Surgical Vision Correction Options for Under 40

IntraLASIK and LASIK

LASIK utilizes the excimer laser for correction of refractive errors.  It combines the use of a microkeratome which utilizes a metal blade to create a thin protective corneal flap followed by application of the excimer laser beam to the bed of the cornea.  The computer-guided excimer laser beam accurately reshapes the cornea by removing microscopic layers of cornea based on the prescription of the eye.  The flap is then placed back in position and allowed to heal.  Healing takes approximately one day.  Following the LASIK procedure, most patients are able to resume their normal activities within one day.  The advantage of LASIK is that there are no raw surfaces left to heal after application of the excimer laser.  The normal physiologic layers of the corneal are left intact after the treatment because the treatment is done beneath the corneal flap.  LASIK is a very successful safe and accurate procedure for most patients.

With LASIK, the corneal flap is created with a mechanical device - called a microkeratome - which utilizes a metal blade.  Though microkeratomes are safe and accurate devices, they are the least predictable part of the LASIK procedure and associated with the majority of complications that can affect vision.  Additionally, LASIK flaps invariably create unwanted subtle aberrations that can interfere with the best overall quality of vision.

IntraLASIK

Now with the use of the INTRALASE laser, we are able to create the corneal flap utilizing a computer-guided femtosecond laser beam which dramatically decreases the risks associated with a microkeratome.  INTRALASIK is an all-laser procedure rather than Standard LASIK that is a part-laser procedure….  This exciting new technology makes LASIK safer and more precise than ever before.  Patients who have “fears” about LASIK should take comfort in the increased safety and accuracy of the “INTRALASIK” procedure using the Intralase laser.

The Intralase FS laser and IntraLASIK software enable surgeons to avoid the complications from the use of the microkeratome.  The Intralase FS laser uses a long infrared laser wavelength that can be focused to a very precise point within the cornea, leaving the surface and surrounding tissues untouched.  The laser beam passes harmlessly through the outer layers of the cornea until it reaches its exact focal point within the corneal stroma (central layer of the cornea).  When it reaches this focal point, the beam forms a microscopic bubble of carbon dioxide and water vapor.  Thousands of these bubbles are placed at a precisely controlled depth to create a dissection plane, and then the laser beam stacks a pattern of bubbles along the periphery of the plane up to the corneal surface.  By utilizing this rapidly fired femtosecond laser and interconnecting the bubbles very tightly, the surgeon may program the laser to customize a corneal flap with remarkable precision.  Such accuracy and precision is impossible with a microkeratome or other steel-bladed surgical instrument.

CONVENTIONAL INTRALASIK

uses the prescription obtained through the standard measurement device in the ophthalmologist’s office (known as the phoropter) to guide the excimer laser ablation.  Conventional Intralasik corrects what are known as “lower order aberrations” which account for approximately 90% of the visual imperfections.  An intralase laser flap is created followed by an excimer laser ablation that corrects approximately 90% of the eye’s visual aberrations.

CUSTOM INTRALASIK (AKA iLASIK)

uses a special computer known as an aberrometer or wavefront measurement device to obtain a more detailed and complete analysis of each eye’s visual distortions.  The wavefront measurement device measures hundreds of subtle imperfections known as “lower and higher-order aberrations” to create a “wavefront map.”  The wavefront map measures 100% of the optical aberrations and is like a unique visual fingerprint that quatifies each eye’s unique focusing problems.  This more detailed wavefront map is then used to guide the excimer laser ablation to reshape the cornea to it’s best focus.  So in custom intralasik, a custom measurement is obtained, followed-by an intralase laser created flap, followed by a wavefront-guided excimer laser ablation.  Custom Intralasik (iLASIK) has proven to provide better quality of vision, especially at night than conventional lasik or conventional intralasik.

Our results using the Intralase laser for IntraLASIK have shown:

1. Complications associated with making the flap are virtually eliminated thus enhancing patient safety.
2. Final visual acuities in eyes treated with intralase are more accurate than any LASIK (blade-flap) procedure.
3. Fewer visual aberrations (halo, glare, starburst) are created in IntraLASIK.  Therefore quality of vision in IntraLASIK should be clearer than with standard LASIK
4. Patients with thin corneas not suitable for standard LASIK can be treated safely with IntraLASIK due to the ability to create an accurate thin flap via computer controlled delivery of the laser
5. Flap wrinkles or striae which occur in standard LASIK are rare to non-existent in IntraLASIK flaps
6. Patients are more comfortable in deciding to have IntraLASIK because of the enhanced safety and accuracy of the all-laser procedure.
7. The optimal combination of technologies for laser vision correction is intralase (laser flaps) with wavefront-guided (custom) excimer laser ablations – Custom Intralasik.

For more information about  Custom IntraLASIK (iLASIK) click onto the link: www.abbottmedicaloptics.com/products/refractive

	IntraLASIK	LASIK
Method by which corneal flap is created	Computer-guided femtosecondinfrared laser pulses delivered precisely within the cornea	Mechanical instrument (microkeratome)that utilizes a metal blade
Ability to accurately control flap thickness, diameter, and architecture	Yes.  Using computer softwarewe can obtain precise flap dimensions for each eye regardless of the patient’s eye dimensions	Variable depending on the surgeon’s technique, surgical blade quality, and the patient’s eye dimensions
Higher-order visual aberrations (Eg glare or haloes) induced when the flap is created	Minimal	Moderate
Risks of flap complications such as corneal abrasions, incomplete or buttonhole flaps	None	Rare: 1-2%. But can significantly affect vision if present.
Risks of Flap Striae/Wrinkles	Minimal to None	1-2%
Overall Patient Safety	The safest method available in the US to create the corneal flap	Overall excellent with limited risks in 3-5% of eyes treated
Overall accuracy of the procedure	Outstanding. IntraLASIK results are more accurate than the results of Standard LASIK	Very Good
Retreatment/Enhancement Rate	2-5%	5-15%

IntraLase - Medical reports supporting the technology benefits over LASIK (PDF)

A free Adobe Acrobat PDF reader is available under downloads.