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Even though laser technology has made eye surgery a safer and more effective procedure, the majority of complications from laser eye surgery are due to using blades to make incisions in the top layer of the eye for procedures such as LASIK and corneal transplants.

The advanced IntraLase® FS Laser offers patients blade-free eye surgery, allowing the surgeon to create a more precise incision with flaps that can safely be made thinner for greater accuracy in correction.

Surgeons at MECA Eye and Laser Center, who favored PRK to LASIK for refractive surgery, now predominantly use the Intralase Method™ for such procedures. LASIK uses a microkeratome (hand held oscillating blade) to create a corneal flap, opening the eye for correction with an excimer laser. PRK is a procedure which utilizes a brush or blade to gently remove the epithelium from the surface of the cornea before reshaping the cornea with a laser. LASIK allows recovery of vision as quickly as a day or two and while few, complications can arise later on, whereas PRK takes longer to heal, but offers fewer complications overall.

“We’re getting the safety of surface ablation (as with PRK) with advantages of rapid healing and the ‘wow’ factor from LASIK,” explained Dr. James Freeman, partner at MECA and medical director of the surgery center. It’s “the best of both worlds.”

At a quadrillionth of a second, this ultra-fast, femtosecond laser creates a uniform layer of bubbles just beneath the corneal surface. The bubbles create a smooth, even surface after the flap is lifted for excimer laser reshaping. The flap then “locks” back into position after the LASIK procedure is performed. Having a corneal flap that’s individualized to the patient contributes to excellent postoperative outcomes.

The creation of the flap itself takes only about 15 to 30 seconds per eye. Including preparation time, the entire LASIK procedure takes about 30 minutes. Patients in clinical trials have reported better overall vision quality with the IntraLase Method, particularly in their ability to see well in low light.

“I think it’s been a significant step forward in safety and further reduced the risk for glare and halos and symptoms that can occur,” Freeman surmised. “Since I began using it, I’ve had no wrinkles on the flap and we’ve made no mechanical flaps since (using) Intralase.”

Its application extends to other eye surgeries and has proven to be a breakthrough for cornea transplantation.

The laser’s infrared light beam, generating 60,000 pulses per second, creates absolutely precise incisions inside the cornea, once again forming bubbles to create the incision. The surgeon programs the laser to create incisions which will form individualized edges of both the patient’s cornea and transplanted tissue, which fit together much like a puzzle.

Traditionally, corneal incisions were made with a trephine, which is stamped onto the cornea like a cookie cutter. It makes a circular incision with straight vertical edges, which results in a plug-shaped tissue graft. Suturing is required around the circumference of the graft, after transplantation, to maintain its position in the eye. Sutures stay in the eye for one year or longer and patients generally do not achieve full visual recovery for at least a year. Intralase’s precise incision may result in more stable grafts and require fewer sutures.

Freeman said Intralase technology has expanded the population that can be treated with lasers, even those with thinner corneas.

“It gives us more capability,” he concluded. “The possibilities are great.”

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