Laser or Microkeratome – Which is the Better Lasik Technique?
Lasik surgery is a remarkable development in the field of eye surgery
that has been of help to millions all over the world in getting
improvements in their vision. Even though the basic approach is
the same for all eye care specialists, the equipment that is used
for the technique might be a little varied. Some specialists tend
to use lasers for the procedure whereas others might prefer to use
a piece of equipment called the microkeratome.
One of the most recent advances in the field of Lasik is the introduction
of equipment called IntraLase system that has aided in making the
procedure much safer. IntraLase utilizes lasers for cutting a flap
in the cornea of the eye which in comparison to the microkeratome
is much safer.
After the flap is incised and elevated, the excimer laser is utilized
to correct the shape of the cornea. By performing the reshaping,
the focus of the lens is improved. Once the reshaping is finished,
the flap is placed back and this acts like a protective bandage
while the healing occurs.
Advantages of IntraLase
Problems arising out of Lasik procedure are not very common and
when they do happen, it is usually because of the blade of the microkeratome
that oscillates. The flap that is reflected might have jagged edges
due to these blades leading to irregular surface of the cornea.
This can give rise to vision problems such as astigmatism.
The oscillating blade of the microkeratome has also been the result
of incomplete flaps that can result in scarring and vision distortion.
Many specialists are of the opinion that chances of scarring is
very less when they use the IntraLase system.
With the help of lasers, the IntraLase is used to create a pattern
with several little overlying spaces under the corneal surface.
The laser operates at enormous speeds with pulses in every quadrillionth
second. This helps in incising the exact tissues without heating
or affecting the other areas.
Another advantage of the IntraLase is that it can be used in people
with a very thin cornea (500 to 600 microns) which is not the case
if a microkeratome was used for the procedure. With a microkeratome,
the precision can be held at 100 to 200 microns. As the IntraLase
can be used to a precision of up to 100 microns, it is useful and
more dependable in such cases of a thin cornea.
As the IntraLase pursues the curvature of the cornea, the flap
that is lifted has better controllable edges in comparison to the
thin borders shaped with a microkeratome. Also, the edge created
with the IntraLase is less likely to shred. Moreover, the formation
of cells below the flap pushing it up and forming an uneven plane
on the cornea is less probable to happen while using the IntraLase.
The use of IntraLase also does to lead to buttonholed flaps where
flaps are incompletely formed.
There are lesser chances of an eye infection setting in owing to
the sterility of the laser with IntraLase.
Probable Risks of IntraLase
Even though the risks of using the IntraLase are quite less in
comparison to microkeratomes, it is not totally without any complications.
One such complication being observed in some patients using lasers
for the procedure is a development of an elevated sensitivity to
light after the procedure. The average number of patients who have
experienced this problem after being operated with the IntraLase
is around 1-20% with only one surgeon giving numbers above 20%.
Luckily, it has been seen that this complication arising after
the procedure only lasts for a few weeks. It is also been seen that
the use of a steroid eye drop for a few weeks have reduced the problem.
Surgeons using IntraLase have held their side of the case saying
whatever side effects are seen is only temporary. The side effects
seen, while using a microkeratome, is much more higher and in many
While IntraLase system has greatly reduced the number of side effects
and improved the safety of the procedure in comparison to microkeratomes,
the expenses of the procedure with the IntraLase has gone up by
almost $300 per eye. For this reason, many patients are offered
the choice of the surgery using a microkeratome or the IntraLase.
But, some surgeons use only the IntraLase system and have just increased
their fees for the procedure.