All-Laser Lasik - iLasik - IntraLasik

All-Laser Lasik, also called "IntraLasik", "iLASIK", and "zLASIK" is exactly like traditional conventional or custom wavefront Lasik, except the corneal flap is created with a femtosecond laser microkeratome rather than a mechanical microkeratome with a metal blade. The IntraLasik name comes from a combination of the name of a femtosecond laser manufacturer, Intralase, and Lasik.

All-Laser Lasik may be performed with conventional laser ablation or wavefront-guided custom Lasik laser ablation.

There are several advantages to All-Laser Lasik that can make All-Laser Lasik more predictable and safer than traditional Lasik with a mechanical microkeratome, however there are limitations and a unique set of concerns that need to be evaluated.

Advantages include more precise positioning of the flap, more accurate thickness of the flap, more even thickness of the flap throughout, and a lower probability of intraoperative complications such as buttonhole flaps, thin/thick flaps, or epithelial defect. Recent studies have shown All-Laser Lasik to be more favorable than Lasik with a mechanical microkeratome in providing vision with better contrast sensitivity.

Some patients, but not all, experience a short period of increased corneal edema with All-Laser Lasik. This slight swelling can cause vision to be blurry, but the swelling normally resolves with healing. Occasionally an All-Laser Lasik patient will experience some photosensitivity. All these issues usually resolve during the normal Lasik six-month healing process, however additional eye drop medication may be required.

All-Laser Lasik is an option for nearly all who decide to have refractive surgery with a corneal flap, but All-Laser Lasik may be a requirement for individuals with preexisting epithelial defects, large pupils, thin corneas, poor contrast sensitivity, or other physiological reasons that indicate the greater accuracy and safety of All-Laser Lasik is required.

If you are ready to choose a doctor to be evaluated for conventional or custom wavefront Lasik, All-Laser Lasik, PRK, LASEK, Epi-Lasik, NearVision CK, RLE, or any refractive surgery procedure, we highly recommend you consider a doctor who has been evaluated and certified by the USAEyes nonprofit organization. Locate a USAEyes Evaluated & Certified Lasik Laser Eye Surgery Doctor.

If this article did not fully answer your questions, use our free Ask Lasik Expert patient forum.

Video courtesy University of Illinois Eye & Ear Infirmary.

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Current Femtosecond Laser Medical Journal News...

A prospective randomized comparison of four femtosecond LASIK flap thicknesses.

A prospective randomized comparison of four femtosecond LASIK flap thicknesses.

J Refract Surg. 2010 Jun;26(6):392-402

Authors: Prakash G, Agarwal A, Yadav A, Jacob S, Kumar DA, Agarwal A, Akhtar R

PURPOSE: To evaluate the visual outcomes, predictability, and planarity of four types of 60-kHz femtosecond laser-assisted LASIK flaps: 90, 100, 110, and 120 microm. METHODS: This randomized, prospective, interventional, comparative trial was performed at a tertiary care facility. Two hundred forty eyes with a calculated residual bed thickness >300 microm (at 120-microm flap thickness and subjective refraction) were randomized into four flap thickness groups to undergo femtosecond laser-assisted LASIK. Pre- and postoperative assessment included uncorrected visual acuity, best spectacle-corrected visual acuity (BSCVA), and refraction. Flap thickness was assessed by anterior segment optical coherence tomography on 28 points per flap at 1-month follow-up. Three new indices were devised to assess the predictability and planarity. RESULTS: The baseline parameters were matched. Postoperative vision and refractive outcome were similar in the four groups (P>.05, analysis of variance). The achieved flap thickness was different at each measured point among the groups (P<.05) with standard deviations ranging from +/-3.2 to +/-7.3 microm. The predictability and planarity were satisfactory in all four groups, although the indices were slightly better in the 110-microm and 120-microm groups. No loss of BSCVA or flap complications occurred in the four groups. CONCLUSIONS: The study demonstrated that all four flap thicknesses are relatively uniform in predictability and clinical outcomes.

PMID: 20677726 [PubMed - in process]