IntraLase LASIK Vs Traditional LASIK

We have both the microkeratome and Intralase at our office. Before we began using the Intralase laser, we had a higher rate of complication with the corneal flaps. I now have control over how thick a specific patients flap should be instead of one-size-fits-all with the microkeratome. The other reason I love the Intralase is that when the flap is placed back on the cornea, it fits in like a man-hole cover as opposed to just resting back in place. There is a greater likelihood that the flap will move around after the microkeratome is used when compared to the Intralase. At our practice, we charge the same for both technologies, making the decision easy for our patients. Go with the better technology. -Dr. Clinch

IntraLASIK is different from LASIK in that it is completely blade-free creating the flap. In IntraLASIK, the flap is made by the separation of the corneal tissue performed with a femtosecond laser ray, which is completely computer controlled and supported by the Inralase software. The results are extraordinary, delivering maximum safety to the patient and a level of precision that is unparalleled for the surgeon. Every procedure is controlled according to the specific visual problem of each patient, so that the surgeon designs the procedure according to the patient’s corneal anatomy. For those patients who have been unsure of whether to get LASIK or not, IntraLASIK now brings unquestioned safety and efficacy that had never been seen before. This technology delivers extraordinary results that have raised the bar in Refractive Surgery. Indeed, our goal is nothing short of 100 percent success for our patients. We call it surgical precision and you deserve nothing less.

IntraLase is a laser that is used specifically to create the corneal flap in the first part of LASIK, or other corneal procedures. In traditional LASIK, a handheld oscillating blade is used in the first step to create the corneal flap. In general IntraLase is:
More preciseCreates a smoother LASIK corneal bed, thus better visionVirtually eliminates flap complications (99% of LASIK complications, which are rare, are flap complications)Reduces incidence and severity of dry eyes after LASIKQuicker recoveryMost importantly when compared head to head to handheld blades, it yields better visionIntraLase uses a computer guided laser, which greatly reduces the uncertainty and risks associated with the oscillating blade and and makes LASIK a truly precise all laser procedure. Since most LASIK complications may be traced back to the flap, it is believed that flap creation is one of the most important steps, and requires the high technology solution of the IntraLase method.A corneal flap created with IntraLase is customized as to shape, diameter, thickness, depending on each eye's unique curvature, corneal thickness, diameter and shape.When a LASIK flap is created with IntraLase, the resulting surface of the underlying stroma is much smoother when compared to the surface after the mechanical blade.

Intralasik utilizes a femtosecond laser instead of a metal blade to form the LASIK flap. The laser is the more technologically advanced approach, but what does that mean for you, as the patient?

 

Basically, it means that using the Intralase is safer for you and your eyes because it gives the surgeon more control.

 

With both tools the ophthalmologist is the one programming the laser for your flap based on your eyes meaning the flap is customized based on the surface of your cornea. Each person's cornea is different similar to a fingerprint and the Intralase creates a custom flap. Additionally, with the Intralase the ophthalmologist can watch as the laser creates the flap and can interfere if needed. The traditional or conventional approach to laser eye surgery with the blade doesn't allow this feature. Once the keratome (device with the blade) is programmed and started, there is nothing the ophthalmologist can do to stop it. He/she cannot see what the blade is doing after he/she programs it and will only know if something is wrong after the flap is made.

 

90% of LASIK complications are flap related, so giving the ophthalmologist more control and more visibility dramatically reduces the likelihood of these complications.

The objective in LASIK is to make a flap.  Traditionally, this was performed with a microkeratome which uses a specially designed blade to make a smooth cut.  The problem with the microkeratome is that it takes a great deal of skill.  As more surgeons have started performing LASIK, they have gone to using a laser to make the flap.  The Intralase and other "femtosecond lasers" work by making thousands of tiny explosions.  The risk of significant complications is probably smaller with the Intralase, but the rate of smaller complications is much higher. In my mind, the two balance each other out.  It matters little which way your surgeon wants to make the flap. the big difference is in the laser used for the treatment.  I believe that results are much better with a Customized Treatment rather than a standard treatment. 

There are very big differences in these technologies!   After Intralase was introduced, I converted over to it and have not cut a corneal flap with a bladed device ever since.  This was almost 8 years ago.  The all- Laser technique (Intralase) has added safety both during surgery and also post op.  There are several side effects and complications which are less frequent when using all laser technology, including dry eye and flap slippage just to name two.   The all laser technique is also more accurate and the smaller footprint created by it allows for more structural integrity of the cornea long term when compared with bladed techniques.  My suggestion is to go to the most experienced Intralase surgeon that you trust.   It is worth the extra bucks.  

AS one of the first centers to use the Intralase and provide some of the early data there is not question that it is a safer, more precise, more accurate way to do Lasik. Simply it uses a Femto Second Laser to create the flap vs. a blade in traditional Lasik. Almost all studies have shown increased safety, less dry eye, more accurate flap thickness with less variability, and less enhancements.

IntraLase was invented about 10 years ago as a way to cut thinner flaps, which make the untouched cornea thicker, so it's stronger and safer than cutting a thicker flap with metal blade like in a regular LASIK.

The incidence of flap complications are also reduced in IntraLase, which is important, as the major and most common risks in LASIK have to do bith cutting the flap.

However, the safest thing to do is to not cut any flap at all, which means your cornea will be much thicker and stronger than after intralase and also your risk of a flap complication is not only reduced, it is totally eliminated.

We were the third site in the United States to introduce Intralase, and completed 900 of the first 1000 Intralase cases ever performed, so there is some bias perhaps in my answer. If you look at the statistics, there is an increasing percentage of eyes that are treated with the Intralase as compared to the microkeratome, which is now over 50%.
There are many benefits to Intralase, which I believe is clearlly safer than the microkeratome, and this is coming from someone who had previously performed tens of thousands of microkeratome cases. It is the achilles heal of LASIK surgery in that most complications of the procedure are microkeratome related.
As to effectiveness, it is probably slightly better than microkeratome but the differences are less substantial than the safety aspect.
There are even newer femtosecond lasers available and we are one of the few sites, but there are others, using the new Zeiss VisuMax laser which is even better than the Intralase in my opinion. It is more accurate, uses a lower suction pressure, and cuts a more precise flap in our experience.
You should not have to pay much more for a femtosecond (this is the technology behind the Intralase and other laser cutting lasers) than for the blade, and the small extra cost is definitely worth it. We only do all laser lasik, and like other centers to not add a premium charge for this better technology which all of our patients deserve.
Rarely, there is a case such as a corneal scar where we do need to use the microkeratome, but only about once a year.

Intralase Custom LASIK, known as iLASIK, is the newest most advance procedure. It combines the all laser method using the Intralase laser with the personalized CustomVue LASIK tailored to treat the unique characteristics of your eyes. iLASIK was approved in September of 2007 to treat the eyes of astronauts and about one year ago, to treat the military. It is now safer and more precise than ever before.