known as Femto-LASIK or All-Laser LASIK, is a form of refractive eye surgery
similar to LASIK that creates a corneal flap with a femtosecond laser
microkeratome rather than with a mechanical microkeratome, which uses a steel
blade. The only difference between LASIK and IntraLASIK is the method by which
the LASIK flap is created. The actual refractive correction by corneal ablation
can then be performed with any excimer laser that is able to perform LASIK,
including conventional, wavefront-optimized, or wavefront-guided ablation.
IntraLASIK can be used to surgically create monovision to enhance the ability
to see objects both distant and near for those affected by presbyopia.
Surgical Laser (ISL) approached Arturo S. Chayet M.D. (Mexico) in 1994 with the
idea of using a picosecond laser as an alternative to the excimer laser for the
correction of refractive errors. Soon enough, however, after a series of
clinical trials, Chayet concluded that the picosecond laser was not well suited
for refractive corrections, but rather for the creation of corneal flaps, which
at the time were created with the mechanical microkeratome (Chayet is credited
with the conception of Intralasik). The creation of the corneal flap with the
picosecond laser, in conjunction with the use of the excimer laser for the
corneal ablation, was the first step to creating a spin-off of LASIK.
Researchers at the University of Michigan, however, realized that the
picosecond laser was inadequate for Chayet's idea and discovered that the
femtosecond laser would work more effectively. In 2000, a corneal flap created
by the femtosecond laser along with a refractive error corrected by the excimer
laser was conducted on a patient for the first time, in which case Intralasik
or All Laser LASIK was conducted for the first time.
IntraLASIK is derived from IntraLase, the name of the first manufacturer to
achieve Food and Drug Administration approval of a femtosecond laser for use in
the United States, and the surgical procedure 'LASIK'. Although additional
femtosecond laser manufacturers have entered the US market, the name IntraLASIK
is commonly used.
computer-guided infrared femtosecond laser is focused just below the surface of
the cornea. Each laser pulse creates a tiny bubble there. A pattern of many
overlapping bubbles is created, allowing the flap to be lifted off the cornea.
The procedure then continues as in traditional LASIK, with an excimer laser
removing material from the exposed surface beneath the flap.
A LASIK flap
created with a femtosecond laser is regarded by many ophthalmologists as an
improvement over traditional LASIK because of a greater accuracy in flap size,
shape, and thickness.
information exists as to whether the use of femtosecond lasers in LASIK
achieves statistically better visual acuity and refractive outcomes than with
final long-term clinical outcome of LASIK with a mechanical microkeratome and
IntraLASIK with a femtosecond laser may be similar, the increased accuracy of
the flap with the femtosecond laser provides an added margin of safety. LASIK
with a flap that is thinner has been shown to provide outcomes superior than a
thicker LASIK flap. A thinner LASIK flap requires greater accuracy and
percentage of IntraLASIK patients develop Transient Light Sensitivity (TLS),
"Although there is no loss of uncorrected visual acuity, symptoms can be
prolonged, especially without prompt steroid therapy.TLS causes severe
photophobia for a period of weeks, however normally resolves with healing and