Trans-Epithelial Surface Treatment

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Trans-Epithelial Surface Treatment

Postby lucyjane » Fri Oct 03, 2008 11:14 am

Hi there

I've recently been thinking about corrective eye surgery for a while now, so went for a consultation (London, UK - we don't seem to have any such forums in the UK so if it's okay I would like to ask a question here. It seems such a great forum!!!)

After my consultation I was told I was a perfect candidate for either Lasik or Trans-Epithelial Surface Treatment. I've tried to do some research on the latter but am unsure about it as it seems slightly different from Epi Lasik or Lasek (and the website of the surgery I went to differentiates it from either)

It states that the laser removes the corneas surface layer and is then programmed to remove the corneal stromal tissue with accuracy. A bandage lens is placed over until the epithelial layer heals.

Advantages given are that there is no flap (avoiding any possible flap complications), and no chemical or mechanical seperation of the epithelial layer as it's done by laser.

I have no issues with thin corneas (quite thick apparently) but the optometrist said she would recommend this over Lasik, and that it is what she would have chosen if it was available when she had her eyes treated (she had Lasik), even though recovery time is longer. The cost for either option is exactly the same.

I suppose my questions would be - is Trans-Epithelial Surface Treatment a fancy name for something already out there and is it really preferable to Lasik?

Apologies if this has already been answered before! It's just i'm rather confused by it all!

Many thanks
lucyjane
 
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Joined: Thu Oct 02, 2008 3:59 pm
Location: UK

Postby LasikExpert » Fri Oct 03, 2008 4:55 pm

Trans-Epithelial Surface Treatment is also known as Trans-Epithelial PRK. It is a variation on PRK.

In PRK the epithelium (soft pliable outermost layer of corneal cells) is disrupted with an alcohol solution and then the dead and dying cells are removed manually. Laser treatment is applied to the area. The epithelial cells regenerate, thicken, and smooth.

With Trans-Epithelial PRK the laser energy is applied to the epithelium and the underlying treatment area, removing the epithelium and making the correction. The epithelial cells regenerate, thicken, and smooth.

Trans-Epithelial was popularized as "No-Touch" laser eye surgery because manual removal of the epithelium is not required.

The theory behind Trans-Epithelial is that the epithelium has already corrected underlying irregularities in the cornea by creating a smooth outer surface. By starting with that surface the laser energy transfers that advantage to the underlying layers of the cornea.

Nothing screws up a perfectly good theory faster than reality and the reality is that studies about the long-term results of Trans-Epithelial v PRK v LASEK v Epi-Lasik seem inconclusive. In the end, the patient gets about the same result. Surgeons who do Trans-Epithelial swear by it - and may be correct - but the studies have not shown it to be significantly better. Trans-Epithelial may not be better than the other surface ablation techniques, but it certainly does not appear to be any worse.

I am personally biased toward surface ablation techniques when they are medically appropriate. There is no flap with surface abaltion techniques like Trans-Epithelial PRK, so there is no possibility of a Lasik flap related problem. Even if the probability of a Lasik flap problem is low, no possibility is almost always better than a low probability.
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Postby lucyjane » Tue Oct 07, 2008 11:34 am

Thank you so much for taking the time to reply, it's helped clarify things for me.

I have another quick question - I was told I have larger than average pupils. Is one type of treatment more suitable for this than the other or are the risks/results basically the same?

Many thanks
LJ
lucyjane
 
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Joined: Thu Oct 02, 2008 3:59 pm
Location: UK

Postby LasikExpert » Tue Oct 07, 2008 5:29 pm

The type of procedure, be it All-Laser Lasik, Lasik, PRK, LASEK, or Epi-Lasik, all have the same limitation when it comes to pupil size. That limitation is the size of the fully corrected optical ablation zone. Our article about Lasik and pupil sizewill provide more detail.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
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Posts: 3309
Joined: Fri May 12, 2006 6:43 am
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