• Parts A, B, and D courtesy of Roger F. Steinert, MD; part C courtesy of Steven C. Schallhorn, MD; part E courtesy of Eric D. Donnenfeld, MD
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    Refractive Mgmt/Intervention

    Techniques for de-epithelialization for surface ablation. A, Scraping with a blade. B, 20% dilution of absolute ethanol in an optical zone marker well. C, Rotary brush debridement. D, “Laser scrape,” in which a broad-beam laser exposes the entire treatment zone to ablation pulses; these pulses remove most of the epithelium that is fluorescing brightly, after which the basal epithelial layer is removed by scraping with a blade. E, Epi-LASIK with a mechanical microkeratome (the epithelial flap may be removed or retained).