IntraLASIK, also 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.
The History Of IntraLASIK
Intelligence 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. 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. 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 the Intralasik or All Laser LASIK procedure was created.
The term 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’.
The computer-guided IntraLase femtosecond laser uses an infrared beam of light to create a flap just below the surface of the cornea. The beam of light is focused to a precise point within the stroma (central layer of the cornea), where a string of tiny 2- to 3-micron bubbles is formed. Thousands of these microscopic bubbles are precisely positioned to define the flap’s dimensions as well as the location of the hinge. Bubbles are then stacked along the edge of the flap up to the corneal surface to complete the flap. The surgeon then lifts the flap and the procedure continues as a regular LASIK treatment, using an excimer laser to reshape the cornea. The flap is then repositioned and allowed to heal. The process from start to finish is very quick, taking approximately 45 seconds.
With the IntraLase laser, the eye surgeon can precisely control the critical first step of LASIK surgery. Pre-programmed laser specifications include flap diameter, depth, hinge location and width, and side-cut architecture – factors which may vary by patient. IntraLase flaps also feature a distinctive beveled edge, which allows for the precise repositioning, alignment and seating of the flap after intraLASIK surgery is completed. This ability to personalize specific parameters is not possible with a microkeratome or other hand-held bladed instrument.
The Advantages Of IntraLASIK Surgery
- Improved Safety: Eliminates the most severe microkeratome-related complications, including invasive corneal incisions and button-hole flaps.
- Better Vision: Patients achieve statistically better vision when the IntraLase laser is used in the LASIK procedure. In comparison with microkeratome-initiated LASIK, more patients achieved 20/20 vision and those with a preference preferred the post-operative vision of their IntraLase treated eye.
- Highest Degree of Predictability and Precision: Micron-level precision creates significantly more predictable and accurate flap dimensions. This increased precision preserves valuable corneal tissue and improves the outcome of the LASIK treatment.
- Fewer Retreatments: The number of laser eye surgery retreatments (or enhancements) is significantly lower for laser-created corneal flaps, enabling the patient to avoid the inconvenience of subsequent surgeries and the associated costs.
- Reduced Dry Eye Symptoms: In several clinical studies, standard tests performed to diagnose dry eye show a significant reduction in symptoms, the largest of which showed patient symptoms were reduced by 72%. This lower occurrence of dry eye symptoms may be due to the uniform and typically thinner flap, creating less disruption of nerves in the cornea.
- Individualized Flaps : The laser flap can be tailored to the individual patient’s needs, allowing the surgeon to individualize all steps in the intraLASIK eye surgery procedure.
IntraLASIK laser eye surgery is the most sophisticated and accurate technology for corneal flap creation available today, and has given patients greater confidence in choosing vision correction surgery. The higher degree of assurance and safety, virtually no risk of severe sight-threatening complications, and more predictable outcomes have been shown to increase patient satisfaction in their LASIK experience and outcome.
Less than 1% of patients who have undergone IntraLASIK eye surgery develop a condition known as Transient Light Sensitivity (TLS). This typically appears around 2 to 6 weeks after surgery, and is characterised by mild to severe light sensitivity without affecting a patient’s vision. It can be easily treated with a short course of steroids. If you experience light sensitivity after your intraLASIK eye surgery, you should consult with your surgeon immediately and seek the appropriate medical attention.