Intralase Laser Beam

How it works: The surgeon has to use special computer software which guides the Intralase laser beam to apply a series of tiny bubbles within the central layer of the cornea. The laser beam creates a corneal flap at a specific diameter, which the surgeon decides before starting the operation. Like with microkeratome, a small hinge is left on the corneal flap that has been made, this is so the surgeon can fold it back and have clearer access to the cornea for the procedure.

What is different about this procedure: The difference is in the precision of the created cornea flap. People who may not have been suitable candidates for LASIK surgery may now fit the bill. Most people have corneas between 500-600 microns thick, and the microkeratomes (the minute knife) cut flaps within a range of 100-200 microns thick. The precision of the Intralase enables flaps to be cut at more reliably and consistent rates as thin as 100 microns. This means surgeons have the option of operating on candidates who have thinner or flatter corneas.

Benefits of Intralase: The precise nature of the Intralase means the laser beam can follow the curvature of the cornea, thus producing a flap with easily managed vertical edges, unlike the thinner edges associated with microkeratomes which might tear more easily. This difference in the flap structure reduces the chance of epithelial ingrowth (cells growing underneath and pushing up on the flap) which creates an irregular corneal surface and leads to defected vision. Using Intralase means that partially formed flaps can be avoided. Also the sterile system of the Intralase decreases the chance of eye infection and contamination.

What Happens after the Intralase Procedure: The recovery of this procedure is very similar to the traditional LASIL surgery. Some patients say that there is eye irritation for up to two days but others report that the irritating is very minimal and goes within hours.

Blade vs Bladeless

Even though LASIK complications are quite rare, those that do occur are often associated with the oscillating blade used with traditional microkeratomes. One of the problems with using the metal blade is that it creates uneven flap edges which results in abnormal corneal surfaces and vision defects such as irregular astigmatism.

Intralase creates a flap using infra-red laser energy that inserts a precise pattern of tiny, overlapping spaces just below the corneal surface. Intralase lasers work at momentous speeds, pulses moving at roughly one quadrillionth a second, this speed allows the eye tissue to be divided at molecular levels without interfering the surrounding tissue.

Studies show that Intralase narrows the number of overall LASIK complications. However one post-operative complication that seems to be unique to the Intralase procedure is photophobia (an unusual sensitivity to light). Although many surgeons state that photophobia is only a temporary complication and can be resolved with eye drops lasting a few weeks. Eye surgeons say that the light sensitivity complication is a less significant problem and can be resolved unlike a defective flap that is a risk when using the microkeratomes which could potentially lead to permanent loss of vision.

Even though the Intralase potentially lowers risks, it increases costs. Patients are usually given the choice of how they would like the flaps to be cut with a blade or with the more expensive Intralase, although some surgeons just now use the Intralase and therefore their costs will be higher than surgeons who choose not to use an all laser procedure.