In the corneal flap formation phase, Intralasik uses Intralase laser, while LASIK flap is removed with a blade called microkeratome. The advantages and ease of laser flap formation in intralasic technique are superior to the Lasik method in terms of physician and patient.
What is Excimer Laser?
Excimer laser is a laser device used to treat refractive defects in ophthalmology. Refractive defects such as myopia, hyperopia or astigmatism can be corrected using this technology.
Excimer laser surgery has taken its place in the medical world as a reliable method that is safe which provides consistent results.
The UV light produced by the excimer laser reshapes the corneal tissue in a certain way and corrects the refractive defects. The laser is outfitted with an eye tracker, so even if the patient moves their eye, laser beams are controlled by the system to counter such movement.
What are the Examination and Tests for Excimer Laser?
There are two important factors for the patient before and during the examination.
- Is the patient’s eye suitable for treatment?
- If appropriate, what type of treatment will be most successful?
Pachymetry measures the corneal thickness. Corneal thickness is vital for availability to excimer laser. Detailed examinations might be required which includes; pupillary diameter, visual acuity, eye pressure, and biomicroscopic examination.
After the examination, your refractive surgeon will plan your surgery and give you information about your eye.
- iDesign WaveFront
iDesign WaveFront is the most advanced method for personalized laser application and personalized vision. Advanced WaveFront device takes detailed measurements and deviations specific to each individual’s eye incredibly precisely and analyze this information, transmitting it directly to the excimer laser device. The information from the WaveFront analyzer controls the entire laser flow of the excimer device. In other words, laser application is completely guided by the Wavefront Device.
- Contrast differentiation is affected less compared to standard Lasik.
- Vision quality at night time is better than Lasik.
- Vision quality at night time is better than glasses or contact lenses.
- Has a higher potential to achieve a greater degree of vision quality and sharpness compared to glasses and contact lenses.
iDesign Wavefront analyzer is capable of detecting all of the aberrations of the vision. While glasses, contact lenses and standard Lasik procedure can only fix the small aberrations of the eye, Advanced CustomVue LASIK can correct both the small and the large aberrations. That is why iDesign WaveFront is the only method that has the potential to achieve better results compared to glasses or contact lenses.
Many studies have shown that a large proportion of patients after iDesign WaveFront optimised Excimer Laser have defined night vision quality as better or a lot better than night vision quality before operation. A small number of patients had complaints with vision at night, yet this portion was much lower compared to standard Lasik treatment. Therefore, it is concluded that night vision after iDesign WaveFront is better in comparison to using contact lenses or glasses.
Lasik Operation consists of two main stages:
- Corneal flap formation
- Reshaping the cornea based on the examination results.
Traditionally, in LASIK Operation, the corneal flap is created with the help of a knife called microkeratome. In the literature; It has been identified that most of the risks and complications of LASIK occur during this flap formation. Surgical techniques and surgical equipment have been modified and renovated to improve satisfaction with the results and reduce complications, but no innovation has revolutionized LASIK as much as the introduction of Intralase Femtosecond Laser.
IntraLase; uses infrared laser and Intralasik software to create corneal flaps at pre-programmed depth and position. A thin flap at the previously calculated depth in the patient’s cornea is formed using water bubbles and carbon dioxide. These bubbles provide a smooth surface between the corneal bed and the flap. Laser energy neither affects nor damages the structure of the cornea. There is no change or harm caused by the thin flap being formed. The laser spot of 3 microns allows the operation to be performed with an incredible degree of precision. The intralase pattern focuses the laser energy on the primary point and then back and forth on the cornea by moving in a zig zag motion. Finally, an incision from the cornea is created with the laser on the based location. This process takes approximately 1 minute for each eye.
- Since we can create thin flaps with intralase, we can apply excimer laser to our patients with higher refractive errors.
- Intralase makes LASIK application a fully laser based method. The control is fully computerized and overwhelmingly accurate.
- The intralase also forms a flap that fits better when it is tilted back into place.
- Flap formation using intralase is pain free and is much more comfortable since it creates much less pressure on the cornea.
- In intralase technique, no blade of any kind contacts the eye. The flap is formed with the help of water vapor and carbon dioxide.
Stage 1: A thin layer (corneal flap) is made by making a very small incision with the IntraLase approximately 550 micron deep, which is located in the tissue layer at the front of the eye called cornea.
Stage 2: Excimer laser, controlled by the computer is applied to the underlying corneal surface while preserving the opened corneal flap.
LASEK is a treatment method that has been FDA approved since 1995, that is used in the correction of small to medium degree vision impairments. It is a surface ablation technique applied under the corneal epithelium. LASEK’s application is smooth since the operation lasts for 10-15 minutes and pain-free. However, it’s biggest disadvantage is that it has a lower degree of patient comfort compared to iLASIK due to the burning, stinging sensations and light sensitivity that develops about half an hour after the operation and can last four to five days, which can be quite distressful depending on the patient’s pain tolerance.
The advantages are that it can be used on eyes that are not suitable for iLASIK, or on patients that does not want people to know they had excimer laser surgery for whatever reason, since as opposed to iLASIK, LASEK technique does not leave a mark that can be noticed through an examination.