Removal of the epithelial flap during LASIK may yield less postoperative pain and faster vision recovery compared with epi-LASIK procedures, according to a study.

In a prospective study of 18 patients, conventional epi-LASIK was performed in one eye and a LASIK procedure involving complete epithelial flap removal was performed in the fellow eye. On the fourth day postoperatively, average pain was significantly lower on a scale of 0 to 10 among eyes that underwent complete debridement compared with patients who underwent conventional epi-LASIK (0.25 vs. 1.44). There was a trend toward lower pain in the debridement group at all other postoperative time points out to 6 months, but the intergroup difference was not statistically significant.

Additionally, there was no intergroup difference between total pain and maximal pain scores. However, the mean pain duration was significantly shorter among eyes that underwent debridement compared to eyes that underwent conventional epi-LASIK (2.72 days vs. 3.72 days); aveage healing time was also significantly shorter (3.56 days vs. 5.33 days).

"Twelve patients perceived more pain after conventional epi-LASIK than after [lamellar epithelial debridement]. However, two patients suffered more pain after [lamellar epithelial debridement], and four patients reported similar pain in either eye," the study authors wrote.

On all postoperative days, uncorrected visual acuity was lower in the epi-LASIK group, but the differences were not statistically significant, and there was no difference at 6 months.