The reports of an increasing incidence of iatrogenic ectasia, the evolution of wavefront aberrometry, and the suggestion that the laser in situ keratomileusis flap could lead to unpredictable biomechanical corneal changes have renewed interest in surface ablation and have set the stage for the introduction of alternative photorefractive treatment modalities. The theoretical advantage of surface procedures, such as laser epithelial keratomileusis that preserve the epithelial button, stems from the repositioning of the epithelial flap over the laser-ablated corneal surface. This epithelial sheet is thought to act as a natural contact lens that decreases postoperative pain and haze formation. Epipolis laser in situ keratomileusis is an alternative modality of epithelial separation with the use of a device that features a blunt oscillating blade. This surgical approach does not require the use of alcohol for epithelial loosening.
*Vardinoyannion Eye Institute of Crete, University of Crete, Crete, Greece; †Department of Ophthalmology, University Hospital of Heraklion, Crete, Greece.
Ioannis G. Pallikaris is the patent holder of the epithelial mechanical separation device presented. The other authors have no financial interest in any device or instrument reported herein.
Correspondence to Vikentia J. Katsanevaki, MD, University of Crete, Medical School, Voutes PO Box 1352, Heraklion, Crete, Greece; e-mail: email@example.com