flap, the surface epithelial skin cells are brushed away before the excimer laser reshapes the exposed surface of the cornea. With modern techniques, the epithelium can be removed with an automated polishing brush, dilute alcohol solution or a motorized instrument. I prefer to use an automated soft brush device, called an Amoils “Soft Brush” Polisher.
In some cases I may use dilute alcohol for Epi-LASIK in eyes that have had previous surgery, such as radial keratotomy. In Epi-LASIK, the actual procedure is completely painless, but patients usually report moderate discomfort during the first 3-4 days, as the corneal epithelial skin cells heal over the laser-treatment area. A soft bandage contact lens is placed for comfort during this time. Good functional visual recovery takes about a week or two, but like LASIK, it can take several weeks to improve to optimal levels. I tell my Epi-LASIK patients to expect eye soreness for 3-4 days and somewhat blurry vision for the first 6-7 days. I use Mitomycin-C medicine immediately after the laser treatment to help the cornea heal better.
• Quick visual recovery
• Widest range of treatment options
• 1st laser creates a flap; 2nd laser reshapes the cornea
• Quick visual recovery
• No flap required
• Fastest return to normal activities
• Allows laser treatment for thinner corneas
• May require more time off from activities
• Requires use of bandage contact lens while epithelial surface regenerates over first few days
• The postoperative healing period can often be uncomfortable
Laser vision correction is a group of procedures that reshape the cornea (the clear front surface of your eye) to correct nearsightedness, farsightedness, and astigmatism. The goal is to reduce or eliminate dependence on glasses or contact lenses, improving your natural vision.
We specialize in multiple advanced vision correction options that are each consider Modern LASIK:
You may be a good candidate if you:
A full consultation with our doctors, including an Advanced Vision Analysis, determines your ideal procedure.
This is not true. Laser vision correction can correct astigmatism. Modern LASIK techniques are highly accurate and are customized to effectively correct astigmatism.
Both are proven, safe, and highly effective when matched to the right patient.
Yes. Modern laser and lens-based vision correction procedures are among the safest elective surgeries performed today. Millions of patients worldwide have achieved excellent results. Complications are rare and typically avoidable through thorough advanced screening and surgeon experience.
The risk of blindness from laser vision correction is zero at our office. Severe complications are rare, and any issues are typically temporary or can be effectively managed.
Follow-up visits and medicated eye drops ensure safe healing.
Most patients enjoy clear vision without glasses for many years. However, natural age-related changes like presbyopia (difficulty reading up close) can develop after age 40. Options such as blended vision or lens-based surgery (aka Custom Lens Replacement) can address this.
LASIK, PRK, and SMILE are permanent for most patients. Some patients will experience a slight change in prescription, which can be addressed through an enhancement or retreatment. Over time, changes in vision will occur that cause some patients to think it’s because “my LASIK wore off.” This is not the case. Vision changes will occur as the natural lens inside the eye ages (like the rest of our bodies). Luckily, lens-related changes can be addressed via Custom Lens Replacement (CLR).
Temporary dryness, glare, or halos can occur, especially early in recovery. Serious complications are very rare. Choosing a surgeon with extensive experience and advanced technology minimizes these risks.
Cost depends on the procedure. We offer transparent pricing, flexible payment options, and accept HSA/FSA funds to make vision correction affordable.
Our surgeons perform a comprehensive assessment, including:
Based on these results, your surgeon will recommend the safest, most effective treatment plan for your eyes. In many cases, the procedure chooses you.
Long-term contact lens use is associated with a higher risk of serious infection than laser vision correction. Studies show you are significantly more likely to develop a serious infection from wearing contacts than from having laser vision correction.
