| SolveYourProblem
eLearning Series:
Lasik Eye Surgery Questions & Answers
( 50 articles
in this series )
Lasik:
Should You Choose
All-Laser vs. Microkeratome?
Lasik eye surgery is an amazing advancement in technology that
has helped millions of people who want to obtain better vision.
Though the concept behind Lasik surgery is essentially the
same from surgeon to surgeon, the actual tools used can be
slightly different. In fact, some surgeons prefer using the
“all lasers” approach, while others use a microkeratome.
Recent Advances
Recently, developers have created the IntraLase system, which
seems to improve the safety of the Lasik procedure. This is
because IntraLase uses laser energy rather than the microkeratome
in order to cut a thin flap in the eye’s cornea. The microkeratome,
on the other hand, is a cutting tool that does not utilize
this advanced technology.
Once the flap is but and lifted, energy from the excimer laser
is used to reshape the cornea. This reshaping process helps
to achieve a sharper focus. After the procedure is complete,
the flap is put back in place and acts as a sort of natural
“bandage” in the healing process.
Benefits of IntraLase
Complications during Lasik surgery are rare, but of those
that do occur, most are the result of the oscillating blade
of the microkeratomes. The metal blade of the tool can create
uneven edges on the flap. This results in abnormal surfaces
on the cornea, which can lead to vision defects like astigmatism.
The metal blades of microkeratomes also have been traced back
to the formation or improper or incomplete flaps, which can
lead to scars that distort vision. Many surgeons feel that
this type of scarring is less likely to happen with the IntraLase
system.
The IntraLase system creates flaps using laser energy by inserting
an exact pattern of many small overlapping spaces. This pattern
is created below the surface of the cornea. The laser of the
IntraLase system is capable of operating at the very high speed
of pulses every one quadrillionth of a second. This helps target
the tissue and divide it a molecular level, rather than with
heat or by impacting the surrounding tissue.
The IntraLase laser also makes it possible for individuals
with thin corneas to undergo the procedure. Previously, those
with thin corneas (of about 500 to 600 microns) were considered
to be ineligible for the procedure because the microkeratomes
cut about 100 to 200 microns. This caused too much of the cornea
to be cut away. The IntraLase laser, on the other hand, can
cut a flap as thin as 100 microns because it is more consistent
and reliable. Another advantage of the IntraLase laser is that it follows
the cornea’s curvature. This creates a flap with more manageable
vertical edges, rather than the thin edges created by microkeratomes.
These thicker edges are less likely to tear. In addition, this
reduces the likelihood of cells growing beneath the flap and
pushing it up, which will create an irregular surface on the
cornea. Partially formed flaps, or “buttonholed” flaps, are
also less likely to occur with IntraLase.
The sterility of the IntraLase laser also decreases the chances
of developing an eye infection. Possible Complications of IntraLase
Although the IntraLase system is associated with far fewer
Lasik complications than using microkeratomes, surgeons are
noticing one possible complication of the system. Recently,
some surgeons have reported that patients who undergo the “all
lasers” Lasik procedure experience the postoperative complication
of having an unusual sensitivity to light. According to reports
this complication has occurred in 1-20% of IntraLase patients,
although one surgeon only reported the 20% figure.
Fortunately, many surgeons also have reported that this postoperative
complication is only temporary. In fact, they report that using
steroid eye drops for a couple weeks seems to rectify the problem.
For those surgeons who prefer to use the IntraLase system,
they argue that the side effects of IntraLase are only temporarily.
The side effects of microkeratomes, on the other hand, are
more serious and can be permanent.
Cost of IntraLase
Using the IntraLase system instead of microkeratomes may have
an increase in overall safety, but it also increases the cost
of the procedure. According to one report, using the “all lasers”
approach adds an additional $300 per eye to the cost. Often,
patients are given the choice between using a microkeratome
or the IntraLase system. Some surgeons, on the other hand,
exclusively use the IntraLase and automatically include it
in their fee.
# # # # #
SolveYourProblem.com
: 2006
> Home > Lasik
Eye Surgery Articles: Main Page
|