J Korean Ophthalmol Soc > Volume 48(12); 2007 > Article
Journal of the Korean Ophthalmological Society 2007;48(12):1623-1629.
DOI: https://doi.org/10.3341/jkos.2007.48.12.1623    Published online December 31, 2007.
Factors Associated with the Successful Separation of Corneal Epithelium in Epi-LASIK.
Kyun Hyung Kim, Joon Heon Kim, Jong Suk Song, Hyo Myung Kim
Department of Ophthalmology, College of Medicine Korea University, Seoul, Korea. hyomkim@kumc.or.kr
에피라식에서 성공적 각막상피 분리에 영향을 미치는 요소
김균형,김준헌,송종석,김효명
Department of Ophthalmology, College of Medicine Korea University, Seoul, Korea
Correspondence:  Hyo-Myung Kim, M.D. Ph.D.
Abstract
PURPOSE
To determine the incidence and perioperative factors of flap-related complications from Epi-LASIK. METHODS: In this study, 122 eyes of 66 patients who had Epi-LASIK using Centurion SES(TM) epikeratome (Norwood Eye Care, Australia) were enrolled. Associations of pre-operative corneal curvature, white-to-white distance, central corneal thickness, refractive error, dry eye, punctate corneal erosion, pannus, and history of wearing contact lenses with flap-related complications were investigated. To decrease flap-related complications, surgeons pressed patients' eyelids with a speculum during epithelial separation, and the effect of this method was verified. RESULTS: Complete epithelial separation was achieved in 74 eyes (60.6%), incomplete separation in 29 eyes (23.8%), and free epithelial sheet in 19 eyes (15.6%). Thin corneas (P=.041), a history of wearing contact lenses (P=.008), and the duration of contact lens use (P=.003) significantly decreased the incidence of successful epithelial separation. Pressing down the eyelids with a speculum while separating the epithelial sheet increased the incidence of complete separation from 50.6% to 83.8% (P=.003). CONCLUSIONS: The risk of flap-related complications from Epi-LASIK may be higher in people who use contact lenses and in people who have thin corneas. The risk can be reduced by pressing the eyelids with a speculum during epithelial separation.
Key Words: Epi-LASIK;Epithelial separation;Flap;Incomplete separation;Speculum


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